Ms Noeline Blackwell:

I thank the Chairman for the invitation to present to the committee. I am the chief executive of the Dublin Rape Crisis Centre and I am joined today by my colleague Ms Angela McCarthy who is our head of clinical services.

A slightly longer paper of our presentation was submitted to the committee and I will now give an edited version of that - a readers' digest version. Our purpose is to give members evidence as based on the experience of our personnel and the analysis of our own data on the impact of pregnancy where it happens as a result of rape of women.

Our data comes from the 24 hour helpline that we run from the Dublin Rape Crisis Centre and from clients that we see face to face.

We support those attending Dr. Eogan's sexual assault treatment unit. We also accompany people to police stations and court.

Over the last number of years, approximately 80% of callers to the national 24-hour helpline were women. Callers to the helpline may not disclose their age at all but of the approximately 12,400 calls we got in 2016 whose age was known, 40% were women under 50 and 44% were women under 60. In terms of people coming directly to our doors, about 90% of those who attended for face-to-face therapy were women, and 80% of the 500 we saw were women under 50 while 89% were under 60.

While rape is about abuse of power, and violence, it does not always require force. Many rapes do involve force but many also happen when a person feels compelled to have non-consensual sex through external or societal pressures. Where sexual intercourse happens without consent, it is rape. Our therapists and helpline counsellors bear witness to the trauma, hurt and harm of rape every day. The psychological impact of rape can include self-blame, depression, post-traumatic stress disorder, flashbacks, sleep or eating disorders, distrust of others and feelings of personal powerlessness. Women may experience none, some or all of those at different times. Those impacts are not signs of illness, deficiency or weakness in a woman, nor are they characteristics of a particular woman, they are responses to traumatic events and trauma is real. In the experience of our personnel, the trauma of rape is exacerbated for those who become pregnant as a result of the rape.

I will say a little about how women present to us generally. Dr. Eogan has said from her perspective, and we can say from our experience, there is no such thing as a "normal" response to rape. Rape impacts on everyone differently depending not just on the circumstances of the rape but on the person themselves. The immediate aftermath of a rape can vary. It can be a time of overwhelming turmoil and confusion where a victim or survivor feels extreme and conflicting emotions. Some people present as numb, quiet and reserved. Others will respond quite differently being distraught, anxious, or hostile. The effects of the trauma can be short term or they can last long after the rape.

I will not speak about the experience of our volunteers in the sexual assault treatment unit because Dr. Eogan has covered that ground but there is some discussion of how our volunteer counsellors work with women who attend there. On the national 24-hour helpline, we aim to hold a confidential non-judgmental space for callers where they are empowered to explore their feelings, consider how the rape has impacted on them and make their own decisions about what to do and how to proceed. We seek to engage the caller and establish whether they are safe, have support or are in need of medical care.

Raising that issue of medical attention can prompt mixed responses. The possibility of having contracted a sexually transmitted disease or getting pregnant is now something else the woman must consider. A caller may ask questions related to a possible pregnancy. These may include questions about termination of a pregnancy. In those cases, callers to our service are referred on to a service that would be better placed to answer questions and provide information such as a free text number or the Positive Options website. Calls that relate to pregnancy are not the only ones we refer on. We also make referrals to other rape crisis centres, domestic violence support agencies, social workers, the Garda, other helplines and the like. It is important that not only do callers have the correct information but that they understand we are there to support them irrespective of the outcome of their decision about pregnancy. Such calls tend to finish quite quickly because a pregnancy and the decisions around it are uppermost in the woman's mind.

In terms of face-to-face therapy, clients present with a blend of issues. Memories of the rape can evoke feelings of shame or betrayal. There can be terror of the physical hurt, the fear of a violent threat and the possibility of a pregnancy. The intensity of their feelings can often overwhelm people as they embark on their therapeutic journey. Some clients will even have difficulty acknowledging the reality of their rape. Some may only reveal that the rape resulted in pregnancy weeks, months or years later. A therapist may never hear about the pregnancy at all. While we note information on those who reveal to us that they have become pregnant we will often only hear about it as a historical event. The scenarios that we hear about include the following: A client has had a baby as a result of a recent rape. That can bring conflicting emotions about an innocent child that is born out of aggression and there can be a loving and-or loathing of the child; a client has had a miscarriage and may have a sense of relief that there is not the added dilemma of being pregnant but there may be a sense of loss of a baby; a client may present as being pregnant and unsure what she is going to do. The pregnancy presents a double crisis - on top of the rape and trauma they also face the additional crisis of pregnancy and a decision in relation to that. They have to work through the practical, financial and emotional difficulties in proceeding with an unplanned pregnancy or having an abortion. The client will have to assess that in terms of all existing relationships within her family and her community; and, a client may present as having had an abortion. She may feel relief that there is not the added dilemma of being pregnant. Some feel a sense of guilt and sadness at having terminated the pregnancy. Others feel stigma, shame and isolation. The secrecy surrounding the abortion presents a burden for some. Some will feel anger that they could not have the abortion procedure in Ireland, travel having made the whole process expensive, complicated and traumatic; a client may have had a baby as a result of a historic rape.

In 2016, 11 women disclosed pregnancies as a result of rape to the Dublin Rape Crisis Centre. We noted the outcomes for those 11 women. Four had become pregnant and were parenting; three had terminations; one had miscarried; one had a child adopted; one had a child fostered and in one case the outcome was unknown. Those figures do not indicate a victim or survivor's choice, but merely the ultimate outcome. The figures may relate to recent or historic pregnancies.

There is no reliable Irish information available about the prevalence of pregnancy as a result of rape because there is such massive under-reporting of rape. Dr. Eogan referred to the 2002 SAVI report, which found that 42% of women reporting abuse had never told anyone at all. Only 8% of women reported their experience of sexual violence to the Garda; 6% disclosed to medical professionals and 14% of women in that survey reported to counsellors. Other studies give comparable results.

In 2014 an EU survey undertaken by the European Union Agency for Fundamental Rights, FRA, found that about 2% of women aged 18 and 74 experienced sexual violence in the previous 12 months. From our own evidence, most rape and serious sexual violence is perpetrated by someone known to the victim. Our statistics for 2016 identified that just under 17% of adult rape and sexual assault was perpetrated by the client's spouse or partner, 2% by other family members and almost 46% by other known persons. That includes friends, recent dates, work mates and the like. About 50% of childhood sexual abuse revealed to us by adults was perpetrated by a family member.

We have no reliable national data on the prevalence of pregnancy as a result of rape. However, from our own statistics over 11 years, and also using the statistics from the Rape Crisis Network of Ireland, RCNI, which collects data from a number of other smaller rape crisis centres, it seems that approximately 4% of the total number of female victims or survivors who presented to rape crisis centres report pregnancies as a result of rape. That is very near the 5% Dr. Eogan spoke about in other surveys. Of that 4%, a little over one third of our clients went on to parent while a little less than one third terminated their pregnancy. The RCNI figures show almost half went on to parent, while just under 20% terminated their pregnancy.

The final point relates to concerns about women's health if rape must be reported to access abortion, the so-called rape exception. If the committee is considering special provisions for those who have suffered rape to access termination, then it seems inevitable that the pregnant rape victim or survivor will have to say that a rape occurred.

Many of those who contact us are not ready to report to police for a long time, if ever. It is noteworthy that the Garda now provides storage of forensic evidence at the sexual assault treatment unit for up to a year, recognising the realities of the investigation of this type of crime. Clients are sometimes fearful of the reality that once they report to the Garda, gardaí must commence the investigation of a crime, thus notifying the alleged perpetrator of the complaint even if the victim is not ready. They may also initially have concerns about their own blame for the events which makes them reluctant to speak. Clients may not be ready to report to a doctor, social worker or the like. They may not want to talk to someone they fear will judge them and who must judge them to some extent. In the context of the long journey our clients and callers must take to re-build their self-esteem and manage their self-doubt after the violence of rape, many would be set back if questions were raised about their credibility.

Requiring a woman to share such a traumatising experience about her rape and subsequent pregnancy has the potential to not only re-traumatise, re-trigger and re-victimise her, it also leaves her in a situation where she has to convince someone that her story justifies access to support. It disempowers the person who has suffered the rape while empowering the person giving permission to access a procedure or service. Once more, the consent of the victim or survivor is seen as irrelevant. I am happy to answer any questions that the committee may have.