Twelve of Ireland's maternity hospitals still do not offer surgical abortions

Cork GP Dr Mary Favier: 'I think come this summer we will have 17 of the 19 providing a service, but this time last year there were 11. That makes a huge difference for GPs. Picture; Eddie O'Hare

Almost six years on from the Repeal referendum, 12 of the 19 maternity hospitals in Ireland are not offering surgical abortions, even though it is legal to do so.

Only three hospitals in the country now offer all three legal methods of termination — surgical and medical abortions and manual vacuum aspiration.

The gaps in the service have implications for wider GP access, doctors have warned.

Most abortions in Ireland are tablet-based medical terminations, provided by GPs, but some women require surgical terminations.

By February 2, these were available in Dublin at the National Maternity Hospital, the Rotunda and Coombe maternity hospitals.

Otherwise, only Cork University Maternity Hospital, Galway University Hospital, Mayo University Hospital as well as Our Lady of Lourdes Hospital in Drogheda do so.

Some 17 units offer medical terminations, but hospitals in Clonmel and Cavan still do not offer this, although they do offer some supports, including managing complications post-termination.

A third option, manual vacuum aspiration, is only available at Cork, Mayo, and the Coombe maternity hospitals.

Dr Trish Horgan, a GP in Cork and member of the Southern Task-Force On Abortion and Reproductive Topics (Start), said hospitals are necessary as backup.

“So you’ve got 17 units providing some level of support for medical abortion,” she said.

“Cavan and Tipperary are not providing anything at all, but only three of the units are providing a choice of all three types of abortion.” 

She added: “The hospital situation has evolved, but we are always saying the GP provision maps to hospitals, so it’s very useful for GPs to see hospitals coming on stream. That, no doubt, has an impact on GP provision as well.” 

Dr Mary Favier, also a member of Start, said GPs sometimes needed hospital support.

“One of the biggest determinants of why some counties have low GP involvement has historically been the hospitals weren’t providing,” she said.

“But that is now being rectified. I think come this summer we will have 17 of the 19 providing a service, but this time last year there were 11. That makes a huge difference for GPs.” 

Cork has a high number of GP providers, and Dr Favier pointed out: “In Cork [CUMH], they have been national leaders on it, they provide a great service to GPs.” 

She echoed the need for a more standardised training approach now.

Terminations were on a key Irish College of General Practitioners exam for the first time only last month.

“It was extraordinary, it is now a teaching subject, that is about as normalising as you will get,” she said.

“It creates an expectation that GPs need to be educated in this.” 

Currently, Start members voluntarily offer support, Dr Favier said, such as Dr Ken Harte in Macroom “who had a big input into the clinical guidance and academic side of it”.

In Cork, GPs voluntarily providing training include Dr Mike Thompson in Midleton, she said, while in other counties the group includes Dr Madeleine Ní Dhalaigh in Roscommon, Dr Sumi Dunne in Portarlington, GPs in Galway and Dr Brian Kennedy in Nenagh.