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Working in the shadows, under the spotlight – Reflections on lessons learnt in the Republic of Ireland after the first 18 months of more liberal Abortion Care

2020; Elsevier BV; Volume: 102; Issue: 5 Linguagem: Inglês

10.1016/j.contraception.2020.07.003

1879-0518

Aoife Mullally, Trish Horgan, Miles Thompson, Catherine Conlon, Brendan Dempsey, Mary Higgins,

Maternal and Perinatal Health Interventions

In January 2019, abortion care became more widely available in the Republic of Ireland (ROI). Prior to this abortion was only available when there was a "significant risk to the life of the mother" due to either physical or mental health conditions [ [1] Protection of Life During Pregnancy Act 2013, Government of Ireland. Available at http://www.irishstatutebook.ie/eli/2013/act/35/enacted/en/pdf (retrieved January 13th 2020). Google Scholar ], resulting in about 25 legal abortions occurring every year [ [2] Cullen P, "24 legal abortions recorded in Ireland last year" Irish Times, June 29, 2017. Available at https://www.irishtimes.com/news/health/25-legal-abortions-recorded-in-ireland-last-year-1.3138006 (retrieved January 13th 2020). Google Scholar ]. Following a public referendum in 2018 that allowed a constitutional change, abortion is permitted in four specific circumstances [ [3] Health (Termination of Pregnancy) Act 2018, Government of Ireland. Available at http://www.irishstatutebook.ie/eli/2018/act/31/enacted/en/html (retrieved January 13th 2020). Google Scholar ]. These include abortion under 12 weeks gestation (12+0) for any reason, and later in pregnancy if there is significant risk to the life or health of the pregnant person or in the case of a "fatal fetal abnormality" where the fetus had a condition likely to lead to death within pregnancy or the first 28 days of life. Clinicians wrote guidelines in first trimester abortion [ [4] Interim Clinical Guidance –Termination of Pregnancy under 12 weeks – Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland. Available at https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2018/12/FINAL-INTERIM-CLINICAL-GUIDANCE-TOP-12WEEKS.pdf (Retrieved January 13th 2020). Google Scholar ], medical conditions [ [5] Interim Clinical Guidance - Risk to Life or Health of a Pregnant Woman in relation to Termination of Pregnancy. Available at https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2019/05/FINAL-DRAFT-TOP-GUIDANCE-RISK-TO-LIFE-OR-HEALTH-OF-A-PREGNANT-WOMAN-220519-FOR-CIRCULATION.pdf (Retrieved January 13th 2020). Google Scholar ] or fetal anomalies [ [6] Interim Clinical Guidance – Pathway for Management of Fatal Fetal Abnormalities and/or Life Limiting Conditions Diagnosed during Pregnancy –Termination of Pregnancy. Available at https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2019/01/IOG-TOPFA-PATHWAY-FINAL-180119.pdf (Retrieved January 13th 2020). Google Scholar ].