Sunday 21 July 2019

GPs must warn women of medical abortion failure rate, say new guidelines

Concerns: Medical director of the ICGP Dr Tony Cox. Photo: Tony Gavin
Concerns: Medical director of the ICGP Dr Tony Cox. Photo: Tony Gavin
Eilish O'Regan

Eilish O'Regan

GPs have been told to inform every woman who is about to have a medical abortion that it has a failure rate and that unrestricted termination cannot be provided beyond 12 weeks of pregnancy.

The advice is outlined in a set of interim guidelines issued to GPs by the Irish College of General Practitioners (ICGP) in advance of the wider availability of abortion, due to come into effect on January 1.

The guidelines give step-by-step advice to GPs to provide safe care to women and reduce complications.

Medical abortion involves a woman taking two tablets and has a failure rate of less than 1pc. She will not know for about two weeks after she has undergone the procedure if it has failed - in which case, she may be outside the legal limit for a termination.

In that case, she is advised to go to a maternity hospital to discuss her options.

President Michael D Higgins is expected to sign the Health (Regulation of Termination of Pregnancy) Bill into law today.

It is understood that at least one GP in every county is now trained in medical abortion, which they can perform up to nine weeks of pregnancy.

A woman who is between nine and 12 weeks pregnant must go to a maternity hospital for a termination.

However, Dr Tony Cox, medical director of the ICGP, said the training body had "written to the Minister for Health Simon Harris to express its concerns at the lack of clarity around referral pathways" to maternity hospitals when required.

It is still unclear which maternity hospitals will provide a service and what the range will be.

"Furthermore, the ICGP has highlighted the concerns of those members with conscientious objections to providing this service," he said.

"The ICGP will continue to provide training workshops and online support, as well as mentoring, in the coming year.

"Furthermore, the ICGP has highlighted the concerns of those members with conscientious objections to providing this service."

He said they also reiterated that the 24-hour helpline to counsel and direct women to the nearest provider must be operational by January 1.

The guidelines give the timelines, involving the three-day pause which must be observed from the point a woman first seeks a termination.

If her first visit to the GP is on Monday, the procedure can start on Thursday.

The first day of operation of the new law is Wednesday, January 2. A woman could begin taking medication for an abortion on the Saturday.

A spokeswoman for Mr Harris said that the HSE had told the minister it had made arrangements with the primary care radiology providers to increase availability of ultrasounds.

In addition, the minister has been advised that hospitals have been asked to provide short to medium-term solutions, as appropriate, to provide additional ultrasounds.

"The referral pathways form part of the model of care and the minister is advised by the HSE this will be available this week.

"The minister fully supports conscientious objection."

The helpline, which will be called My Options, will be fully functional by January 1. It will be manned by counsellors, but will have the support of nurses.

The helpline will offer the woman information on all her options, including a termination.

Irish Independent

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