The ‘Contraceptive Train’ and Dr Caroline De Costa

Julie Breathnach Banwait and Gill Kenny

(This interview first appeared in The Journal (Vo. 30 no. 3), a publication of the Australian Irish Heritage Association of Western Australia. Our thanks to Julie Breathnach Banwait for permission to reproduce it here.)


Dr Caroline Costa

Dr Caroline De Costa is a professor of Obstetrics and Gynaecology at James Cook University, Queensland.

She was the first female professor of Obstetrics and Gynaecology in Australia. Caroline has long been an advocate for indigenous health and abortion rights. She is also an engaging and accomplished writer of non-fiction books and crime novels. To date she is the author of around 90 research articles and many textbooks.

Caroline, from Sydney, started studying medicine in 1963 and continued her undergraduate studies at The Royal College of Surgeons in Ireland where she would later return to undertake specialist training in Obstetrics and Gynaecology. Even though she was already a qualified medical professional, when she applied to do her specialist training in Sydney during 1974, she was refused admission because she was a woman. But Caroline did not let this stop her.

Back she went to Ireland where gender was not an issue at the Royal College of Surgeons. Caroline became an advocate for women’s reproductive rights in Ireland whilst living there as a medical student. She was involved with the now infamous contraceptive train in which members of the Irish Women’s Liberation Movement (IWLM), supported by Nell Mc Cafferty and Mary Kenny, took a train to Belfast to buy contraceptives and carry them back to the Republic of Ireland to distribute. Caroline’s newly published book ‘The Women’s Doc’ outlines her journey into medicine, her advocacy for women’s rights and how she managed to juggle the high demands of a career in medicine with being a mother of seven and a writer.

On her background, on what drives her, on her connection with Ireland

My paternal grandfather was born in Dublin, into a Protestant family, in 1864 in Synge Street in Dublin, and was educated there. And then I know very little about him because he didn’t marry my grandmother until 1917. So he was 50 or thereabouts, when he married and was 52 when my father was born. Although I knew he was born in Ireland and had been Irish, he died 12 years before I was born and I didn’t meet him and my father spoke very little about him. Although I have photos of him, in Melbourne – a family tree – showing me where he was. He took himself to South Africa fairly early and he said he was there during the Boer War, although he was not fighting on either side. I know there was an Irish Brigade, supporting the Boers. 

But then he came to Australia. And he worked in the Goldfields for quite a while as an accountant. One of his friends there was Herbert Hoover, who was an engineer. He maintained a relationship with Herbert Hoover. Once Herbert went back and became President of the United States, there were letters, according to my grandmother, but they’ve totally disappeared. But I didn’t go to Ireland with the idea that I am of Irish descent. I went there independently. I loved it and I felt very much at home.

My father turned up from Australia to just visit me and see how it’s going at the College of Surgeons quite early and stayed a couple of days and he took himself down to the building of registry of births and deaths to find his father’s birth certificate, which he did. While he was doing that, they said to him, you can be Irish. You not only can, but you are Irish and you can have an Irish birth certificate and then have an Irish passport, a green passport with a harp on it. At that point, it wasn’t the European passport. He was absolutely chuffed. And he got it. And then he said you can be Irish now which I wanted to be because I was living in Ireland.

So I became Irish and all my children are Irish, as well as Australian. I go back to Ireland when they’re not holding pandemics! I’ve got a lot of friends from when I was a student there, mainly in Dublin. So the College of Surgeons, even in the 1960s was very multinational and had a very, very good atmosphere, a wonderful place to just be a student but also to study medicine. Medicine was very hard.

But I can’t really answer that question (on motivation). My parents were both very keen that we should as children be as well-educated as possible in whatever direction we wanted to take. My father took us on a road trip from Gibraltar, Spain, France and Italy and the former Yugoslavia, which is over six months in a car and my mother was there too. So when I left Australia, I was 17. My parents were somewhat apprehensive. But they didn’t say you can’t go and they encouraged us to be curious and to be interested in everything in the world.’

On being a part of the infamous ‘contraceptive train’ on 22 May 1971

Contraception in the Republic of Ireland had been illegal since 1935 under the 1935 Criminal Law (Amendment) Act but in Northern Ireland it was legal but restricted. Initially, the IWLM were not in agreement on who should go to the North with some suggesting that it was inappropriate for single women to go as it implied that they engaging in pre-marital intercourse.

For those who went, there was the risk of being detained or prosecuted for bringing birth control into the Republic if caught. They also risked exclusion from family and friends and possible social stigma for being involved with such an immoral and rebellious demonstration.  During this time, due to the lack of available contraception, families averaged 6-10 children in the Republic of Ireland (ROI) and women faced, in the words of one member and later Fine Gael TD Nuala Fennell, ‘the nightmare of unremitting pregnancy‘. 

This brave act of defiance, with Caroline as part of the group, paved the way for discussions about access to contraception in the ROI and particularly highlighted the need to start exploratory discussions on the provision of contraception for Irish women living there.

Preparing for maximum exposure, this group of extraordinary women were accompanied by media from Ireland, the US and Japan.

Caroline returning to Connolly Station, Dublin, from Belfast


Caroline describes it as follows:

There were demonstrations, women’s lib demonstrations in Dublin and meetings with the health minister and things that we all went to as well.

So it was all part of a campaign to get contraception, which was completely illegal. But it was good fun. Because it was a beautiful day. We got on the train to go to Belfast and come back with condoms, and we thought we’d try and get the pill, but we didn’t have prescriptions. So we bought aspirin and told the customs officers it was the pill, they didn’t know the difference.

Now (Nell) McCafferty and Mary Kenny, were at that time journalists and members of the women’s lib organization and they were very instrumental in publicising the fact that we were going to do this and getting a group of women together. So there were 47 of us who got on the train and went to Belfast and we got condoms. We were nervous about the day.

But the customs officers, when we got to Dublin, were much more nervous. They didn’t know where to look. They were absolutely pink with embarrassment and some of them had no idea what a condom looked like, they didn’t know what they were searching for. One of them said  ‘Miss ave ya got any of them things? And I said yes. He was just completely overwhelmed. So they hung on to us for a while and there was a lot of the press taking photographs. Some asking women ‘why did you do this?’ We were saying you need to have contraception for  women. And for Irish men too, but we were pretty much concentrating on the women because they were getting pregnant.

We weren’t brought to court but we all had to give our names and addresses and so on. But I think it did focus national attention on the fact that there was no access to contraception. It was illegal, but also  the Catholic Church had a stranglehold on women’s bodies.

The Rough Magic Theatre Company

The Rough Magic Theatre Company produced a musical in 2015 called The Train, written by Arthur Riordan and Bill Whelan of Riverdance fame, based on the story of the contraception train. A musical may seem a rather interesting way to depict an issue of such social significance, however, it quickly became a success.  Riordan wrote in the in 2015  ‘I reckoned that the best way to address the bizarre, through-the-looking-glass world of Irish society in the early nineteen seventies would be through the form of musical theatre’. The Irish Independent reported ‘it hits the emotional hot spot’ and the Irish Times described it as a ‘ball of energy, the pace enhanced by a quintet of live musicians….this kinetic production reminds us how far women have come.’ Caroline, clearly bemused by the idea, says ‘I just couldn’t stop laughing. It was just so funny. There’s some great numbers and it really made the point.

It had a long run in Dublin,  it was packed houses all the time. And what was really heartening was that there are many young people there who hadn’t been around at all in 1971, and who hadn’t realised that something so valuable had been completely forbidden to their parents or their grandparents. It had value there. I thought it was very important.’

On the changes she has noticed in Ireland since her time as a medical student

Ireland has changed dramatically since the 70’s. It has become an affluent society with reduced unemployment and poverty. Social change has also been apparent and fast moving, particularly in terms of female participation in the workforce, their involvement in education or changing attitudes generally among and about women (National Economic and Social Council, 1989:117; Fahey & Lyte, 2007; McGinnity et al., 2007).

Norms and values have evolved and shifted, the choking grip of the Catholic church has been loosened, abortion has been legalised, divorce is now available which has allowed many women freedoms that they had never experienced before. Same sex marriage has been legalised. Since 1973 there have been fourteen amendments to the constitution concerning social justice issues such as abortion, adoption, children, same-sex marriage, divorce and the voting rights of both immigrants and migrants.

The younger Irish generation is generally recognised as being a highly educated and adaptable workforce. Ireland has been considered an attractive base for operations for foreign direct investment companies. The numbers of people completing third level education has risen dramatically particularly over the last two decades.

The emergence of women in national politics has become apparent. Mary Robinson was elected as President in 1990 and subsequently Mary McAleese to the same position in 1997, Mary Harney as Tánaiste. Mary Lou Mc Donald is currently Uachtarán for Sinn Féin, Frances Fitzgerald, Joan Bruton along with numerous others, have brought women to the fore and to positions of power in politics. Caroline, a regular visitor to Ireland, describes the changes she’s noticed,

The changes have been incredible. Couples live together without getting married and they’re having children. So there’s equality in relationships there. There is now abortion of course and divorce. I knew many people really who were unhappy in their marriages but they appeared together and it (was) kind of hidden, there was a lot of that kind of thing. Plus, there were lots of people who didn’t get themselves organised to separate.

There were a lot of unmarried mothers, so called, who had to give up their children and had to have their babies in secret so there were a lot of adoptions. There are many people who realise that they were adopted and as they grow, wanting to seek out their birth mothers. That has been a phenomenon, for example, illustrated by the film Philomena. I think the standard of living has certainly risen since and you can see that in the shops and buildings, transport and so on. I love the Irish.  I feel that I’m Australian but of Irish origin.

On receiving the order of Australia and handing it back

The Order of Australia is an honour that recognises Australian citizens for achievement or meritorious service. It was established by the Australian Government in 1975. A nomination for such an award usually requires an outline or description about how the nominee is considered to have made a significant contribution to the community. Nominating is an opportunity to acknowledge  commitment, service and dedication. Caroline speaks of receiving this award and subsequently why she felt the need to return it.

I was very humbled and honored to receive it in 2014. The day I received it was a very happy day, I had it until January this year. But at that time, Margaret Court, a retired Australian tennis player was elevated to the highest level. And I was shocked by that, because she  has made so many derogatory and hurtful statements about LGBTQI people. And another doctor had already given up her Order of Australia. And I thought about it and I was concerned about what she said on a number of occasions and when you read what people are supposed to have done for that, they actually use the word ‘have benefited humanity’ and I felt that this was really, really inappropriate.

I wrote to the Governor General and said, I’m of this opinion, and I wish to return the the order, so eventually, I sent it back. My younger son is gay. I was surprised I received messages and emails and things from people who congratulated me on doing it, which was nice of them. But I also got a bit of hate mail and I realised that this is what you have to put up with. Part of this quite large group of people who wish to live their lives a certain way and why shouldn’t (they) be allowed to do so.

Connolly Station, Dublin

On what she’s most proud of

My children, all of whom are dual citizens. We got women into training in obstetrics and gynaecology in Australia. There are now more there and I suppose the practice and the privilege of being able to be there for women.

Caroline, against the greatest of odds, has achieved so much for Irish women during her time in Ireland. She has faced many obstacles in her path yet has persevered and has not only saved Irish women’s lives through her skilled work as an obstetrician and gynaecologist, but through influencing social change for the betterment of all women. We, as Irish women, owe her so much and wish to thank her for the courage and bravery she has shown in the emancipation of Irish women and the commitment she still continues to show today.