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Abortion in Ireland - what is the likely future reality as Eighth is repealed?

The detail on the provision of abortion services will need to be ironed out - but we do have some indications as to what the final service will look like, writes Laura Larkin


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AS the votes are tallied at count centres around the country today, a 'Yes' vote will see focus shift swiftly to the provision of abortion services. Here is everything we know so far about how the proposed service will work.

The proposed law:

Health Minister Simon Harris has published draft legislation to give people an idea of what the law introduced in the event of repeal may look like. Any legislation will have to pass in the House of the Oireachtas.

The proposed law allows for termination of pregnancies up to 12 weeks - 12 weeks is counted from the first day of a woman’s last period. A ‘pause period’ of 72-hours will come into play here.

The law also allows for abortion after 12 weeks in exceptional cases - these are when there is a risk to the life or health of the woman and the foetus has not reached viability (the point where it can survive outside of the womb).

A termination will also be legal under the proposals when a fatal foetal abnormality is diagnosed. 

So what do we need?

We will need doctors who are fully trained in providing abortion services, and who are given the resources they need to do so.

There will also be a need to develop wraparound services including counselling and other auxiliary services might be needed such as helplines for women taking abortion pills at home.

Have we made plans to do that?

Health Minister Simon Harris has consulted with senior consultants on how the best abortion service could be developed which reflects best practise - but there has been little in the way of specific detail at this point. The Minister has suggested that any abortion service in Ireland in the event of repeal will be a GP-led service.

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This has caused some concern among GPs - both over fears about training and resources and by doctors who would not feel comfortable providing an abortion. GPs have not yet been consulted on this but will be in the event of a repeal vote. Meanwhile, the Royal College of Obstetricians and Gynaecologists has said they will train Irish doctors to provide abortion services.

Under the proposed laws any medical practitioner who has a conscientious objection may refuse to carry out an abortion but will be required to refer the woman on to someone who is willing to provide the service.

What will the actual abortion procedure be?

Most abortions up to 12 weeks can be administered as a medical abortion - which means taking a combination of medicines, commonly known as the abortion pill, to end the pregnancy.

Up to nine weeks an early medical abortion can be administered - this involves taking mifepristone (to block the hormone prostegen) and misoprostol  (which causes the womb to break down). The pills are usually taken at home. In the UK women who experience adverse effects can contact a 24-hour nurse-led helpline. It is not known if something similar will be established here.

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After nine weeks the same combination of drugs can also end the pregnancy but are taken at a higher dose and under medical supervision.

Surgical abortions, which involve the removal of the foetus from the womb using suction methods or through a method known as dilatation and evacuation, will also need to be provided.

These are most common in post-12 week terminations, which under the proposed law will only be legal in Ireland when there is a real risk to the life of the mother or in cases of fatal foetal abnormality. At the moment it is expected these women will already be engaging with a hospital and will be cared for there. A surgical abortion may only be carried out by an obstetrician. At the moment there are 25 "appropriate institutions" who are authorised under the Protection of Life Bill to carry out terminations.

It is not known if women will have a choice between either a medical or a surgical abortion as is the case in some places. In England and Wales in 2016, 62pc of abortions were medical abortions.

Who will pay for it?

It is envisaged that abortion services would be made available in the public health service.

This means that women who have a medical card will be able to access the service for free but those who don’t will have to pay for the doctors visits and the abortion pill.

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