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Clare Daly Ts at today's meeting. Oireachtas.ie
AS IT HAPPENED

'These are the cases that keep us up at night' - GPs tell politicians about crisis pregnancy

The Irish College General Practitioners were speaking at today’s Eighth Amendment Committee meeting.

THE OIREACHTAS EIGHTH Amendment committee had a long and fractious day yesterday.

Two of Ireland’s top obstetricians gave their hard-earned insights into the effects of the Eighth Amendment on healthcare in Ireland.

There was also tense scenes as Senator Rónán Mullen claimed that the committee and its guests were imbalanced.

Despite all that, the committee was back today and is scheduled to hear from the Irish College of General Practitioners about how GPs deal with crisis pregnancy.

This is how it went.

Hello, Rónán Duffy here again for today’s meeting.

They’re currently meeting in private session but should be getting started soon. In the meantime, we can catch up on what’s been going on.

Yesterday’s meeting saw plenty happening and you can catch up here.

But in brief, Dr Rhona Mahony of the National Maternity Hospital told members that the Eighth Amendment clouded doctors making decisions.

“There are no other areas where people are charged with making medical decisions under the shadow of a custodial sentence of 14 years,” she said.

Professor Fergal Malone of the Rotunda Hospital explained the difficulties in determining viability in cases of fatal foetal abnormality.

“The doctor and the patient are best placed to make that decision,” he said.

There were also some angry exchanges yesterday when Senator Rónán Mullen complained that he was not being given enough time to ask his questions.

He went on to claim that there was  an “imbalance” on both the views of the members and those invited before the committee.

There has since been talk that Mullen and Mattie McGrath TD may withdraw from the committee and both are to make a public statement on the matter later today.

“Deputy Mattie McGrath and Senator Rónán Mullen will be releasing a statement this afternoon relating to their participation in the Oireachtas Committee on the Eighth Amendment,” a press advisory from the pair said today.

The proceedings are now underway with Senator Catherine Noone telling the meeting that the HSE’s Janice Donlon will not be appearing because of a health issue.

Dr Brendan O’Shea of the ICGP is outlining some of the scenarios encountered by GPs in cases of unplanned pregnancies.

“Every crisis pregnancy is different…. However, the approach taken by the doctor to manage the crisis pregancy is the same,” he says.

He says among the main goals for doctors are to maintain trust and to explain options for their patients.

O’Shea says that options for women in cases or crisis pregnancy are to continue with the pregnancy, have an abortion or to put the child up for adoption.

Although he notes that the third option is rare.

O’Shea says that if a GP has a conscientious objection to the option chosen, they must make this clear to the patient.

He also says that while GPs can advise on travelling for an abortion, they cannot make the appointment for the patient.

PastedImage-47211 Dr Karena Handley. Oireachtas.ie Oireachtas.ie

Dr Karena Handley is now speaking about women who procure abortion pills online.

She says that criminalisation must be looked at as it may prevent women seeking medical care.

O’Shea says that Irish women are using abortion services and that “we must deal with it more effectively as a society.”

Jan O’Sullivan TD is asking the GPs about the availability of contraception in Ireland and wants to know if they could be made more available.

She is also seeking their opinion on so-called “rogue agencies” in cases of pregnancy.

Hanley says there are agencies out there that have “an agenda” and seek to heavily influence the decision.

O’Shea adds that women “are encouraged to take their time and delay and delay” by those rogue agencies.

He says that in such situations of early pregnancy, delaying a decision may pose issues.

Clare Daly TD is asking GPs “what’s the best way” of getting access to better care for women.

She asks would it be providing access to abortion up to 12 weeks.

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Daly says it may make “perfect sense” for women to be able to be prescribed abortion pills from GPs.

O’Shea says that it is certainly the case that studies in the UK show that Irish women usually secure an abortion later during pregnancy, likely due to Irish laws.

“We know for example that, from British figures, when Irish women have termination in Britain, they tend to be several weeks later,” he says.

Daly then asks both GPs if there are any other scenarios where criminalisation, such is the case with abortion, interferes with the discussion between GPs and their patients.

Both agree that there is no such other situation.

Lisa Chambers TD asks the GPs if the Eighth Amendment and the Protection of Life During Pregnancy Act as they currently stand present a risk to the health of women.

“Yes,” is Brendan O’Shea’s short response.

O’Shea says that the requirement to travel adds a significant level of extra risk to women in cases of crisis pregnancy.

Apart from the delay which causes its own risk, there is a psychological risk that goes along with issues such as raising money and planning etc.

He adds that in cases of crisis pregnancy, it may be the cases that normal support structures a woman has will not be in place because they have not told friends, family etc.

Senator Lynn Ruane is asking about the rogue agencies and wants to know how we “set a standard” in terms of pregnancy counselling.

She feels a national framework for pregnancy counselling is needed.

Dr Karena Hanley says that there a multiple ways of educating GPs and that they are encouraged to keep up to date with best practice.

The ICGP says that greater regulation of crisis pregnancy agencies is needed.

Dr Karena Hanley say that IGCP would be in a position to provide guidance if required.

Kate O’Connell TD asks the GPs about women who may have underlying health problems and about how they feel sending patients like that away by themselves for an abortion abroad.

Brendan O’Shea says: “These are the cases that keep us awake at night.”

He quotes a famous Irish political slogan and says that it is “grotesque, unbelievable, bizarre and unprecedented”

“There is no other situation in healthcare when we are not allowed to make a referral,” he says.

O’Shea says that it is ironic that the Irish State is now finally rolling out electronic referrals but that GPs still cannot make a paper referral in such cases.

Ruth Coppinger TD is quoting a survey of GPs provided by the ICGP which said that 10% of GPs were opposed to abortion in all circumstances.

“If a GP is opposed to an abortion are they really gong to supply it as an option,” she asks the GPs.

Hanley says that GPs have an ethical obligation to do so.

Meanwhile, committee members Senator Rónán Mullen and Mattie McGrath TD are outside Leinster House amid talk that they will withdraw from the committee.

They are saying that are “actively considering” their position on the committee.

In a joint statement, they said:

We’re not directing our criticism at individual members of the Committee but there’s no escaping that this process is entirely skewed and unfair. Over 20 groups and individuals pushing for abortion have been invited before the Committee while only a handful of pro-life people have been invited.

Peter Fitzpatrick TD says the GPs have given some personal stories from women who travelled for an abortion but have not told any stories from women who regret their abortion.

“I have witnessed in my lifetime where women have lost their lives due to not having a termination in time,” Dr Karena Hanley says.

She adds that it is heartening to see women “being safer” as legislation has developed.

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Bernard Durkan TD is asking about cases of alleged rape and how women in such cases present to GPs.

He asks the GPs if they feel the victim in such cases have enough choice at present and if sex education is at a level where women are aware of their options in cases of rape.

O’Shea says that sex education has improved but that there is “more to do”.

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Here’s our full report on Rónán Mullen and Mattie McGrath’s press event outside Leinster House.

“There’s no escaping that this process is entirely skewed and unfair,” they have said,

Anne Rabbitte TD has asked if there are many women who present with a crisis pregnancy and return to say that they have had their baby and are happy with the decision.

“Absolutely,” says Dr Karena Hanley, adding that this is the case with the majority of women who present with a crisis pregnancy.

That’s the end of today’s committee meeting. It will return again next Tuesday.

We will be sending out an email round-up of what happened at the committee later today.

To get the weekly round-up, just enter your email in the box at the bottom of this article.

Thanks for joining us.

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