Maternity Hospital Master Rhona Mahony has said she favours repeal of the 8th Amendment on abortion, writes Irish Examiner Political Editor Daniel McConnell.
Speaking at the Labour think-in in Athy, Co Kildare, Dr Mahony said that in cases of fatal foetal abnormalities, it is no longer tolerable that we are sending women over to the United Kingdom for termination.
She said: "We can't keep sending people to England pretending it doesn't happen."
She also said that the Irish health system is a "toxic place to work" and after six years as Master of Holles Street she said she is "exhausted".
"Six years in and I am exhausted, I really am," she told delegates before insisting she still loves her job.
In a hard-hitting address to Labour party members, she said that termination of pregnancy only takes places here where there is a substanital risk to the woman's life that can only be removed by termination of pregnancy.
"I favour a repeal of the eighth amendment for a variety of reasons relating to women's health. We have in Ireland terminations only when there is a substantial risk to the life of the mother that can be removed only by terminating the pregnancy," she said.
She said this poses great difficulties because doctors are making decisions based on risk, trying to quantify a risk and also in certain conditions she said they have to wait until a woman is sick enough before she qualifies for substantial risk to her life.
In some cases, she said this can amount to medical roulette and be very challenging.
"But this poses great difficulties prior to foetal viability because we are making decisions based on risk, trying to quantify a risk and also in some cases we have to wait until a woman is sick enough to qualify. In some cases, that is medical roulette," she added.
She added that if the law deals with right, medicine deals with risk and sometimes they come into conflict.
Dr Mahony said that when she is dealing with patients she finds it very difficult as a doctor to know that they will make their own arrangements.
She said she can discuss their options but cannot refer them for treatment and can't deliver the treatment at home.
The Master of the National Maternity Hospital said there are huge difficulties when you travel away, even the practical thing of bringing the baby's body home and the stigma associated with being on a plane in the context of a huge tragedy .
She added that women can be separated from their family and friends and don't really want to talk about it.
She said women must feel at some level that Ireland doesn't want to recognise or acknowledge this.
Dr Mahony also said there are too many hospitals in this country. She said there are 49 acute hospitals in a population of 4.7 million.
Even within those acute hospitals they are performing four different functions.
This means while we have lots of hospitals, we actually have a shortage of acute hospital beds and the way we use those beds is inefficient.