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Varadkar 'reluctant' to make changes after review of state's abortion laws seeks end to three-day wait

Health Minister Stephen Donnelly will bring a memo to Cabinet on Tuesday on the report’s recommendations.

LAST UPDATE | 21 Apr 2023

THE TAOISEACH HAS said he would be ‘reluctant and uncomfortable’ to make any major changes to Ireland’s abortion laws after a review recommended that women shouldn’t have to wait three days for a termination.

Health Minister Stephen Donnelly will bring a memo to Cabinet on Tuesday on the report, which the government was legally obliged to have carried out. 

The review found a lack of sufficient clarity as to how certain sections of the Health (Regulation of Termination of Pregnancy) Act 2018 apply, requesting fresh ministerial guidelines on issues around fatal foetal abnormalities in particular.

It will also highlight an insufficient provision of services in some areas of the country.

The Journal has learned that barrister Marie O’Shea, who was appointed as the independent chairwoman of the review last year, recommends 10 changes to current abortion legislation. 

The Journal also understands that the report suggests 60 operational changes in relation to termination services and laws.

Speaking in response to the report today, Leo Varadkar expressed his reluctance to make any major changes to Ireland’s abortion legislation.

He said that when he became Taoiseach he said he would push for a repeal of the Eighth Amendment to protect women’s health and the public agreed to this in a majority vote.

Speaking in Cork, Varadkar said, “When I went out and others went out to look for a yes vote, we said that there would be safeguards and that included things like the waiting period”.

“It included things like conscientious objections and I have to say I for one would be reluctant and uncomfortable to make any major legislative changes so soon after that referendum”, the Taoiseach said.


In Ireland, a person is permitted to terminate their pregnancy for up to 12 weeks. Under the current legislation, a GP or doctor must first certify that they are no more than 12 weeks pregnant. 

There also must be at least three days between being certified and having the abortion procedure or taking the required medication. 

O’Shea has also recommended the removal of any criminal element from the legislation.

The National Women’s Council (NWC) had argued that the criminalisation of doctors and the mandatory three-day waiting period are “all limiting access to abortion for those who need it”.

The removal of the criminal element is expected to be contentious as the government still wants to ensure it can prevent illegal abortions taking place. 

While the woman is decriminalised under the Act, assistance outside of the law is not.

The Act still criminalises anyone who assists a pregnant person to obtain an abortion outside of the provisions of the Act, with a prison sentence of up to 14 years. Abortion Rights Ireland has said that this is at odds with the spirit of repealing the Eighth Amendment and contradicts medical best practice.

It flags that criminalisation could impact a parent or partner who orders abortion pills.

Numbers of abortions

The report confirms that between 2019 and end-2022, nearly 18,000 terminations took place in the Republic of Ireland, with the vast majority of these being under 12 weeks. 

The number of abortions because there is a risk to the health or life of the mother is still very low, the review will state. 

The number of GPs offering abortion services is highlighted as a concern with 500 GPs carrying out abortion services in their practices.

Geographical disparity and cost of travel for abortion service are raised as causes for concern by O’Shea. 

The report finds that women in the north west, midlands and border counties in particular have a shortage of services.  

As a result, some women have to travel long distances for a first appointment with a GP, and then make the long journey again for the second appointment three days later, which adds to the cost, time and trauma of an abortion. 

This can also lead to a four-to-five day wait instead of the legislated for three-day wait if the woman lives in a rural area.

Echoing criticisms of the Health Minister, the review also highlights how not all maternity hospitals are providing abortion services.  

Shortage of services

Government sources have said more work has to be done to get more doctors on board with providing abortion services.  

In the Dáil yesterday, Donnelly said it is “totally and utterly unacceptable” that abortion services are not being provided at all Irish maternity hospitals.

Currently only 11 of 19 maternity hospitals are providing abortion services. The minister said he wanted to see that increased.

Separately, the review finds there should be a legal framework put in place to protect women from persons or organisations who coerce them to continue their pregnancies with misleading information and actively interfering with their access to a termination. 

It also criticises a possible breach of Ireland’s human rights obligations in relation to diagnoses of fatal foetal conditions and incidences where there is an immediate risk to the health of the mother.

Under law, after 12 weeks, a woman can only have an abortion in exceptional circumstances, such as when continuing the pregnancy:

  • Puts your life at risk
  • Will cause serious harm to your health 
  • Is likely to lead to the death of the foetus either before or within 28 days of birth, because of a problem with its development

The review finds there is a lack of sufficient clarity as to how such sections of the Act apply and requests the delivery of ministerial guidelines. 

O’Shea states in the report that there is an ongoing need for education on the law and how it should apply, such as on the aspect of conscientious objection for staff. 

The Act currently gives doctors, nurses and midwives the right to refuse to participate in a termination to which they have conscientious objection as long as the pregnant person’s life or health are not in danger. 

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