Dr. Caitriona Henchion:

There are a few different challenges. Without harping on this point too much, but to return to this issue again, the first concerns the three-day waiting period. We have had women in this situation. It tends to occur in the context of bank holidays and similar periods, when women present within the 12-week limit, but in situations where they are close to the end of those 12 weeks. The need to refer them to hospital means that we cannot get them an appointment before their 12-weeks are up. Even though they have presented to us within the terms of the legal framework, it is still difficult even within that time, plus the three days. The three days themselves might just put these women over the limit. This gives rise to situations where it is necessary to have a discussion with somebody to say that if I had been able to do what was required yesterday, it would have been fine, but it is not today.

That is a really difficult conversation to have with somebody for whom the consequences are going to be financial, social and very difficult.

The other thing where the 12 weeks really come into play, and I referred to this earlier, is with regard to the people who might have a failed termination. The risk of failure with medical abortion is between 1% and 2%, depending on gestation. That is a significant number of women, and we see it. In the community, we would see people up to nine weeks plus six days, and from then onwards they need to go to hospital. If we have seen somebody at nine weeks plus, and it is two or two and a half weeks before she can do a pregnancy test to check that it has been successful, she is pretty much at 12 weeks at that stage and if it has failed, she has to travel. We have given her medication that is potentially teratogenic, which means it could cause harmful foetal anomalies. We are now telling women they have to travel to continue this treatment. We are not giving any flexibility to continue that treatment for that person where it has failed.

Those would be two biggest areas, the people who have narrowly missed it and the people who have had a failed termination. Again, with regard to the people who narrowly miss it, we would have dealt with people who have had contraceptive failure, the failure of a contraceptive that would stop them having periods. It is not that surprising that they did not realise they were pregnant on time, because the contraception they were using was causing them to have no periods. It will take longer for those women to recognise they are pregnant. There are also women who, due to physiological reasons or medical conditions such as polycystic ovaries, only have two, three or four periods per year. It will take them longer to discover that they are pregnant than somebody who has a very regular cycle. The 12 weeks can be very difficult for some people to recognise on time. It is very difficult if people are just beyond it and it really comes into play, big time, when it comes to the risk of failed termination.