Doctor agrees to take up abortion post at Portlaoise hospital

A doctor has finally been recruited to carry out pregnancy terminations in Portlaoise hospital more than four years after abortion was legalised in Ireland according to an independent report into the effectiveness of the nation's abortion laws.

The review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018 by Independent Chair Marie O’Shea was completed in February 2023 and published by the Minister for Health. 

Government policy is that termination of pregnancy services should be provided in all nineteen maternity hospitals. The new report found that as of February 2023, the Midland Regional Hospital Portlaoise was one of eight hospitals with maternity units not fully engaged with the termination of pregnancy services as mandated. Mullingar was the only midland hospital to provide services as mandated under laws that resulted from the abortion referendum.

However, the new report says that the Department of Health confirmed in January 2023 that a candidate has been appointed to Portlaoise hospital with a start date agreed. On the basis that lead time to the recruitment of medical practitioners is approximately one year, the report predicts that the Portlaoise maternity unit and four others will begin providing services in 2023.

The report also highlights that there were 185 terminations recorded in Laois between 2019 to the end of 2021 where four GP practices provide termination services.

The report says data shows that in some areas of the country, particularly in the southeast, northwest, midlands and border counties, women are depending on very low numbers of providing GPs, which makes for "extremely tenuous service provision, at risk of ceasing altogether were the provider to withdraw the service".

One of the key recommendations the report calls for the removal of the current mandatory three-day waiting period between the certification of a termination of pregnancy and the procedure taking place.

The report says the uneven distribution and shortage of services, particularly in the southeast, northwest, midlands and border counties, has required women in those areas to travel, sometimes long distances by public transport, at significant cost, to access a providing GP. The report says the mandatory three-day wait between the first and second appointments compounds this problem. Both issues also present logistical problems for women, particularly those who are time constrained.

It also recommends that the Department of Health engage with stakeholders to obtain a better understanding of the difficulties in making diagnoses relating to whether the condition of the foetus will lead to death in utero or within 28 days of birth.

It has also called for the development of ministerial guidelines to provide clarity on the thresholds of 'risk' to the life or 'serious harm' to the pregnant woman.

The report added that the Department of Health should amend the legislation to acknowledge it may be difficult to predict whether a termination would avert the risk to a woman’s life or health.

In response, Cabinet has agreed to refer the recommendations proposing legislative change to the Joint Committee on Health for its consideration.

The Health Service Executive (HSE) will establish an implementation group to deliver the operational recommendations.

Expanded access to abortion was brought into law in Ireland following a referendum which repealed the eighth amendment of the constitution in 2018.

Big expansion of Portlaoise's Midlands Prison floated by Government

Prior to the referendum, termination of pregnancy could only be performed where there was a risk to the life of the mother.