Access to Safe Abortion Services in Ireland 

Background:

In May 2018, a historic referendum in the Republic of Ireland repealed the 8th Amendment to the Irish Constitution that had rendered abortions unconstitutional since 1983. The Health (Regulation of Termination of Pregnancy) Act of 2018 legalised abortions in Ireland on 20 December 2018 (Mishtal et al., 2021). Under this Act, abortion are now available on request for those under the gestational age of 12 weeks (under Section 12); at any gestational age including over 12 weeks if they pose a risk to the life or a risk of significant harm to the health of the woman (including emergency scenarios) under Sections 9 and 10; at any gestational age can be provided under Section 11 of the legislation in cases of fatal foetal anomalies. 

Abortions in the first trimester (9 weeks plus 6 days) are carried out in the community setting, primarily by General Practitioners in Family Practices and in five family planning clinics in County Dublin. Cases from 10 weeks to 12 weeks plus 0 days are carried out in hospitals with maternity units by Obstetricians and Gynaecologists where medical or surgical abortions can be provided. The Act is currently undergoing a review after a period of 3 years in practice. 

The Study:

Between 2020 and April 2021, a multi-disciplinary team of four social scientists, one historian with experience in qualitative research, three General Practitioners in Ireland, three ObGyns carried out a research funded by the World Health Organization to study the factors that account for implementation, scale-up and sustainability of an expanded abortion service in Ireland following legalisation (Mishtal et al., 2021). It identified the facilitators and barriers to policy implementation and the gaps in existing policy that affected service users' access to abortion services in the country. We collected 108 in-depth interviews (58 - healthcare providers; 30 - service users; 27 - key informants) and conducted secondary and internet based research for the purposes of the study. 

Dissemination: 

The results were disseminated in a National Workshop held on 23 April 2021. We have also presented the results at National Women's Council of Ireland's Abortion Working Committee's Meeting. We have used the results from this study to make a submission for the ongoing consultation for the Three Year Review of the Health (Regulation of Termination of Pregnancy) Act of 2018. We have also published 5 peer-reviewed articles in different journals including PLOS One, Social Science and Medicine - Population Health, Social Science and Medicine - Qualitative Research in Health, Women's Studies International Forum, and Sexual and Reproductive Health Matters.