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'I have nightmares about women here buying abortion pills over the internet ... one of these days someone is going to die'

As she retires from her regional organiser role at the Royal College of Midwives, Breedagh Hughes looks back at the highs and lows during her career

By Lindy McDowell

After 21 years at the helm, Breedagh Hughes, director and regional organiser of the Royal College of Midwives is retiring on her 60th birthday, on August 12. As "the voice of midwives" in Northern Ireland, Breedagh has been an outspoken critic of abortion legislation here. She's faced considerable online abuse and at one point was even "arrested". With an increasing number of local women now sourcing abortion pills online, she warns: "I have nightmares over that. Some of these days a woman is going to die." Here she pays tribute to the work of midwives in Northern Ireland, pointing up the challenges facing frontline staff due to the continuing impasse at Stormont. And with a pay deal in limbo, she says she believes that there will be a public sector strike "before Christmas".

Q Where did your family come from originally?

A My mother was Stella Byrne, from Dublin, and my father, Fred Heatley, was from Belfast. They both died in the last couple of years. They met in Omeath when they were both youth hostelling. I was born in Dublin but there wasn't any work there for daddy at that time so they moved back to Belfast to live with my paternal grandparents in the Docks.

Then we got one of the then new houses in Rathcoole which was just being built. That was my earliest memory; living in Rathcoole and meetings, meetings, meetings. Other people have claimed to be, but my father actually was, a founding member of the Civil Rights Association.

He was their treasurer. So our house was always full of comings and goings. My father was also a lifelong trade unionist. We have a very strong family history of trade unionism. My sister Siobhan is very active in Unison. My other sister Bronagh, who lives in England, got an MBE for service to the community where she lives. And we have two brothers, Fintan and Conal. Conal works for the Commonwealth Games. He is absolutely devastated that, because we have no Assembly, the 2021 Youth Games for which he worked so hard were lost.

Q What made you decide to become a midwife?

A My father and I were two very strong characters and we didn't always see eye to eye, so I left home at 16. I went to work in an office but also had a part-time job as a youth worker in the New Lodge. I got married at 19 (the marriage later ended in divorce) and I had my first son at 21.

My son was born in a GP unit. But that was a complete misnomer. It was a midwife-led unit. I remember looking at these girls and they came into work with a smile on their faces and they left at the end of the day with a smile on their faces and I was thinking 'What a brilliant job must this be?' I trained as a nurse in the City Hospital in Belfast in 1982 when my first son Ciaran was 18 months old.

But I was totally focused on being a midwife. Then I had my second son Aidan, and when he was 18 months old, I started my midwifery. They're both married now. Ciaran is married to Rosa and Aidan is married to Rosie. Two fabulous daughters-in-law. And Aidan and Rosie have one wee boy Reuben (2), who is the love of my life.

I trained in the Jubilee and then went to work in the Royal. I just loved clinical midwifery. I loved being with women. That's what midwife means - it's an old Anglo Saxon word meaning "with women".

I was also the shop steward for the Royal College of Midwives. Eventually I took up my current post in 1997.

Q In your current role you've been an outspoken critic of abortion law in Northern Ireland. In 2008 you were even "arrested" by the police. How did that come about?

A I was always fortunate in that I was able to say things knowing that I would be protected by my employer. The year Precious Life had me arrested, I was actually on holiday on a Greek island. They went into Mahon Road police station, in Portadown for some reason, and made the complaint about me on the foot of an article that had been written in 2004.

They'd sat on this article for four years before going in to the police station. Bernie Smyth (from Precious Life) said: "This woman has admitted to carrying out illegal abortions."

Whereupon the lid came off the pressure cooker. As I was on holidays, my colleague rang headquarters. I'd been in this job about 10 years at that time. The first thing the boss said was: "You are not to disturb her holiday. She can deal with this when she gets back.

And secondly, you are to make sure she has a solicitor waiting for her getting off the plane if necessary." I wasn't actually arrested - I was interviewed under caution. Then it took the best part of a year for the Prosecution Service to come back and say there was insufficient evidence.

The police inspector had put it to me: "At all times when you were participating in an abortion in Northern Ireland, were you acting under the directions of a doctor in the best interests of the woman?"

And I told him: "Absolutely." And that was it, the end of the interview. But it was a worrying time. My late parents were getting on a bit then and they knew it was happening and it was worrying for them.

Q You take a lot of abuse on the internet. How do you cope with that?

A I don't look at it, by and large. When my sons were younger and it was brought to their attention I told them: "I know the person that I am and you know the person that I am, so you know that what they are saying is wrong." I feel that if I was to try to take action against any of them (internet trolls) it would just be pouring petrol on the flames. I know it's there, but it doesn't bother me.

Very rarely, somebody picks up a particularly bad bit and tells me about it, but I've got used to it over the years. It goes with the territory. It would be much more hurtful if it was somebody I knew and liked and respected and was friendly with who said something nasty. But some anonymous person posting anonymously?

It's been easy for me to speak out because I have the support of the College behind me. We have 47,000 members and when we made the decision in 2016 to support the Trust Women campaign, only 14 members resigned out of 47,000. And not one of them from Northern Ireland, I'm proud to say. So we really are representing the views of our members.

The year Edwin Poots put out the awful document that was heavy on the jail sentences and light on anything that resembled clinical guidance, I went round every single maternity unit in Northern Ireland and I spoke face-to-face with about a quarter of all our midwives. I was so humbled. A number of them said: "I personally don't think abortion is a good thing, but how could I turn my back on a woman who needed me?"

They were so professional about it. They were not judgmental, they were sympathetic. Sometimes I think there are women who jump into an abortion without thinking it through. They do it because they panic and they can't see any other way out.

In an ideal world, we would have counselling for every woman. Not everyone sings on the same hymn sheet on this one. Generally though, I think that everybody who's active in this field believes that it should be a woman's right to chose.

Q Would you like to see the 1967 Abortion Act extended to Northern Ireland?

A No. A couple of campaign groups in England want the 1967 Abortion Act extended to Northern Ireland. But we have never campaigned for that. The 1967 Act is not a good piece of legislation. It was of its time. It was created at a time when all abortions were surgical and women needed to go to hospitals or clinics to have anaesthetics. That's not the case now. And the need for two doctors - I don't know why that is. I don't see why one doctor would not suffice to prescribe medication - more or less what they're going to do in the south.

All the '67 Act does is provide a defence for the medical team. It doesn't actually change the legislation in any way. There are other groups who think that it is okay for women to buy pills off the internet and take them. We don't agree with that either. I have nightmares over that.

Some of these days a woman is going to die. There's no guarantee they're buying them from a reputable source and God knows what they're taking. And even those that are buying them from a reputable source - well, desperate women do desperate things.

You do an online consultation and the doctor asks how far on you are and you say, eight weeks when actually you're 16 weeks. But you've got your friend also putting in an application...so you get two lots of pills and you take them. But the pills are not supposed to be taken after nine weeks.

I do think absolutely that abortion should be off the statute book. It should not be a criminal offence. It should be a healthcare procedure like any other healthcare procedure.

You can't go into a chemist and buy hardcore sleeping tablets over the counter, because they're potentially dangerous. The safest way, and the best way, is to go and see your GP and let your GP know you have a problem.

Maybe he or she can suggest something other than hardcore sleeping tablets. And I think abortion is no different. If you are in desperate need, go and speak to your GP. Your GP should be able to send you to societies and services that can support you if you really are conflicted about continuing with the pregnancy.

Otherwise, if you go into your GP and say I've seen a counsellor and my mind is made up, I want to terminate the pregnancy, then the GP should be able to prescribe the medication.

Q You have been critical of the lack of guidelines given to frontline health workers dealing with women who may have taken abortion pills. What is your concern there?

A We've told our members that because of a piece of legislation that applies in Northern Ireland but nowhere else - the 1967 Criminal Law Act - it's a criminal offence if you know that an offence has been committed and don't report it. So we've told our members that if a woman tells you she has taken (abortion) pills, you must report it.

For my successor, Karen Murray, this is top of her first list.

To write to the Chief Executives of the five trusts and ask them what process have they put in place to enable staff to comply with this piece of legislation.

The answer will be - none. They haven't done anything. I know they haven't done anything, because I spent a day on the phone about a month ago.

I had a midwife whose manager rang me to say they had a woman who was having maternity care in their unit and who was pregnant as a result of rape. What should they do about it?

But between ringing the police, the Public Prosecution Service and the director of legal services in the health service, I got conflicting advice from all of them.

Q New figures have shown that in the Belfast Trust area alone, 17 cases of Female Genital Mutilation were recorded in just nine months. This again, must increase the pressure on your members?

A Again, it's the staff who are left to make the decisions for themselves. When I spoke to the Chief Medical Officer he said the law is clear. They have to report it to the police. But I said: "How? Do they report it to a designated person in their employment? Do they ring the police themselves? How? What is the mechanism? How do they do it?"

I don't want any of our members spending four hours in a police station in the way that I had to. I don't want that happening to anybody.

But so far, nobody is telling them what they have to do to comply with the law. We've had a number of meetings now with the NSPCC and social workers, because they're in the same boat.

We met with one of Secretary of State, Karen Bradley's junior ministers a few weeks ago and he was of no help at all. He just said justice was "a devolved matter".

The Department of Justice hasn't issued any guidance. The Department of Health hasn't issued any guidance. So I'm the backstop. There is no mechanism at all. I've had a lot of meetings to try to get answers. The law is what the law is. But we need clarity.

Q Your members are also angry that, with the Assembly suspended, they haven't been able to avail of the pay deal like their counterparts across the water. What do you envisage will happen there?

A With the pay deal, at the minute, my best guess is that unless somebody pulls something out of a hat very quickly, the health service unions, in fact the public sector unions in Northern Ireland, will be on strike before Christmas. That's my best bet.

Public sector staff in England have got their pay rise in their pockets this month. Scotland and Wales won't be far behind them.

And we're being told that here the last ministerial directive, which was four years ago, capped pay at one percent. And that's all the Permanent Secretary can offer following the Arc 21 case which said that the civil servants here didn't have the authority to make new decisions.

Over the years in this job there have been periods of total frustration as there is at the moment with there not being an Assembly. It feels as if everything has ground to a halt.

My worry is that if we don't move forward we'll start to slide back and I think all the things we've managed to achieve over the years for midwives and for women are in danger of being lost.

Q So what's next for you, Breedagh, post-retirement?

A There comes a time in everyone's life when it's time to go and do something different.

I've a doctorate that's been sitting on ice for four years - I suppose it'll have to be rewritten - I want to have the time to do that. I want to go and live in Spain. I've just bought a new camper van and driven it out and it's there waiting for me. I am going to miss all my friends though.

Particularly Mary Caddell and Anne Marie O'Neill who've worked with me here in the office - the three musketeers. And all the midwives it's been my privilege to work with.

They're not my colleagues, they're my friends. I've such admiration for the work they do. They're fabulous.

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