Abstract
BackgroundIn May 2018, the Irish Constitution was changed following a referendum allowing termination of pregnancy by abortion. It is envisaged that the majority of terminations will be by medical abortion and will take place in general practice before 12 weeks gestation.AimTo elicit attitudes and level of preparedness of Irish GPs to provide medical abortion services.Design & settingCross-sectional study of 222 GPs who were associated with the University of Limerick Graduate Entry Medical School (GEMS) and GP training programme.MethodAn anonymous online questionnaire was distributed via email. Reminders were sent 2 and 4 weeks later.ResultsThe response rate was 57.2% (n = 127/222). Of the responders, 105 (82.7%) had no training in this area, with only 4 (3.1%) indicating that they had sufficient training. Nearly all responders (n = 119, 93.7%) were willing to share abortion information with patients. Just under half of responders (n = 61, 48.0%) would be willing to prescribe abortion pills, with 47 (37.0%) unwilling to do so. Only 53 (41.7%) responders believed that provision of abortion services should be part of general practice, with 52 (40.9%) saying that it should not. As to whether doctors should be entitled to a conscientious objection but should also be obliged to refer the patient, 92 (72.4%) responders agreed. Over two-thirds of responders (n = 89, 70.1%) felt that necessary patient support services are not currently available.ConclusionThere is a lack of training and a considerable level of unwillingness to participate in this process among Irish GPs. There is also a perceived lack of patient support services for women experiencing unwanted pregnancy. It is incumbent upon state and professional bodies to address these issues.
Highlights
Few areas of mainstream medical practice are as controversial as abortion, for those who believe that it involves the extinction of a human life
53 (41.7%) responders believed that provision of abortion services should be part of general practice, with 52 (40.9%) saying that it should not
There is a lack of training and a considerable level of unwillingness to participate in this process among Irish GPs
Summary
Few areas of mainstream medical practice are as controversial as abortion, for those who believe that it involves the extinction of a human life It may be carried out medically with the anti- progesterone drug mifepristone, followed by misoprostol, a prostaglandin analogue.[1] Until recently, abortion was illegal in Ireland unless there was a threat to the life of the woman.[2,3] Beyond this, medical practitioners were limited to providing information on abortion services lawfully available in other states.[4] In a referendum held in May 2018, the Irish people voted to remove Article 40.3.3, which prohibited abortion in all but the most limited of circumstances,[5] from the Irish Constitution. It is envisaged that the majority of terminations will be by medical abortion and will take place in general practice before 12 weeks gestation
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