Abortion ultrasounds may be contracted

The option of contracting commercial scanning clinics to provide an ultrasound service to women seeking an abortion, under proposed new legislation, is being considered.

However, doctors have queried how they will source the required expertise, given that there is a shortage of sonographers.

Dr Mike Thompson, a GP member of Start (Southern Taskgroup on Abortion and Reproductive Topics), said the clinics had not previously provided routine pregnancy scans, so it was “unclear how they can now offer a very specialised scanning service”.

He said while family planning clinics were likely to provide a termination-of-pregnancy (ToP) service in Dublin, elsewhere, use of private clinics was likely.

“These commercial scanning companies don’t have a background of doing early medical ultrasounds” he said.

He said the HSE was already struggling to recruit sonographers (specialists in ultrasound) to existing maternity services, and that it was difficult to see how clinics could install the same expertise by 2019.

Dr Thompson said they anticipated up to a quarter of women would need to be referred for dating scans in the early days of the service, although this was likely to drop-off, as the service bedded in.

Under the Health (Regulation of Termination of Pregnancy) Bill, 2018, GPs can provide an abortion service up to day 63 of pregnancy. Dr Thompson said the vast majority of women know their dates, but where doubt existed, they would have to be referred for an ultrasound. He said there was concern hospitals would not be ready to provide the service in January, while others may be reluctant to take part.

“We don’t know if all hospitals in the South/Southwest hospital group will take part,” Dr Thompson said.

He said hospitals had not been asked what they needed or how they would provide the services. Neither had advice been given on how to manage or measure conscientious objection among staff. Representatives of the 90-member Start group, comprised of doctors drawn from general practice, obstetrics, and gynaecology and psychiatry, met with Dr Peter Boylan, at Cork University Maternity Hospital, last Wednesday night.

Dr Boylan, former master of the National Maternity Hospital, was appointed at the start of October to assist the HSE in preparing to implement abortion services.

Dr Thompson said it was the first meeting they had in relation to how they are expected to operate an abortion service, “even though there are only 53 working days to go, until the service is due to be introduced”.

He said assurances were provided around a number of issues, including a commitment to set up a 24-hour helpline staffed by trained personnel, to co-ordinate care, arrange appointments with abortion service-providers, and give reassurance or referral. Doctors were also satisfied with assurances around indemnity and around sourcing of abortion medication.

“The medicine is sourced and ready-to-go and it will be dispensed by GPs,” he said.

However, doctors remained concerned that free contraception would not be available to women who undergo an abortion. 

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