Psychiatrists given clear guidelines on abortion law: HSE
The HSE said it has issued "clear guidance" to the heads of mental health services "detailing and clarifying" the roles and responsibilities of psychiatrists in cases where a pregnant woman is seeking an abortion on grounds of suicide risk.
The Protection of Life During Pregnancy Act allows for abortion where a woman is assessed as suicidal on the opinion of two psychiatrists and an obstetrician.
But an internal HSE document, overseen by Philip Crowley, the HSE national director for quality improvement, warned of the failure to always secure a psychiatrist locally to give the necessary second opinion.
In some cases this stage is having to be bypassed and the woman must go before a review panel to assess her case.
Doctors have the right to conscientious objection to be involved. The HSE has previously been warned also of the resource pressures faced by mental health services.
A HSE spokeswoman said the guidelines on the role of psychiatrists were issued to executive clinical directors and heads of mental health services in regions across the country.
Just seven abortions under the risk of suicide clause have been carried out since the legislation came into effect in 2014.
However, the difficulty in always obtaining a second opinion highlights some of the hurdles to be faced in implementing any potential future legislation widening the grounds for abortion, including permitting medical abortions to take place in the first 12 weeks of pregnancy.
It is envisaged that this could be GP-led. But many family doctors' practices are already swamped with patients and some have closed their lists.
Women seeking abortion will need to be counselled and also undergo a scan to date their pregnancy.
Draft proposals by the department envisage that a woman seeking a medical abortion would have to make an initial appointment with a GP to assess the request for an abortion.
There must be extensive counselling and also consent obtained.
She would have to wait another three days before returning again for an abortion pill, which would block the pregnancy hormone necessary for the pregnancy to continue.
One or two days later the woman would need to return to the doctor again for a second pill which causes a form of miscarriage.
This form of abortion is free in the NHS in the UK but costs more than €700 if a woman attends a private clinic.