Sir, – In discussions in media, social media and in conversations with colleagues, I am hearing recurring themes regarding the provision of abortion services. There appears to be little progress on planning, training and resourcing of care pathways. The timeframe for implementation seems unrealistic. In addition there is a sense that with an overburdened health service there is little appetite to increase the workload further.
There has been a focus on doctors who are conscientious objectors. I think there are a much greater number of doctors who think there should be a service available but as a separate service, “somewhere else”. The World Health Organisation Clinical Practice Handbook for Safe Abortion recognises that abortion can be provided safely in different settings. Our primary care services (general practice) and local hospitals would be able to provide these services safely with adequate resources and training. This would minimise barriers, particularly for women in rural areas. There are doctors who are interested in providing care within the existing health service and have developed evidence-based guidelines for this. Doctors who are willing to be conscientious providers need to be supported.
There is a sense, however, that abortion services should not be accessible within our existing services, despite the fact that 66.4 per cent of us voted to repeal the Eighth Amendment. The views I have heard expressed are that women in this situation should be referred to “other” services which would provide abortions, to “other” doctors for early medical abortion (tablets), to “other” sonographers not in our hospitals to carry out ultrasound in the cases where it is necessary, and to “other” health facilities for surgical abortions. Is this because these are “other” women, to be treated differently to anyone else in need of healthcare? – Yours, etc,
Dr JULIANNE REIDY,