Ruth Coppinger (Dublin West, Solidarity) | Oireachtas source

I thank the witnesses for attending. I want to bring the conversation back to the women who are travelling, with over 1,000 having had to do that since we voted in May. We will never know the exact figure but from studies which have been done on telemedicine providers, up to five people a day in Ireland use abortion pills purchased online. These are the key people that we need to take into account. I agree and understand that GPs and doctors need training, infrastructure and resources, it is vital that unnecessary elements are not built in that will further delay women and those who are pregnant from getting the healthcare that they should get in this country. With that in mind, we should start with safety. Abortion is a very safe procedure as testified to in the evidence we heard in the Joint Committee on the Eighth Amendment of the Constitution.

On abortion pills, I have spent much time researching them because I was involved in helping to distribute them at a time when they were illegal. There are more deaths from wisdom tooth extraction than there are from using the abortion pill. People may have an impression that abortion is highly dangerous and has many requirements. It is safer than Viagra. It is probably safer than antibiotics with regard to reactions because people have reactions to antibiotics. I make these points because there seems to be a layer of bureaucracy that has been talked about being built in to the provision of abortion. Adverse outcomes are very rare. I respect the doctors and the studies that they have done but studies have been done on women in Ireland, who have used an abortion pill purchased online, by Women on Web, which is the biggest provider internationally.

Dr. Abigail Aiken testified that less than 3% required any medical follow-up, and this tended to be either antibiotics or a blood transfusion. A really extreme adverse outcome was rare. That was in the case of early use of the abortion pill and is in a study published in The Lancet.

I was very glad to hear Dr. Favier state early scans in a GP surgery would not be necessary because we can imagine how long that would take. I have read very recent studies from 2015 and 2016 that show they are not required for early pregnancy.

I want to speak about the 24-hour helpline. I would love 24-hour helplines for many issues. We do not even have 24-hour helplines for domestic violence because we do not have the money. Is this also something that is not really necessary? If the service will be provided, and I completely reject the idea of opting in, it should be a normal part of healthcare. It should not be abnormal that a doctor opts in. It goes against the grain of everything people voted for to introduce opting in and making the service abnormal. People should be able to go to their GP and have a discussion. This is what everyone spoke about in the referendum campaign.

The waiting period is another issue. I reread the committee report, and I stand to be corrected, but I do not see much, or any, reference to it. Absolutely, it was referred to during the committee's deliberations but there is no medical need for it. The doctors have just said this and it is what the WHO told the committee. We all know it was put in as a sop so Deputies could say there are restrictions on women. Let us be honest. The WHO told us it is dangerous because it inhibits access for people who are poor or victims of violence. A woman with other children would have to go for a second appointment. It looks like this is what will happen but it is not really required. One appointment should be enough. If we build in a waiting period, will a woman have to take the first pill in the doctor's surgery? This is not necessary. People are taking it with guidance online and they can take it with guidance from their GP. It would enforce barriers and would mean the most vulnerable women will have time added on. It is paternalistic. We do not have a waiting period for anything else. We do not have a mandatory waiting period for a vasectomy. It might be recommended to the person to go away and think about it but it is not written into law. It would be really dangerous for this to be enshrined in legislation rather than being left up to a doctor to tell someone she needs to think about it.

My next question is on health and I ask the doctors before the committee to comment. There is a difference between what the committee on the eighth amendment recommended and what is in the legislation and I am quite concerned about this. In the committee's report people were at pains to make sure, based on all of the evidence from doctors themselves, that what health was would not be nailed down in law. The general recommendation was to include reference to risk to health but what we actually have is reference to serious harm. There is a difference between these two things. This is a deviation from what we discussed in the committee and it should be opposed. There would be no consultation with the pregnant person at the centre of it, which is highly paternalistic. It is not even mentioned that the view of the pregnant person on what is the risk to her should be a factor in the final decision. It is completely up to two doctors. I respect doctors but they are not infallible. The person should have a say. If a doctor is in a situation where somebody is outside of the 12 week range we would still have criminalisation. This can have a chilling effect on doctors, as can reference to serious harm rather than reference to risk to health. Will the doctors comment on why these different responses are included?