I welcome the Minister of State. Since the passing of legislation to regulate termination of pregnancy, early medical abortion has, for the most part, been provided to women by general practitioners and community providers. Clinical guidelines allow for the provision of early medical abortion in the community where gestation is less than ten weeks. These cases are being dealt with quietly and efficiently within the community. However, whereas the legislation permits provision of abortion where the gestation has not exceeded 12 weeks, pregnancies that are ten weeks or more are to be provided for in a hospital setting for clinical reasons.
Where gestation is between ten and 12 weeks, clinical guidelines advise GPs to refer women to hospital, where the abortion can be provided. It appears the method of abortion in the vast majority of these cases is medical. This method is safe and effective. However, it carries a small risk - less than 1% - of ongoing pregnancy following the process. If the pregnancy is ongoing following early medical abortion where it is nearing the 12-week gestation limit, the most effective way to complete the process is by surgical abortion. The availability of surgical abortion in Ireland is not clear to the community providers.
The Southern Taskgroup on Abortion and Reproductive Topics, START, in Cork and the surrounding region, which provides an abortion service in the community, has found that despite initial difficulties, pathways for women seeking abortion are relatively straightforward where gestation is between ten and 11 weeks. That said, there is a concern on the part of this group of GPs that pathways for gestation over 11 weeks are less than clear. Many GPs across the country have found that pathways for the referral to a hospital were created locally as the need arose after the beginning of the provision of services from 1 January last year. Nonetheless, GPs in several parts of the country are concerned that there are no actual pathways for women seeking termination where gestation is between 11 and 12 weeks. It is deeply concerning that should such a case arise, time will be of the essence and it is important that GPs and community providers would be given clear and reliable information about referral pathways for all patients coming under the provisions of the Act, regardless of how close to the 12-week limit they may be.
Will the Minister of State confirm that the State is providing abortion services for all women where their circumstances meet the criteria set out in legislation, regardless of how close to the 12-week limit they may be? If that is so, how many hospitals are participating in this and which ones are they? Will the Minister of State seek to have clear and public published referral pathways for these cases so the community providers can refer women to a hospital that can provide these services in a seamless, established and agreed process?