"Whichever model of care is developed, the patient must be front and centre in the required clinical care pathway."
The Institute of Obstetricians and Gynaecologists and Irish College of General Practitioners have expressed concerns over the proposed timeline regarding the introduction of abortion services in Ireland.
This follows the news that President Michael D. Higgins, on Tuesday, signed a bill formally repealing the
Eighth Amendment.
Taoiseach Leo Varadkar, following the lift of the constitutional ban, told the Dáil that legislation to facilitate abortion would be introduced during the first week in October.
Wednesday saw representatives of The Institute of Obstetricians and Gynaecologists of Ireland (IOG) and The Irish College of General Practitioners (ICGP) attend a session of the Joint Oireachtas Committee on Health to discuss the clinical guidelines being prepared in light of the impending introduction of abortion services.
Both bodies expressed concerns over the legislative process and the provision of services.
Dr John O'Brien, of the Irish College of General Practitioners, expressed concerns over privacy, equitable access to a clinical assessment, timely arrangements for the provision of termination of pregnancy and immediate referral to appropriate antenatal care for those who choose not to proceed to termination of pregnancy among others.
The Chairman of the IOG agreed, going on to describe the proposed timeline as "challenging".
The IOG – whose members have studied the system currently in place in Scotland – believe that a similar structure should be in place in Ireland.
"We have looked to the example of Scotland, a country with a similar population to Ireland for data on TOP (Termination of Pregnancy) services," their statement reads.
"In Scotland, around 75% of TOPs are at less than 9 weeks and 91% of these are medically induced. Approximately 10% require hospital attendance because of complications. We believe that Irish figures should be in line with those of Scotland."
They recommend, among others, the following in order to deliver fit-for-purpose services for termination of pregnancy in Ireland. That:
- Services should be free to all at the point of delivery and funding for the service, as with all women’s health care, should be appropriately resourced and ringfenced.
- In line with international best practice, it is proposed that early medical abortion takes place less than nine weeks into pregnancy.
- Pre-termination ultrasound scanning is performed, if readily available.
- Appropriate and immediate investment in ultrasound is an integral element of TOP services.
- Between 9 - 12 weeks, medical TOP takes place in the hospital setting due to the increased risk of complications such as bleeding.
- A 24 hour, 7 days a week, helpline be established to help with appointments, provide reassurance, and provide information if a woman is concerned about any aspect of her care.
- A waiting time, if any, should be from the time of the first contact with the service.
- Contraceptive advice and services, including long-acting options, should be available at the time of the TOP.
- Blood tests for anaemia, blood group, and HCG, if appropriate, should be taken at the time of the first consultation. It may also be appropriate to test for sexually transmitted infections (STIs).
"International experience, supported by data, is that following legalization of abortion services numbers decline with the passage of time for a variety of reasons including the removal of barriers to access and when the service includes advice on and provision of contraception," their statement reads.
"The IOG therefore strongly supports the proposal of the Oireachtas Committee on the Eighth Amendment and the Minister for Health’s proposal that every effort should be made to reduce crisis pregnancies, including by the provision of free contraception."
Full statement can be read
here.
