Professor Veronica O'Keane:

I thank Deputy O'Connell. There are quite a few questions in that. I will start again at the end because of my short attention span.

Deputy O'Connell talked about the vulnerable women who were unable to travel. If I had to pick the worst situations that arise from our current situation in relation to an absence of a proper abortion service it would be those of the women who are left behind. It is the women who sometimes do not have the education to understand how to access resources. They do not have the confidence to go to professionals. They do not have the knowledge to access the professionals and they do not have the confidence to talk to those professionals about what they might want. They may be ashamed of what they want. They may be in a terrible state of conflict about it. They may want an abortion and not be able to put words on it. There are as many extremely sad situations as there are women pregnant who are left behind in that very vulnerable category.

I can only talk about my experience of dealing with very vulnerable women who have very significant mental health disorders. I might be talking about women who may not even understand that they are pregnant for a few months. Perhaps the medication they are on is suppressing their menstruation and they do not have regular cycles, and they may not even be aware. By the time they become aware of the pregnancy, they could be 14 to 16 weeks pregnant. They are unable to process the idea that they have to go for maternity care and their GP will try and sort out their obstetric care, when they go to their GPs. This group of women do not have sensitive, appropriate services that can meet their high needs. These sensitive services are available in other branches of medicine for these women. I have had women who have had breast cancer and they have had really wonderfully appropriately sensitive services, in terms of guiding them through the palliative stage of their care and, indeed, from the palliative stage of their care to their passing. We can only guess about those women. In a sense, I know that group of women are left behind. We should feel ashamed by the fact that these women are ignored and neglected.

In relation to early abortions, obviously, the earlier an abortion, the better it is for the woman. The situation that we have in Ireland delays abortion. I have just told the committee how the Protection of Life During Pregnancy Act 2013 is cumbersome and certainly delays abortions, but travelling also delays abortions because some women do not have passports, some women do not have the finances and some women have not made up their excuses that they are going away with a friend for a weekend for fun in Liverpool or whatever. Obviously, travel takes away a woman's privacy. That is probably one of the worst aspects of it but it also leads to later abortions. It is an established fact that the average age of gestation of Irish women is higher than that of women in the UK.

On unplanned pregnancies, I think the Deputy referred to "unplanned and forced pregnancies". I guess I would see them as being in very different categories.