Coronavirus: Concern crisis could prevent timely access to abortion services

Doctors and women’s groups are concerned that timely access to abortion services could be compromised during the coronavirus outbreak.

They say the legal requirement that a woman seeking an early medical abortion (before 12 weeks) must make two GP visits, three days apart, is “irreconcilable” with current public health advice to avoid all but essential travel.

With some doctors reporting "difficulties" providing abortion services, women's health organisations say Minister for Health Simon Harris must provide a direction that one of the medical consultations can be done over the phone. They say travel for an abortion after 12 weeks must be classified as "essential travel" during the crisis.

In a letter to the Minister, six organisations, including the National Women’s Council of Ireland (NWCI) and the National Traveller Women’s Forum, call for “urgent measures”.

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“Mandating two face-to-face appointments is not in alignment with government policy to restrict travel and social interactions.” they wrote.

“It poses risks to patients and staff of transmitting Covid and reduces availability of providers, as it precludes those providers who are self-isolating but well from providing the service whilst working remotely.”

They call for “legislative or other measures to enable abortion services to continue during the Covid-19 outbreak” and to “make provision for remote consultation in accordance with public health guidance and home administration of both abortion medications (mifepristone and misoprostol)”.

Increase

The Dublin Well Woman Centre, which has three clinics in the capital, has seen a "significant increase" in the number of women seeking abortion services in the last two weeks, says chief executive Alison Begas.

“This is probably down to the pressure GPs are under managing the coronavirus outbreak.”

She said the clinics had reconfigured services in the past fortnight to minimise the needed for women to visit in person.

The organisation has also been in contact with the HSE seeking clarification on if the first medical consultation for early abortion could be delivered over the phone. They were yet to hear back, Ms Begas said.

Dr Caitríona Henchion, medical director with the Irish Family Planning Association, said, “The current model of early abortion care requires a lot of contact time. This is not ideal in this environment, and is causing difficulties for both doctors and pregnant women.”

Out of order

A series of Opposition amendments to allow for telemedicine in the context of abortion services during the crisis were ruled out of order on Thursday, when the Dáil was debating emergency Covid-19 legislation.

Amendments put forward by Sinn Féin, the Social Democrats and Solidarity-People Before Profit were deemed “not relevant to the provisions of the Bill”.

Orla O’Connor, director of the National Women’s Council of Ireland (NWCI), said: “Amendments to the emergency Bill, specifically providing for remote consultations, would have been very helpful in providing immediate certainty to women.

“However, NWCI believes the provision of remote abortion care in accordance with public health guidance is still possible within our current legislation.

“Examination of the pregnant woman as described in the Termination of Pregnancy Act could include remote examination and we are asking for guidance to be given to healthcare professionals to clarify this.”

Mr Harris said his officials and the HSE were “working together with some urgency to revise the model of care for termination of pregnancy services” so that “only ...for the duration of the Covid-19 pandemic... remote consultation with a medical practitioner will be permissible”.

He did not indicate when this would commence.