GPs may decide nine-week limit to allow abortion
Family doctors may decline to provide a medical abortion to a woman who is more than nine weeks' pregnant if access to ultrasound is not available.
Proposed legislation widening the grounds for abortion following repeal of the Eighth Amendment will allow medical terminations up to 12 weeks in pregnancy.
However, draft discussion guidelines from the Irish College of General Practitioners (ICGP) in advance of the legislation warn that it may be difficult to measure how far along the pregnancy is after nine weeks.
In those cases, a scan involving an ultrasound will be needed - but this may not be readily available to the GP.
A draft position paper sent to family doctors by the ICGP pointed to difficulties in correctly measuring gestational age after nine weeks.
A medical abortion involves taking two medications, usually 24 to 48 hours apart, to induce a miscarriage.
One of the issues which the proposed regulation of medical abortion will have to work out is whether a woman who is given the go-ahead for the procedure is dispensed the medication in the GP surgery or whether she will have to go to a pharmacy.
There is currently no consensus among doctors on whether a woman should take the medication at the surgery or at home.
GPs will need to undergo training before becoming involved in the service.
The ICGP document said the second medication could be taken at home as opposed to the doctor's surgery.
However, there will be a need for an emergency helpline to be available to allow her to seek medical advice in the event of complications.
Most women won't experience any problems, but there is a small risk of complications, such as excessive bleeding, infection, some of the pregnancy remaining in the womb or damage to the womb.
GPs can exercise conscientious objection and opt not to provide the service.
However, they have a duty of care to the patient and ensure they are not judgemental while referring her on to a doctor who performs medical abortions.
The Government has promised the new law will become effective in early January.
However, it is unlikely this deadline will be met for several reasons, including the need to train GPs and ensuring that it is not launched during what is the most chaotic month in the year for the health service due to the trolley crisis and the spread of flu.
GPs are normally in the front-line during the post-Christmas rush and would be under even more pressure if a significant number of women came forward seeking the new service.
The legislation is due be debated before the Oireachtas over the autumn and winter months.
The fees to be paid to GPs have yet to be agreed and they are expected to be quite sizeable.