Legality of abortion scheme in doubt

The Government is prepared to seek legal advice if Irish women seek abortions under a home abortion pill programme due to be launched shortly in Britain.

A pilot project to allow women have terminations at home using an abortion pill is planned by the British Pregnancy Advisory Service (BPAS), one of the UK's largest pregnancy advisory agencies.

A spokeswoman for the BPAS confirmed to The Irish Times last night that it had sought approval from the British Department of Health to conduct a trial on allowing women to take the second abortion pill at home.

However, the spokeswoman said that, while protocols to govern the trial had not been agreed, given the potential legal difficulties in Ireland it may be that Irish women participating in the programme may have to remain in the UK while taking the pills.

Last night, the Department of Health said the Government would assess what was involved in the proposed trial and would seek legal advice if considered necessary.

In a statement, it said that termination of pregnancy in Ireland was not legal unless it met the conditions set down by the Supreme Court in the "X" case, where there was a substantial risk to the life and health of the mother.

"The question of the prescription and administration of [the abortion pill] RU486 to Irish women who have travelled to the United Kingdom for an abortion would require detailed consideration, especially in the context of the prevailing legal environment governing abortion in Ireland. Ultimately, the need for legal advice would also have to be assessed where the issue of such Irish women being prescribed RU486 arose," the Department of Health said in a statement.

The Department said information on abortion services could be provided within the terms of legislation introduced in 1995 and that women could travel abroad for an abortion.

The spokeswoman for the BPAS said that no agreement had been reached on a date for the commencement of the trial.

It is expected that any legal advice sought by the Department of Health would seek to address the potential conflict between a woman's right to travel to seek an abortion and the possibility that she would be committing an offence if she took an abortion pill in Ireland.

The BPAS, which carries out a quarter of all terminations in the UK, has sought approval from the British Department of Health to conduct a trial allowing women to take the second of a two-stage course of abortion pills without medical supervision in their own home.

At present, the two abortion pills, which terminate pregnancies of up to nine weeks, have to be administered two days apart in a clinic or hospital.

The plan prompted reports at the weekend that Irish women participating in the scheme would be able to take the second pill back to Ireland and carry out abortions themselves at home.

Abortion procedures

Up to nine weeks gestation: early medical abortion involves the use of drugs to cause a miscarriage. Mifepristone - an anti-progestogen drug - blocks the action of the hormone that makes the lining of the womb hold on to the fertilised egg.

Misoprostol, given 48 hours later, causes the womb to contract. The lining of the womb breaks down and the embryo is discharged as bleeding takes places. Early medical abortion does not require an anaesthetic.

Five to 15 weeks of pregnancy: vacuum aspiration literally involves a suctioning of the womb. A thin plastic tube is inserted through the neck of the womb and either an electric vacuum applied or a hand-held plastic syringe used to evacuate the uterine contents. Dilatation of the neck of the womb is also required after nine weeks' gestation. A local or general anaesthetic is used.

Thirteen to 22 weeks of pregnancy: surgical dilatation and evacuation (D&E), which unlike a D&C does not include the use of a sharp instrument to scrape out the lining of the womb. Usually involves a general anaesthetic.

Twenty to 24 weeks: late medical abortions involve the use of misoprostol alone or in combination with mifepristone, given more than once. Drugs may also be injected directly into the womb. A local anaesthetic is required.

Complications: The medical complications of abortion include bleeding, infection, incomplete abortion, laceration of the neck of the womb, perforation of the womb and the possibility of a clot travelling to another part of the body.

The later the abortion the greater the risk of side effects. The rate of complication is 3-5 per cent after 12 weeks with a death rate of 9 to 12 women per 100,000.