Update for GP members regarding medical terminations

08 January 2019

Updated 8 January 2019

Following the referendum and Constitutional amendment in 2018, legislation to regulate the termination of pregnancy was signed into law on 20 December 2018.  The relevant legislation is the Health (Regulation of Termination of Pregnancy) Act 2018.

The Department of Health has issued a press release welcoming the enactment of the legislation, and Simon Harris, Minister for Health, described it as “another truly historic moment”, adding that “it paves the way for the introduction of the service for termination of pregnancy from January 2019.”

Following the enactment, termination of pregnancy is now lawful in Ireland under the following circumstances:

  • without restriction up to 12 weeks of pregnancy
  • 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.
It is thought that most terminations up to 9 weeks of pregnancy will take place in the community setting – with the expectation that 80 per cent of terminations will be carried out in such a way, although a small number may need to take place in maternity hospitals for medical reasons. All terminations after 9 weeks of pregnancy will take place in maternity hospitals.

To date, 165 GP clinics have agreed to provide abortion services, and the HSE has set up an information and counselling helpline for those individuals experiencing an unplanned pregnancy. This free service, called ‘My Options’, launched on 1 January 2019 and is available to everyone who needs it.  The Freephone advice line – available on 1800 828 010 - has professional and experienced counsellors on hand to talk to people about their options, including continued pregnancy support and how to access termination of pregnancy services in Ireland. Further information about the service is available online at myoptions.ie

Under the Act, no medical practitioner, nurse or midwife is obliged to carry out or participate in carrying out a termination, to which they have a conscientious objection, except in an emergency situation.  However, a person who has a conscientious objection must make alternative arrangements for the transfer of care to enable the woman to access termination services as necessary.

Following the enactment, the Medical Council has deleted various paragraphs of the Guide to Professional Conduct & Ethics, removing any conflict between the Ethical Guide and the Legislation. The amends include the removal of paragraphs 48.1 to 48.4 and the amendment of paragraph 48.5 as follows:

“You have a duty to provide care, support and follow up for women who have had a termination of pregnancy”

The Medical Council is also working through a detailed process to update the Guide following the enactment, reviewing a number of paragraphs to ensure that the guidance is relevant and appropriate for doctors and patients in light of the new legislation.

The Institute of Obstetricians and Gynaecologists of the Royal College of Physicians of Ireland has published ‘Interim Clinical Guidance: Termination of pregnancy under 12 weeks’, and we understand that the ICGP has also issued interim guidelines to its members.

Medical Protection considers that medical termination of pregnancy falls within the scope of general medical practice. Provided the doctor is appropriately trained and complies with the law and clinical and Medical Council guidance, Medical Protection is willing to offer indemnity to those GPs who choose to provide this service, and presently, does not expect the price of GP subscriptions to be affected by this development.

Members should also be aware of, and comply with, evolving clinical and IMC guidance, particularly with regard to conscientious objection and working within and maintaining competence.