Women still facing abortion barriers in Ireland

Mandatory three-day wait and shortage of GP providers barriers to accessing terminations, Dáil committee told

Oireachtas health committee told of one woman who contacted seven GP practices seeking a termination, but six declined to treat her and the seventh referred her to the HSE helpline ‘My Options’.

Women are still facing barriers in accessing abortions in Ireland, including a mandatory three-day wait, a shortage of GP providers and lack of information, the Oireachtas health committee heard on Wednesday.

They were told of one woman who contacted seven GP practices seeking a termination, but six declined to treat her and the seventh referred her to the HSE helpline ‘My Options’.

Barrister Marie O’Shea, who published a review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018 earlier this year, answered questions mainly on the mandatory three-day wait imposed on patients.

Under legislation, there must be at least three days between a woman being certified to have an abortion and having the procedure.

“We are not suggesting that the model of care changes,” Ms O’Shea said, adding: “I don’t think that this committee can disregard what we heard about the barriers this is causing to people as well; people who potentially time-out because of the three-day wait, or because of the three-day wait combined with the lack of 365 [days a year] services in hospitals.” 

Green Party TD Neasa Hourigan described the requirement as “degrading”, noting it was not required for other healthcare procedures.

Senator Martin Conway said while the wait was “disrespectful” of women, he also called for further research into why some women attend one appointment but do not return for treatment.

Dr Catherine Conlon, associate professor of social studies at Trinity College Dublin, said there were ethical concerns around this. However, she suggested two models for surveying this group.

Fatal fetal abnormality

Ms O’Shea also discussed terminations linked to a diagnosis of fatal fetal abnormality. Many women have told her the legislation is “a breach” of what they voted for in the 2018 referendum, she said.

A termination after 12 weeks is available when health conditions are likely to lead to the death of the fetus either before or within 28 days of birth.

Dr Deirdre Duffy, sociologist at the University of Lancaster, who researched clinicians' experience of providing abortion services here, described a “chilling effect” of potential criminal action around this.

She quoted a consultant neonatologist who “has asked for the criminality aspect of the act removed or dealt with significantly to allow people to practise in a professional way, and make people feel more protected”. 

Social Democrats TD Róisín Shortall raised questions about how the HSE and Department of Health were engaging with the review. 

Ms O’Shea said she did not know whether a promised HSE implementation group was already at work or not, and she had not met officials from the Department of Health.

Senator Sharon Keogan asked about the safety of expanding virtual or telemedicine appointments, saying if a woman was a victim of domestic abuse this may be hard to ascertain or to accurately know the date of gestation.

Ms O’Shea said in response a lot of GPs tell her they have adopted “a hybrid model of care”, so a woman could be offered a mix of remote and in-person appointments.

A number of TDs and senators discussed the idea that termination of pregnancy was not yet culturally accepted in Ireland by everyone as part of healthcare.