The right to ‘con­sci­en­tious ob­jec­tion’ for med­i­cal and nurs­ing per­son­nel is provided for in the pol­icy pa­per so long as they re­fer the pa­tient to a doc­tor who could meet their needs

Irish Independent - Weekend Review - - FRONT PAGE -

In gen­eral terms, if a woman is un­der nine weeks preg­nant, she could take both pills to­gether and com­plete the abor­tion at home. It is likely that she would be provided with pain re­lief and an­tibi­otics to pre­vent in­fec­tion.

Miso­pros­tol causes cramps and heavy bleed­ing, which is why many women choose to wait un­til a Fri­day evening be­fore tak­ing the med­i­ca­tion. The World Health Or­gan­i­sa­tion rec­om­mends that “fa­cil­ity-based abor­tion care should be re­served for the man­age­ment of med­i­cal abor­tion” in preg­nan­cies over nine weeks.

In this sce­nario, miso­pros­tol might be ad­min­is­tered 1-3 days later, in a hospi­tal set­ting, where the pa­tient could be mon­i­tored through­out the pro­ce­dure.

Ac­cord­ing to re­search, just un­der 10pc of women who take the abor­tion pill at home seek med­i­cal at­ten­tion. Some of th­ese women would re­quire gy­nae­co­log­i­cal in­ter­ven­tion in a hospi­tal set­ting. In Bri­tain, women can call a 24-hour nurse-led ser­vice for af­ter­care ad­vice. A sim­i­lar ser­vice would have to be of­fered here.

Med­i­cal abor­tion has a very good safety record but there are some risks. Ex­ces­sive bleed­ing oc­curs in about 1 in ev­ery 1,000 abor­tions and, in some cases, re­quires trans­fu­sion.

In­fec­tion is an­other risk, which is why an­tibi­otics would likely be pre­scribed as a mat­ter of course. Re­duced bleed­ing and cramp­ing usu­ally in­di­cates that the preg­nancy has ended. If a woman is un­der nine weeks preg­nant, she would more than likely self-as­sess by mon­i­tor­ing her ‘be­fore’ and ‘af­ter’ symp­toms, in­clud­ing nau­sea and breast ten­der­ness. An ab­sence of bleed­ing may in­di­cate that the preg­nancy is ec­topic. (Mifepri­s­tone and miso­pros­tol do not ter­mi­nate ec­topic preg­nancy.)

The con­tin­u­a­tion of preg­nancy, and the risk of some of the preg­nancy re­main­ing in the womb, is pos­si­ble, but not prob­a­ble, af­ter a med­i­cal

The think­ing is that a woman should have a check-up four to six weeks later to make sure she has re­cov­ered phys­i­cally and emo­tion­ally.

Women can choose between a sur­gi­cal abor­tion and a med­i­cal abor­tion in other ju­ris­dic­tions but it is not clear if women would be given the same op­tion here.

Sur­gi­cal abor­tion would take place in a hospi­tal set­ting and would most likely only be per­formed on women who ex­pe­ri­ence com­pli­ca­tions through med­i­cal abor­tion, or, in ex­cep­tional cir­cum­stances, women who are more than 12 weeks preg­nant.

Three things: a se­ri­ous risk to the life or health of the mother, a de­ter­mi­na­tion that the foe­tus This is not yet known. In Bri­tain, BPAS treats teenagers aged 12-17 with­out parental con­sent, un­less they be­lieve they are s in “se­ri­ous dan­ger”, but they do re­quire some­one over 18 to bring them home. In Italy (where abor­tion is le­gal but hard to ob­tain due to the high rate of con­sci­en­tious ob­jec­tors within the med­i­cal com­mu­nity), un­der 18s need the con­sent of a par­ent or guardian.

While abor­tion is funded by the NHS in the UK, a small mi­nor­ity of women still choose to at­tend a pri­vate clinic for con­ve­nience and con­fi­den­tial­ity. It is too early to know if pri­vate clin­ics would open­here.

A spokesper­son from Marie Stopes, Bri­tain’s largest abor­tion provider, said there are cur­rently no plans to pro­vide ser­vices in the Repub­lic of Ire­land.

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