Termination of pregnancy services in Irish general practice from January 2019 to June 2019

To describe how a general-practitioner-delivered community medical abortion service is provided in Ireland, including a description of the unique model of care delivered within the framework of new legislation. To investigate the characteristics and contraceptive choices of women attending in the first six months of the service.

Twenty-seven general practitioners conducted a retrospective chart review. We described the service and analyzed demographic characteristics, treatment outcomes, adverse events, and contraception use. We defined treatment success as complete abortion without surgical intervention.

Twenty-seven general practitioners from the Southern Task Group on Abortion and Reproductive Topics (START) group collected data from 475 women who had attended requesting medical abortion from January 1st 2019 to June 30th 2019. Out of these, 315 (66%) were more than 25 years old, and 261 (55%) had at least one child. The mean gestational age at initial presentation was 49 days. Five (1%) had a gestational age which exceeded 84 days. Four hundred and twenty (89%) proceeded with community medical abortion following an initial consultation. The process was completed without the need for surgical intervention in 412 (98%) cases. Six (1.4%) women had a mild post-treatment infection, and received community treatment with oral antibiotics. Thirty-three (7.9%) patients were referred to hospital for additional evaluation following treatment. Two hundred ninety (69%) adopted contraception post abortion; only 160 (34%) were using contraception prior to pregnancy.

The general-practitioner-delivered community medical abortion service described in the study is safe, effective, and accessible for the majority of, but not all women seeking abortion. The model of care used in Ireland provides an ideal opportunity to discuss contraceptive choice.

This review provides demographic, efficacy, and safety data for the general-practitioner-provided community medical abortion service in Ireland. An effective and largely accessible model of care is demonstrated. These findings can help inform legislative review, clinical guidelines, and generate hypotheses for future research.