Belfast Telegraph

Eilish O'Regan: Contentious system is running smoothly south of the border

Eilish O'Regan
Eilish O'Regan

By Eilish O'Regan

Abortion was among the most divisive issues in the Republic of Ireland for decades.

It was regarded as politically toxic with various governments relying on the courts to rule on when termination of pregnancy be permitted or prohibited.

All the while it was a daily reality. Thousands of women from the 26 counties were going to the UK for terminations annually - over 3,000 in 2017. There was growing use of online abortion pills although they were illegal.

But since January this year, and the triggering of new legislation, abortion has been legally available in most counties in the South, at a level which only a few years ago many would have regarded as "liberal".

It has not been without some controversy, but everyone is surprised by how relatively smoothly it is running.

It allows for medical abortion on demand up to 12 weeks of pregnancy. Termination is permitted in cases of fatal foetal abnormality and also where there is a risk to the life or health of the woman.

What is remarkable is how the abortion system is quietly functioning, to the public eye at least, in GP surgeries and hospitals without sparking loud protests, obstruction or emotional outbursts.

There have been some demonstrations by anti-abortion groups.

The most upsetting has been a protest outside the National Maternity Hospital in Dublin in which protesters held three white child-size coffins.

But Garda Commissioner Drew Harris recently said he believed there is no need for new legislation setting up safe-access zones around health facilities.

This is because there is "no evidence to suggest that there is threatening, abusive or insulting behaviour directed towards persons utilising such services".

So how did we get here? Irish Health Minister Simon Harris deserves credit for the manner in which this time around the debate was more extensive and reasoned.

There were open hearings of a Citizens Assembly gathering over many months where all groups, including medical experts, gave their views. It produced recommendations for abortion on demand up to 12 weeks which few expected.

This was followed by more debate in the run up to May 2018 referendum to repeal the Eighth Amendment guaranteed to protect as far as practicable the equal right to life of the unborn and the mother.

The result was a 66.4% vote in favour of repeal. The Health (Regulation of Termination of Pregnancy) Act 2018 came into effect on January 1.

So why has it worked? There are no designated abortion clinics.

Medical abortion is performed by GPs for women up to nine weeks gestation.

Terminations between nine and 12 weeks of pregnancy are carried out in hospitals.

It means the women sitting in a GP surgery waiting for the procedure are anonymous with nobody but the doctor aware of why they are there.

There is a mandatory three-day wait between applying for the abortion and it being certified.

The GPs receive a fee from the State for the service which is free to women and involves taking two medications. There have been no reports of adverse incidents.

Some 340 of 2,500 GPs have signed up to provide medical abortion. Two counties are without a participating GP. There is no onus on GPs to take part but they must refer a woman to another doctor who is participating.

Just 10 hospitals are providing a full abortion service and staff with conscientious objection are allowed to opt out. Other hospitals provide support such as treatment for any complications. There is a reasonable geographical spread .

We don't know how many abortions are being carried out and we must wait for an annual report in January.

One tragic incident is under review where a foetus was aborted on the basis of a misleading test result which wrongly showed a foetus had a fatal foetal abnormality.

Key lessons to be learned by NI health authorities will be ensuring training for doctors and proper guidelines.

  • Eilish O'Regan is the health correspondent of the Irish Independent

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