Women seeking an abortion during the coronavirus outbreak will not need to visit a GP in most cases, under guidelines issued by the Department of Health on Tuesday evening.
The emergency provisions, to apply only for the duration of the Covid-19 emergency, dispense with the requirement for women to make two GP visits, three days apart, to access an early medical abortion.
“In the current situation, where the need for social distancing, reducing personal contacts and reducing the burden on medical practitioners are paramount, it may not be possible or advisable for a woman to attend a medical practitioner in person to access termination in early pregnancy,” say the guidelines.
Remote consultations – either by phone or video-call – may take place for both consultations. A doctor, in some cases, may deem it necessary that at least one of the consultations take place in person, but these “should be kept to a minimum during the Covid-19 public health emergency”.
GP sources on Tuesday welcomed the "revised model of care" almost two weeks after Minister for Health Simon Harris said concerns about women's access to abortion during the crisis were being addressed.
One GP, from the south of the country, said she and her colleagues had been working “in a vacuum” for the past fortnight as these guidelines had been promised but seemed to be delayed. Others had warned women were delaying visiting their GP for abortion services due to difficulties attending two appointments days apart.
“This will provide certainty for women and doctors and ensure abortion services are sustainable during the crisis,” said one.
Under the revised guidelines, where the woman is nine weeks and six days pregnant, remote consultations will replace both GP visits in almost all cases.
The first will involve certification that the pregnancy is less than 10 weeks, referral for ultrasound where there is doubt about dates and referral to hospital if the woman is between 10 and 12 weeks.
During the second consultation, abortion medication – mifepristone and misoprostol – is prescribed along with instructions on how to take these, one to two days apart. Also prescribed are pain relief and a pregnancy test to take after the termination.
“Arrangements must be made for collection of medications, low-sensitivity pregnancy test, any prescriptions and the written information set out above.
“Collection is also permitted by a nominated individual or courier. Where a nominated person is collecting the medication, his/her details should be provided by the patient in advance so they can be recorded and verified when medications are supplied,” says the document.
A third, post-termination consultation is optional and may also take place remotely.
Where the woman is 10-12 weeks pregnant she will be referred to a hospital following a first remote consultation with a GP. She will attend and take the first abortion medication. She will return to the hospital one or two days later to take the second medication and will be monitored for up to eight hours or overnight to ensure the termination completes.
Under the Termination of Pregnancy Act 2018 a woman may seek a medical abortion, without giving a reason, in the first 12 weeks of pregnancy.