Minister for Health welcomes the enactment of the Health (Regulation of Termination of Pregnancy) Act 2018

Minister for Health, Simon Harris TD, today welcomed the enactment of the Health (Regulation of Termination of Pregnancy) Act 2018.

The Minister described the enactment of the legislation as:

He added that:

The legislation permits termination of pregnancy to be carried out where there is a risk to the life or of serious harm to the health of the pregnant woman, in an emergency situation where such a risk is immediate, where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth, and without restriction up to 12 weeks of pregnancy.

It is envisaged that most terminations, up to 9 weeks of pregnancy, will take place in the community setting. A small number of these terminations will need to take place in maternity hospitals for medical reasons. All terminations after 9 weeks of pregnancy will take place in maternity hospitals.

Preparations for the service are currently being finalised and details of the information and counselling helpline for termination of pregnancy will be available at myoptions.ie. People experiencing an unplanned pregnancy are encouraged to contact the My Options counselling service. Counsellors can provide information on where women can access termination of pregnancy services.

Helen Deely, Programme Lead of the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP), outlined the supports offered by the My Options counselling service, saying:

Minister Harris said:

ENDS

Key Messages

• use contraception
• if you have had unprotected sex or your contraception failed — seek emergency contraception (Emergency Hormonal Contraception or IUD) urgently from your pharmacist
• if you think you may be pregnant — take a pregnancy test as soon as possible
• if this is an unplanned pregnancy — seek counselling and explore your options as soon as possible
• if you want a termination — visit a GP or Family Planning Clinic as soon as possible

Termination of pregnancy in the public health service – frequently asked questions

1. When will the expanded service for termination of pregnancy be available?

The Health (Regulation of Termination of Pregnancy) Act Act 2018, which allows for the introduction of the service for termination of pregnancy, was enacted on the 20th of December. The service for termination of pregnancy will be available from January 2019.

2. Under what circumstances can a woman have a termination?

The legislation permits terminations to be carried out up to 12 weeks of pregnancy or where there is a risk to the life, or of serious harm to the health, of the pregnant woman; or where there is a risk to the life, or of serious harm to the health, of the pregnant woman in an emergency; or where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth.

3. A woman is pregnant (up to 12 weeks) and wants a termination — what should she do?

She should attend a community-based medical practitioner (e.g., a GP or a clinic) as soon as possible. Information on GPs/clinics that are providing the service will be available from the HSE’s ‘My Options’ helpline service for termination of pregnancy. A termination of pregnancy is a time-sensitive procedure so it is vital to access the service as early as possible in the pregnancy.

4. Where can a woman have a termination?

Most terminations, up to 9 weeks of pregnancy, will take place in the community setting. A small number of these terminations will need to take place in maternity hospitals for medical reasons. All terminations after 9 weeks of pregnancy will take place in maternity hospitals. In the first instance, the pregnant woman will need to contact a GP or a clinic that is providing the service and, if necessary, she will be referred to a maternity hospital for a termination.

5. How many visits to the medical practitioner will she need?

For terminations up to 9 weeks of pregnancy, two visits to a medical practitioner will be required due to the 3-day waiting period specified in the legislation. A third visit to a medical practitioner will be offered for aftercare. If the woman is between 9 and 12 weeks pregnant, her community-based medical practitioner (e.g., a GP) will refer her to a maternity hospital.

It is important to note that the 3-day waiting period applies to all terminations up to 12 weeks of pregnancy, regardless of whether the termination takes place in the community or a maternity hospital.

There is no waiting period required in cases where a termination is needed in an emergency, where there is a risk to the life or of serious harm to the health of the woman; or where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth.

6. A woman decides to proceed with a termination — why does she have to wait 3 days?

Under the legislation, for terminations up to 12 weeks of pregnancy, a 3-day period must elapse between the medical practitioner certifying that the pregnancy has not exceeded 12 weeks and the termination being carried out. This requirement is not unusual; several countries in Europe, including Belgium, Germany and the Netherlands, have similar provisions. For the purposes of the legislation, 12 weeks of pregnancy is dated from the first day of a woman’s last menstrual period, in line with normal medical principles.

7. Can a woman go direct to the maternity hospital for a termination (up to 12 weeks of pregnancy)?

No. She must attend a community-based medical practitioner (e.g., a GP) who will refer her to the maternity hospital, if necessary.

8. A woman is more than 12 weeks pregnant — can she have a termination?

Yes, but only where there is a risk to the woman’s life or of serious harm to her health; where there is a risk to the woman’s life or of serious harm to her health in an emergency; or where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth. The legislation sets out the number of medical practitioners involved and the criteria that must be met to allow a termination of pregnancy to be carried out in each of these situations.

9. What is the difference between a medical and a surgical termination?

A medical termination uses two medications, usually taken 24 to 48 hours apart, whereas, a surgical termination involves a procedure carried out, under anaesthetic, in a maternity hospital.

10. Will a woman have a medical or surgical termination?

While most terminations will be medical, in line with best and safest practice, some women, in consultation with their medical practitioner, may have a surgical termination in hospital.

11. Can a medical practitioner refuse to carry out a termination of pregnancy because they have a conscientious objection?

Yes. Under the legislation, a medical practitioner, nurse or midwife is not obliged to carry out, or to participate in carrying out, a termination of pregnancy if they have a conscientious objection. However, they must arrange for the transfer of the care of the pregnant woman, as soon as possible, so she can avail of a termination. The conscientious objection provision does not apply in an emergency.

12. Can a medical practitioner refuse to carry out a termination of pregnancy for reasons other than conscientious objection?

Yes. A medical practitioner will be unable to carry out a termination if, in his or her reasonable opinion, the criteria set out in the legislation are not met.

13. A medical practitioner refuses to carry out a termination of pregnancy — can this decision be reviewed?

Yes. The woman may seek a second opinion or she may apply to the HSE for a review where a medical practitioner refuses to carry out a termination of pregnancy or does not give an opinion. This review provision only applies where there is a risk of serious harm to the health of the woman; or where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth (i.e. under sections 9 and 11 of the legislation).

14. How much does a termination cost?

A termination of pregnancy will be free, under the public health service, for women ordinarily resident in the State. Additional medicines, such as analgesics and antibiotics will be subject to existing eligibility frameworks. If a woman chooses to access the service privately she will have to pay the full cost associated with the procedure.