Access to comprehensive contraception service


A chara, – As doctors who are providing abortion services in Ireland, the Start group of doctors wishes to respond to the article “Women to have access to free contraception from 2021, says Minister” (News, October 10th).

We are very disappointed at the lack of funding to provide a comprehensive contraception service in the recent budget proposed by the Government. We believe that providing access to a contraceptive method of the woman‘s choice should be a priority for the Minister for Health and this Government. Delaying this for another year is simply not acceptable.

We are working at the front line of reproductive health care within family medicine in Ireland and we can confirm that cost remains a significant barrier to access for many women, particularly those for whom long-acting reversible contraception (LARC) is their method of choice. Failure to fund this is unfair to women and disproportionately affects those who are disadvantaged

We in Start believe that follow up contraception is a fundamental part of any consultation around abortion. It is becoming very clear to us that cost is proving a substantial barrier to accessing contraception, leading to the initial crisis pregnancy and inadequate follow up contraception afterwards. We feel it is anachronous that the State is providing free termination of pregnancy care but is delaying the introduction of free contraception

In the article, the Minister mentions increasing access to condoms and putting vending machines into a number of locations throughout the country. We agree that this is an excellent proposition to reduce the incidence of STIs (sexually transmitted infections) and we also agree that STIs are at a worrying level in our country.

However, condoms are not very reliable if used on their own for contraception. They are user-dependent and carry a failure rate of anything up to 18 per cent.

The Minister also mentions that most forms of contraception, including LARCs, are provided free to those with medical cards. However, one form of LARC, the copper coil, is not free to anyone, whether or not they have a medical card. The copper coil is the most reliable method of emergency contraception but unfortunately it is not readily available. LARCs are among the most cost-effective methods of contraception but the up-front cost can be very prohibitive to women whose income is just above the medical card threshold. They are also the most effective of all methods, up to 20 times more effective than short-acting methods, such as pills.

By ignoring the evidence put forward by this group and others, including the Irish Family Planning Association and the National Women‘s Council of Ireland, the Minister for Health and this Government are allowing a situation to persist whereby the State is abdicating its responsibility to women who simply want to vindicate their right to reproductive healthcare so they can plan their families and contribute to society without fear of unintended pregnancy. – Yours, etc,






On behalf of Start doctors,