Clare Daly (Dublin Fingal, Independent) | Oireachtas source

I will have to be good. I thank Dr. Lohr for coming in. It is an interesting point as Senator Mullen made the point about Dr. Lohr's services being the subject of a critical review while in the Dáil Chamber they are discussing Portlaoise hospital. It is the subject of scathing reports arising from the death of babies. The solution was not to shut the maternity service but to improve it. Dr. Lohr's comments on the need for every medical procedure to be constantly improved were well made. We have an unusual position as Irish people have a constitutional right to have an abortion but we do not have the right to have it in Ireland. On behalf of the tens of thousands of Irish women who have availed of Dr. Lohr's services, I sincerely thank her for that.

Will the witness speak to the point about the irony that our abortion regime, if one likes, arises from the 1967 Act, which is the only avenue Irish women in the main have been given if they have the money to travel?

In the context of the 50th anniversary of that Act and the increasing dialogue on the need to modernise the British service, what are the best lessons for us, given that we will be starting, in essence, from scratch? The witness has addressed medical abortion, but I was struck by the point that in a scenario where there is funded legal abortion services, hundreds of women in England or Wales are accessing the service from Women On Web. Is that an illegal activity or is it a grey area? How can we learn from that?

I am confused. We have spoken before about the call by the head of the Royal College of Obstetricians and Gynaecologists asking for nurses and midwives to be allowed to administer the abortion pill on the basis of one doctor. My understanding was that that does not exist now and that it has to be two doctors, and that nurses and midwives cannot do it, or that they can when there are two doctors. Perhaps the witness could clarify that; it is potentially an important way forward.

The impact of decriminalisation and what it would mean is another area that is linked to this. It is a discussion that is happening in Britain at the moment and has been discussed in every session we have had here. What will it mean and how can we learn about it?

Dr. Patricia Lohr:The Deputy is correct to observe that Irish women currently have their abortions within the confines of the 1967 Act. There are a number of problems for women with the way the Act is written. A positive from the Act is that those definitions of the grounds for abortion are widely interpreted, and that has meant that most women who need to have an abortion are able to access that, but it is the case that there are some women who cannot. For example, the door closes when the gestation passes 24 weeks unless there is a serious foetal anomaly or a threat to life.

The question of when a woman's life becomes endangered is an important one. Where women present stating that they are suicidal, what are the mechanisms that one needs to go to in order to ensure that is the case? That puts up serious barriers and creates a situation where women and doctors are struggling to ensure that they are working within the law, while what the woman needs is to end the pregnancy which is so burdening her.

The Deputy mentioned women accessing or trying to access Women on Web because they feel that the current framework under which abortion is delivered in the UK is a barrier. It consists of having to go into a clinic and using the medications in the clinic, having to have more than one appointment and having to have a doctor sign off. In some cases, although it is not a funding requirement some of the funding bodies require that a woman goes to her GP and gets a referral into abortion care. For a woman who does not want her GP to know that she is having an abortion that is a barrier for her. Women on Web do not provide medications to women living in Britain. It would be an illegal activity if those women did obtain medications over the Internet. Women on Web will provide women with advice and guidance on how they may obtain lawful abortion care. However, we know from the requests received by Women on Web it is the case that the way that medical abortion is delivered and the restrictions on how women can obtain those medications is a barrier to them accessing services which could be provided safely and better. If we were able to provide women with truly telemedical medical abortion services, such as those that exist in some parts of the United States, they could freely and openly have a consultation, perhaps using a web chat-type module. They would have access to follow-up ultrasound scans, anti-D immunoglobulin etc., that women who obtain these medications over the Internet are not always able to access.

Are my answers too lengthy? I am trying to pick up on each of the points.