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‘Restrictive law’ forcing women to travel for abortion, doctors warn

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Depressed young woman sitting in chair at home

Depressed young woman sitting in chair at home

Depressed young woman sitting in chair at home

Ireland’s “restrictive” abortion law is forcing women to travel for terminations in cases where babies have conditions which they will “absolutely not” survive, expert doctors have warned.

New research has revealed how Irish doctors are in fear of being prosecuted for getting a diagnosis of fatal foetal abnormality wrong. The new abortion law has also caused tension and conflict in hospitals, and some doctors are struggling to cope with the difficulty of terminating late pregnancies without professional support.

Terminations for fatal foetal abnormalities have only been legal in Ireland since January 2019. Two doctors, including one obstetrician, must agree that the baby’s condition is likely to lead to death during pregnancy or within 28 days of being born.

Over half of doctors specialising in fetal medicine are afraid of being prosecuted or facing “media scrutiny” if they get a diagnosis wrong. Doctors warned there can never be any certainty about when a baby will die, and there is always an outlier case where a baby lives longer than expected.

Ten fetal medicine specialists from five of the six fetal medicine units in Ireland participated in the research led by the Irish Centre for Maternal and Child Health Research (INFANT) at University College Cork. Over half said that the law was too “restrictive,” and was forcing women to travel for conditions that are not “quite fatal enough but [the babies] are absolutely not going to survive.” Doctors said women with severe but not fatal diagnoses were “ostracised.”

Over half also reported struggling with the “psychological burden” of providing late term abortions, with some doctors feeling that they caused the baby’s death. But “almost all” doctors said that they felt justified providing terminations in such cases, with some stating it was the right thing to do.

Doctors also struggled with cases where neonatologists who would refuse to provide palliative care to babies who were born alive after an early induction. In some cases, there was no clarity around “who will look after those babies.” Doctors reported being left “begging people to help” provide palliative care.

In other cases, doctors felt that conscientious objection to abortion from their colleagues was sometimes delaying terminations. Doctors working for hospitals where management objected to abortion did not feel supported. Meetings about cases of fatal foetal abnormalities were described as “contentious,” and there was a “a massive uncomfortableness” and “suspicion” around abortion for cases of fatal foetal abnormalities.

The research, which was published in the British Journal of Obstetrics and Gynaecology (BJOG), said “the legal right to termination of pregnancy does not automatically ensure the provision of appropriate termination of pregnancy care.”

“Our findings advocate for the abolishment of the retained criminal liability attached to the legislation and for the need for legislators to listen and trust foetal medicine specialists in their expert management of pregnancies affected by fatal foetal abnormalities,” it said.

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