HSE hospitals are lacking in abortion access, new report finds

Just over half of HSE hospitals have been providing termination services, finds the Unplanned Pregnancy and Abortion Care report.

Picture shows the Rotunda hospital, one of the 11 hospitals offering abortion access.
Image: Wikipedia

A study commissioned by the HSE Sexual Health and Crisis Pregnancy Programme has been released, providing details on abortion access and individuals’ experiences when using abortion services. The study, Unplanned Pregnancy and Abortion Care (UnPaC) was conducted by Dr Catherine Conlon of the School of Social Work and Social Policy at Trinity College Dublin.

The study monitors the provision of reproductive healthcare since the Regulation of Termination of Pregnancy Act was introduced in 2019.

It found that whilst most people were satisfied with the care they received from their primary care providers, many barriers persist in finding appointments as they are not universally or transparently provided by all GPs.

The primary issue identified in the report is the provision of abortion services. At present, only 10 out of 19 HSE hospitals provide abortion services. Women found that practitioners opting for conscientious objections, which legislation permits, has remained a significant barrier to abortion for participants in rural areas.

Those interviewed for the report described their “shock” when discovering the limited availability of providers in their area. Some women were forced to travel long distances for GP access, another issue for those without access to their own vehicles.

The location of maternity services was also concerning for those participating, forcing those accessing abortion to encounter pregnant women and babies. Those that took place outside of these settings were also considered disconcerting, with some describing it as being pushed to the “nether regions” of the hospital. 

When asked about the three-day waiting period, many people saw it simply as a legal barrier, whereas others saw it as a distressing deterrent to care.

12 individuals in the study sought abortion care after 12 weeks gestation, with each receiving a diagnosis of a fatal foetal abnormality. A particular concern was not being “fatal enough” and having to travel abroad to access healthcare. The current legislation was described as having a “chilling” effect on interactions and openness between clinicians and those accessing services during the assessment process.

Conlon notes that “not qualifying for care in Ireland signified the denial of care, and travelling to access termination abroad was associated with shame, stigma and judgment.”

The report comes after the Cabinet has decided to move forward with the proposed Safe Access Zones which would prevent anti-abortion protestors from being within 100-metres of a healthcare facility carrying out abortions.

The Minister for Health, Stephen Donnelly has said the law will come into place later this year and he believes this will encourage an increase in abortion provision.

“At the start of this year, only 10 of the 19 HSE hospitals were providing termination services. In my view, it needs to be all 19. By the end of this year, we’ll be at either 14 or 15, so there will be a very big increase this year,” he said. “There’s still a very small number of GPs involved for various reasons.”

Figures published earlier this month showed that the number of abortions reported to the Department of Health last year fell to 4,577, some 2,000 fewer than in 2020, though some sources questioned the accuracy of writing during the pandemic.

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