IRELAND – Long anticipated review of abortion services recommends major improvements
National Women’s Council
Taoiseach (Prime Minister) Leo Varadkar has said that the operational recommendations in the long anticipated, independent review of abortion services, published on 26 April 2023, will be implemented immediately. The review was carried out by barrister Marie O’Shea and was passed by the Cabinet on 25 April. The main findings and action proposals were as follows:
1. Only 11 of the country’s 19 maternity hospitals are providing surgical terminations, and there was an uneven geographic spread of hospitals providing termination services. A programme is being put in place to ensure that all 19 provide abortion services by early 2024.
2. There are (only) 422 community providers of abortion services.
3. Legislative changes were being referred to the all-party Oireachtas (Parliament’s) Health Committee for their consideration.
4. Social Democrats leader Holly Cairns said women were facing delays and obstruction when seeking services. The requirement for a three-day wait period was “paternalistic and patronising” and was particularly indefensible in cases of fatal fetal abnormality.
5. 700 women still had to travel abroad for an abortion since the law was changed. People Before Profit TD Brid Smith criticised the three-day wait in causing this.
6. Legislative changes proposed in the review include removing medical practitioners from the scope of criminal sanction, removing the mandatory three-day waiting period and allowing abortion beyond 12 weeks in certain circumstances.
7. Enabling nurses, midwives and other healthcare professionals to become more involved in the provision of termination services is proposed. Increasing the number of GPs in Ireland to 6,000 by 2028 is also seen as important to improve access to termination services.
It is “clear” there are differences in access to abortion services across Ireland, according to the former Master of the Rotunda Hospital, Consultant Ob-Gyn Professor Fergal Malone. He described the recommendations in the review as “well thought out” and “pragmatic”. He said some parts of the country are well served, while other parts, less so. He also described “conscientious objection” as one of the factors but not the main reason why this difference exists. He pointed out that if there is a large hospital providing abortion services, a small hospital nearby may take the view not to provide this service. “That is not really fair on the larger hospitals and also not fair on local families, who might prefer to stay in their local community to get services,” he said. “That does require strong management from healthcare leaders to make sure that is not happening.”
He also addressed the issue that most GPs are not offering abortion services. “From talking to GPs, I get the sense it is just a clinical volume in their practice.” Prof Malone said that he does not believe that the proportion of GPs who are conscientious objectors is any different to the proportion of nurses or obstetricians or other service providers.
SOURCES: RTE, by Sandra Hurley, 25 April 2023 ; RTE, 29 April 2023
SEE ALSO The Independent Review of the Operation of the Health (Regulation of Termination of Pregnancy) Act 2018, from the Department of Health, 26 April 2023, updated 27 April 2023