Thursday, 29 November 2018
Health (Regulation of Termination of Pregnancy) Bill 2018: Report Stage (Resumed)
The issue of ultrasound is quite complicated. I will try to clarify it within the four parameters the legislation proposes. Under the first parameter it is proposed that termination can occur if there is a risk to the life or health of the mother. In that instance, that baby is a much-wanted baby. Circumstances have overcome that pregnancy such that the life or health of that woman is at risk. That woman will have had several ultrasounds because her pregnancy will be monitored. There will be no necessity for her to have a compulsory ultrasound. She will have ultrasound carried out during normal obstetric practice. In the issue of the risk to the life or health of the mother, there will be ultrasounds to monitor that pregnancy. It will be a much-wanted pregnancy and it will be devastating for that mother if that pregnancy has to be terminated to preserve her life or preserve her health.
In the case of risk to life in an emergency, there may or may not be an ultrasound, or there may or may not be time for an ultrasound. It is not relevant in that situation.
When we come to the condition likely to lead to the death of a foetus or fatal foetal abnormality, again there will have been many ultrasounds in that circumstance. There will be high-definition ultrasounds to identify accurately the fatal foetal abnormality. Again it is not an issue regarding this amendment.
The fourth issue relates to early pregnancy. Ultrasound may or may not be clinically indicated in such a pregnancy. It may be necessary to have an ultrasound to date that pregnancy, but that will be a clinical decision. This amendment contains the word "shall" which means it must take place at least 24 hours before termination of pregnancy. I accept that people seeking a termination before 12 weeks gestation may from a clinical point of view need an ultrasound to date their pregnancy or possibly to identify an ectopic pregnancy. Those are very reasonable reasons to seek an ultrasound. However, enshrining that in legislation is not the way to go about it. That will be a clinical decision.
I am reading one part of the amendment which may make the amendment invalid. The proposed new section 23(9)(i) states:
(i) in the case of a termination of pregnancy to be carried out in accordance with section 10 or 12, the obstetrician by whom the termination of pregnancy is to be carried out, and
Those are the wrong sections because a new section was inserted on Committee Stage. Therefore that should read section 11 or 14, I think. In the proposed new section 23(9)(ii) I believe section 13 should be section 14. Therefore there are technical issues with the amendment anyway.
Ultrasound is a complex issue, but for many of the circumstances in which women will seek a termination, ultrasounds will already have been carried out. It is only in early pregnancy that there may be a need for an ultrasound to date the pregnancy or to rule out an ectopic pregnancy.