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RCOG/FSRH respond to new regulations on abortion care in Northern Ireland

News 27 March 2020

The Royal College of Obstetricians and Gynaecologists and Faculty of Sexual and Reproductive Healthcare welcomes new regulations on abortion care in Northern Ireland but warns they fall short of ensuring safe care during COVID-19.

This follows a historic vote in Parliament in 2019 to decriminalise abortion care in Northern Ireland, which only allowed an abortion if a woman's life was at risk or there was a danger of permanent and serious damage to her physical or mental health. Many women had to travel to England to access this essential area service.

The new regulations seek to meet the requirements of the UN Committee on the Elimination of Discrimination Against Women (CEDAW), which ruled in 2018 that abortion law in Northern Ireland breached human rights in a “grave and systematic” way.


Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“We welcome the regulations permitting abortion care in Northern Ireland. This legal framework, while not delivering all the recommendations that we made, is a step towards provision and acknowledgement that abortion care must be delivered safely and effectively within any nation. These regulations also accept the key role midwives and nurses play in providing this service.

“In getting to this point, we recognise the tireless work that led to this decision, and the many brave women who shared their experiences of the impact a lack of care had on their lives. We also recognise the work of those Fellows and Members of the RCOG in Northern Ireland who have led discussion with the Government and who will now support the Northern Ireland Department of Health to develop a model of care as quickly as possible.

“We recognise that this change comes in the middle of a pandemic. We are facing a public health emergency which will prevent many women travelling to England for care in the interim period before a service is established. The need is therefore greater than ever to establish care for women in Northern Ireland to reduce the spread of COVID-19. The health minister must temporarily permit the home-use of mifepristone to ensure access to early medical abortion remotely. This is safe, effective and recognised best practice.”

 Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“The Faculty of Sexual and Reproductive Healthcare commends the Government for introducing the new Northern Ireland abortion regulations in times of COVID-19 duress. This is a significant day for women who need to access safe abortion care within Northern Ireland, and for all who have suffered the effects of an outdated framework which penalised doctors for providing what is widely considered to be essential healthcare.

 “However, the regulations will not ensure women have timely and safe access to abortion care in Northern Ireland as intended unless the Government temporarily allows home use of the mifepristone pill, the first course of abortion treatment.

 “Allowing home use will avoid unnecessary and risky visits to healthcare facilities, thereby protecting the NHS and saving lives, including those of frontline healthcare professionals.

 “It is also perplexing that the regulations fail to address contraceptive care. This goes against recommendations from Paragraphs 85 and 86 in the CEDAW requiring the State to ensure accessible and affordable sexual and reproductive healthcare, including safe contraception, adopting a protocol to facilitate access at pharmacies, clinics and hospitals.

 “We urge the Government to work with the Northern Ireland Office to guarantee that all CEDAW requirements are met, to ensure that women in Northern Ireland have access to the full range of contraceptive methods – particularly at this time.”

Ends

Notes to Editors

For media enquiries, please contact the RCOG press office on +44 (0)20 7045 6773 or email pressoffice@rcog.org.uk.

The Regulations, coming into force by 31 March 2020, will make provision for:

1. Early termination of pregnancy - access without conditionality to abortion services up to 12 weeks gestation

2. Termination of pregnancy up 24 weeks - access to abortion services up to 24 weeks gestation in cases where the continuance of the pregnancy would involve risk of injury to the physical or mental health of the pregnant woman or girl, greater than the risk of terminating the pregnancy.

3. Fetal abnormality - access to abortion services in cases of severe fetal impairment (SFI) and fatal fetal abnormalities (FFA) with no gestational time limit. This is where there is a substantial risk that the condition of the fetus is such that the death of the fetus is likely before, during or shortly after birth; or if the child were born, it would suffer from such physical or mental impairment as to be seriously disabled.

4. Risk to the woman or girl’s life or risk of grave permanent injury – access to abortion services with no gestational time limit where there is a risk to the life of the woman or girl, greater than if the pregnancy were terminated, or where necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman or girl, including in cases of immediate necessity.

5. A registered medical practitioner licenced by the General Medical Council (a doctor), a registered nurse or a registered midwife will be able to perform a termination