Dept of Health says review of abortion law to be 'progressed' this year

The Department of Health has said a review of the Termination of Pregnancy Act will be "progressed" this year.

It follows calls for the Minister for Health Stephen Donnelly to give a timeline regarding a review.

Under the Termination of Pregnancy Act the Minister must carry out a review of the service no later than three years after its commencement.

A spokesperson for the Minister for Health has said the Minister and officials in the Department intended to initiate a Review of the Termination of Pregnancy Act last week.

However, the Department says the cyber attack on the Department of Health has created significant difficulties in this regard "which we are working to address at this time".

The Department confirmed that the review is scheduled to be progressed in 2021 and will be overseen by Department of Health.

It says research to inform the service user and service provider strands will be commissioned and carried out independently.

"The Department of Health will manage the public consultation, which will extend a public invitation to all interested groups, organisations and members of the public to provide their views to inform the review of the operation of the legislation.

"To ensure transparency, a report on each of the three strands of the review will be published."

It says once data has been gathered on all three strands, a full report with any necessary recommendations will be submitted by the Department to the Minister for Health for consideration.

Research published by the National Women's Council shows women in rural areas and from marginalised backgrounds face extra challenges in accessing abortion services in Ireland.

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'At least' one person per day travelling to the UK for an abortion

At least one person a day is travelling to the UK for an abortion according to the paper, the majority of which are later term procedures.

The research marks the third anniversary of the referendum on the Eighth Amendment, when the public voted to legalise abortion services in Ireland.

'Accessing Abortion in Ireland: Meeting the Needs of Every Woman' shows that one in ten GPs are providing abortion services here.

However, it states that access remains "particularly difficult" for those who are told their baby has a severe or fatal foetal anomaly.

The research, which explores the experiences of abortion services since their introduction in 2019, comes ahead of a review of the current abortion legislation.

Dr Sinead Kennedy of Maynooth University conducted interviews with community and hospital-based service providers, as well as campaigners and activists, throughout November and December 2020.

It looks at the experience of people accessing abortion services as well as providers' experience of service delivery with the aim of identifying barriers to access.

The report says that outside of urban centres, abortion services are limited, particularly in the northwest.

At present, there is no provision in Co Sligo and a round trip of up to 100km to Donegal or Roscommon is required to access a GP twice - three days apart - with the possibility of a third visit if a scan is required.

One doctor reported that a Donegal-based woman, in need of a scan, travelled a ten-hour return journey to a Dublin hospital on public transport in the same day.

The most recent available statistics show that in 2019, 375 Irish residents travelled to England and Wales for abortions. Most sought assistance during the second trimester and almost 20% of those had received a diagnosis of foetal anomalies.

Under Section 11 of the legislation, the inclusion of the 28-day time limit in the definition of "condition likely to lead to the death of the foetus" was not included in the draft General Scheme - this, according to the report, has created difficulties in clinical practice.

Over half of the participants referenced the legislation as "restrictive" and argued that it was forcing them to travel for a termination of pregnancy under conditions not "quite fatal enough but are absolutely not going to
survive".

The report recommends that the legislative review process should be wholly independent of Government and chaired by a specialist in reproductive rights and equality-based healthcare, and the review group should be composed of a panel of experts, including service users, providers, and reproductive rights advocates.

Organisations such as Termination for Medical Reasons Ireland, which provides support to parents who experience an fatal foetal anomaly pregnancy, reported that many women continue to be denied care in Ireland because of the 28-day guidelines.

The Director of the National Women's Council said the 12 week limit is causing huge problems for women and that many do not realise they are pregnant until ten weeks.

Speaking on RTÉ's Morning Ireland, Orla O'Connor said it is really important that the review takes these issues into account and said women are best placed, along with their doctors, to decide when to access these services.

She said women whose first language is not English also report delays in being able to access services, while some women are forced to travel because the abortion pill may have failed.

In addition, she said, people who have been given a diagnosis of a fatal foetal abnormality are still travelling for services, because doctors must be able to predict a foetal mortality within 28 days, which is very difficult to do.

GPs support continuation of telemedicine

Telemedicine was introduced during the Covid-19 pandemic and all the medical practitioners interviewed for the paper "enthusiastically supported" the continuation of a telemedicine option post-pandemic.

GPs also noted that while most women are happy for the first consultation to take place remotely, most choose an in-person meeting for the second consultation.

The Abortion Support Network (ANS) also provided an insight into gaps in service provision in Ireland and some reasons why people travel.

ASN helps people living in Ireland who need to travel to access abortion services abroad.

The network was contacted by 235 people who were resident in the Republic of Ireland, asking about abortion services between January 2019 and June 2020.

Several people contacted ASN at 11 weeks four days, 11 weeks five days and 11 weeks six days pregnant, having been told that they were "too far" to get treatment in Ireland.

Pregnancy is dated from the first day of the last menstrual period. A three-day waiting period must elapse before the abortion can take place.

At least five women who believed they were under 12 weeks, based on their last period, scanned at over 12 weeks at appointments in Ireland.

ASN also encountered many cases where women did not realise they were pregnant until they were at or over 12 weeks.

More than 25 clients had an early medical abortion in Ireland which failed, and they were then over the 12 weeks.

The review will be challenged by TDs and Senators who are opposed to the legislation.

On 12 May, Independent TD Carol Nolan introduced the foetal pain relief bill in the Dáil for late-term abortions with the support of ten other TDs.

Aontú leader Peadar Tóibín described "the harshness of the new regime that makes it legal of the State to end the life of one individual living human" as hard to fathom.

He said that because of his human rights stance he was suspended from Sinn Féin and forced out of the party.

"This was a matter of conscience and compassion for me - I have always believed, throughout my political activism, that everyone has value, and everyone should be protected."

The Pro-Life Campaign has issued a statement saying the Government painted a very "sanitised picture" of the abortion regime that would operate in the event of repeal.

It said now that the opposite has happened "they don't want to talk about it or deal with the reality of what they have created".

Eilís Mulroy said the movement regards what has happened as an absolute betrayal of women and their unborn babies, but she said it is "realistic enough to know that it's going to take time to get the word out about the reality of what the new law really involves".