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Guidelines published for GPs who will provide abortion services

Services are expected to begin from 1 January.

THE IRISH COLLEGE of General Practitioners (ICGP), the professional and training body for Irish GPs, has issued its interim clinical guidelines to members who wish to provide termination of pregnancy services once this is legalised.

The guidelines, which are also available online, are accompanied by e-learning resources and training workshops.

The organisation has trained an initial group of GPs who are in a position to provide abortions from next month under the Health (Termination of Pregnancy) Bill 2018.

There are also additional training and educational supports available on the college’s website. Further training will be available in the new year.

The guidelines set out the steps under which GPs can carry out a medical termination of pregnancy. The law states that GPs can carry out a termination, via medication, for females with a pregnancy of under nine weeks’ gestation.

The Bill passed through the Oireachtas lask week, in what Health Minister Simon Harris called “a genuinely historic moment“. 

The guidelines outline three consultations with a GP, with a three-day delay between the first and second consultation.

At the second consultation, a woman is given her first medication at the doctor’s surgery or clinic, and a second medication to be taken at home up to 48 hours later.

The patient is advised of possible complications, and encouraged to return. Long-acting reversible contraception (LARC) is offered.

The third consultation, usually within two weeks of the second, is to confirm that the cycle is completed, and offer counselling or contraception, and management of any complications.

Should the GP be unsure of the gestation dates, the GP must be able to access an ultrasound facility for dating, or complications. If the gestation dates are over nine weeks, the woman is referred to a relevant hospital for a surgical termination.

“These detailed clinical guidelines map out the process for GPs who wish to provide this service,” Dr Tony Cox, Medical Director of the ICGP, said.

“The ICGP will continue to provide training workshops and online support, as well as mentoring, in the coming year”, he added.

Lack of clarity 

The ICGP said it has written to Harris to “express its concerns at the lack of clarity around referral pathways to secondary care when required throughout the country”.

The organisation has reiterated that the proposed 24-hour helpline, and the community supports to facilitate safe care for women and girls, must be in place and fully operational by the deadline on 1 January. 

Earlier this month, Taoiseach Leo Varadkar said abortion services may not be available in every hospital come January but terminations will be available

“Like any new service it is going to have to be phased in,” he said, adding that “it may not be available in every single hospital and every single place, but the service will be available”.

Harris previously said each GP has been written to, expressions of interest in providing the service have been sought and details of the level of participation should be known over the coming weeks. 

“No doctor is obliged to provide the service if they do not wish to do so,” Cox noted. 

Doctors wishing to exercise conscientious objection should “make such arrangements for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the termination of pregnancy concerned”, according to the legislation. 

The HSE has also been working closely with the Irish Family Planning Association and the Well Woman Centre to ensure they are able to provide the service from January.

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