Proposal for a GP-led abortion ‘service’ is impractical as well as unjust

Minister Simon Harris wants GPs in Ireland to be the main providers of abortion, and to prescribe the abortion pills to women ‘with no restriction as to reason’ in the first 12 weeks of pregnancy. The vast majority of abortions take place during this time frame.

It is hard to believe he has thought this through properly because his proposed system seems to be unique both in terms of the extent to which it will be GP-led and how late into the pregnancy GPs will be able to prescribe the abortion pill.

The Netherlands is a country that is often portrayed as a model by the pro-abortion side. Last November the Dutch government withdrew a bill that would have permitted the prescription of those pills until six weeks and two days of gestation. After that period, according to the Dutch Department of Health, “the effectiveness [of the abortion pills] decreases and the chance of complication increases”. Only hospitals and clinics currently provide abortion pills.

The bill was rejected on the basis that it would have increased the abortion rates, which have already gone up since 1990. A new similar bill has been proposed again this week by opposition parties, but there seems to be no intention from the government to support it.

In Sweden, which is another country often presented as a model by pro-choice activists, the abortion pill can be given out only in clinics or hospitals, as they have to carry out an ultrasound beforehand and ascertain the age of the unborn child to make sure that a medical abortion is suitable.

In Australia, since 2012, accredited GPs can prescribe abortion pills up to nine weeks gestation but only 1.5% of them have obtained a certification to do this. A recent study investigates the reason for such a low participation.

Apart from obvious ethical motives, there are practical reservations. Some were concerned about it dominating their work or about the “negative impact provision may have on their practice reputation and how this might change the family-focused practice they aspired to run”. Some practitioners didn’t want to be known as the “abortion doctors” and being inundated by requests, particularly coming from patients they wouldn’t know.

Seventy-five percent of the doctors who participated in the study believed that existing abortion clinics should continue to provide the ‘service’.

Some GPs noted that it is too complicated to provide a proper assistance due to logistical constraints with accessing the pills, coordinating ultrasounds and setting up links with hospital for referral. Doctors “had practical experience of the difficulties establishing procedures and accessing supporting services such an ultrasound in general practice settings”.

They found it arduous “to organise an ultrasound in a timely manner and order anti-D immonuglobulin for women who were Rhesus negative.”

These reservations were expressed in a context where abortion is already provided extensively by hospitals or clinics. One can easily imagine how unworkable would be the model proposed by Minister Harris, where GPs are the primary providers.  A model that doesn’t exist in other countries.

The impression is that this Government, and Minister Harris in particular, have not really considered the full implications of their proposal. In the rush to have a piece of legislation available before the referendum, they simply are implementing the recommendations of the Joint Committee.

It’s no wonder the National Association of General Practitioners has strongly objected to Minister Harris not consulting with them on the proposal.