Abortion system could collapse, finds researcher – The Irish Times

Elements of Ireland’s abortion system are “unsustainable” in their current form and the service could collapse, according to a researcher involved in a review of the state’s laws on abortion.

dr Deirdre Duffy, now at Lancaster University, and a team of researchers from Manchester Metropolitan University were commissioned by the government to conduct a study examining the experience of abortion service providers such as hospital staff and GPs.

Her research has identified issues related to conscientious objector guidelines, as well as deficiencies in the dissemination of services available across the country and the availability of staff and facilities in hospitals.

This work should form an essential part of the review of the Health (Regulation of Termination of Pregnancy) Act 2018 which has now been sent to Health Secretary Stephen Donnelly.

When the original Access to Abortion Treatment Act went into effect, the government decided that it would have three years to review how effectively the system was working. It looked at the experiences of women and service providers and there was also a public consultation. The overall review, chaired by attorney Marie O’Shea, also assessed the extent to which the objectives of the law have been met.

The research on the experiences of women using the service was released before the broader review was completed, but Dr. Duffy’s contribution to this has not yet been published.

About her research into the system, Dr. Duffy: “There are parts where I have real concerns that the service might collapse because it’s just not sustainable in its current form. It’s an advisor-led service and there aren’t very many advisors.”

[ Review calls for Ireland’s abortion rules to be relaxed ]

dr Duffy and her team spoke to healthcare providers across the country, including midwives and consultants at hospitals that perform and do not perform abortions. She also conducted a survey of GPs to identify some of the reasons why they don’t provide such services.

“Zip Code Lottery”

When asked for her assessment of the current provision of abortion services based on her research so far, she said: ‘It’s better than before the referendum, but it’s a postcode lottery. It can fall down in so many areas. It is unfair.”

Regarding conscientious objection, she said there are regulations and guidance, but her research had found evidence that conscientious objection was interpreted in various ways, which was inconsistent with those regulations.

“When someone breaches their duties in a hospital, it’s almost impossible to challenge them. For example, if you remove someone from the station for unprofessional behavior, there may not be anyone there to fill their post,” she said. “There is a lack of consistent handling of conscientious objection.”

dr Duffy said availability of facilities and staff is a major issue and there are cases of people being sent back from operating rooms or access to abortions “timed out” because of this. Details of these cases were included in their research.

[ Donnelly receives final report on review of State’s abortion laws ]

She said there was “complete confusion” about how many GPs actually offer abortion services. She also highlighted issues with staff being given sufficient time and the size of the workforce.

“As researchers, including myself, have asked, who handles patient referral calls from the community? They could be for scans or complex needs, it could be a person on a part-time job taking the RV away on weekends or holidays. But what if they get sick? There is no thought about how to have excellent service.”

She added that there were problems with abortion referrals under Section 9 of the law, which allows abortion to be performed when there is a risk to the woman’s life or serious harm.

“There is very limited guidance and no stable pathway for mental health applications,” she said. “There’s no thinking about how to lead multidisciplinary teams.”