Some pregnant women whose unborn baby has been diagnosed with a major foetal abnormality may still have to travel abroad for a termination, according to new guidelines issued to obstetricians.
The guidelines, from the Institute of Obstetricians and Gynaecologists, point out the new abortion law restricts termination in this country to diagnosed foetal abnormalities that are likely to be fatal.
Obstetricians in maternity units across the country were only issued with the guidance on how to manage cases of fatal foetal abnormality under the new abortion law yesterday. It follows the claims made in the Dáil earlier this week that a pregnant woman, who was told by doctors in the Coombe Hospital in Dublin that her unborn child had a fatal foetal abnormality, was refused an abortion.
Confusion remains about the exact details of the case, and the full diagnosis which was given to the woman when she went for a scan at 13 weeks into her pregnancy.
The document makes clear that not all foetal abnormalities can be diagnosed as fatal early on and cases should be discussed by a multi-disciplinary team of doctors to reach a consensus and prognosis.
It lists 14 fatal foetal abnormalities and life-limiting conditions which are highly likely to lead to death in the womb, or in the newborn period in the first 28 days of life.
"The prognosis may become clearer as the pregnancy progresses," the document pointed out.
The document also states that surgical terminations after 12 weeks of pregnancy are unlikely to be "widely available" in maternity services in 2019. This may also be the case for dilation and evacuation after 14 weeks of pregnancy "but this might change over time".
If a pregnant woman has a scan and major foetal anomaly is suspected, she should be referred to a specialist on foetal medicine within 24 to 72 hours.
Last Thursday, the Dáil was told by Solidarity TD Ruth Coppinger and People Before Profit TD Brid Smith the woman who was attending the Coombe was informed the organs of the foetus were outside the body.
They said the woman was advised to wait a number of weeks for to see if she had a "spontaneous miscarriage".
Women who are turned down by doctors for an abortion have the right under legislation to apply for a review under the new law with different specialists deciding their case. The Coombe is providing terminations to women who seek a termination after a diagnosed fatal foetal abnormality which has been certified by doctors under the new legislation.
The Coombe Hospital has had to limit the full range of services it is providing under the new law since January 1. It has informed the HSE it hopes to be able to provide a full service in the first week in February. Chief Medical Officer Dr Tony Holohan has told obstetricians that doctors carrying out terminations under the new law will not be prosecuted.
The Association for the Improvement of Maternity Services in Ireland has also called on the Rotunda and National Maternity Hospital to accept referrals for abortions from outside their catchment areas.