The Adelaide Hospital Society, which runs the Adelaide Hospital in Dublin, is urging a comprehensive programme of care for women in crisis pregnancies, a reduction in the number seeking terminations and legislation for abortion following the judgment in the X and C cases.
These are outlined in a submission to the Interdepartmental Working Party on Abortion, set up by the Department of Health to prepare a Green Paper on the issue. The paper is due next month.
The Adelaide is one of four Dublin hospitals which will combine to make up the new hospital in Tallaght, due to open later this year. The others are the Meath, the National Children's Hospital in Harcourt Street, and St Loman's psychiatric hospital.
The Adelaide's submission states that legislation for abortion should be accompanied by the establishment of clinics to support women with crisis pregnancies. These clinics would provide professional counselling and medical assessments, both in crisis pregnancies and following an abortion. They should also perform medically-indicated termination of pregnancies, either pharmacological or surgical, under local or general anaesthetic. Such terminations should take place within the first eight weeks of gestation.
When the Adelaide moves to Tallaght "the most profound change for the hospital will be to provide a comprehensive gynaecology service to the female population of the communities we serve", according to the submission. "A major component of this service will be to develop strategies to reduce both the number of those seeking the termination of pregnancy and the period of gestation at which such a choice may be made by the women concerned.
"An exceptionally high proportion of women in the Tallaght area are of reproductive age and many of these are single. These women are at especial risk of having a crisis pregnancy and we wish to be prepared to deal with this as comprehensively as possible, within the law."
In its introduction, the submission points out that on average 125 Irish women choose to have an abortion every week, a figure it believes can be significantly reduced. Many do not receive professional counselling or gynaecological assessment beforehand. And most do not receive a post-abortion scan which could radically reduce the risk of infection and possibly infertility. It describes the constitutional and legal situation as "highly unsatisfactory" and criticises the poor access to contraception in many parts of the State.
The submission stresses that the primary aim of a health-care policy for women should be to reduce the number of pregnancy terminations. Where they do occur the women should have better health care than is provided at the moment and the terminations should take place much earlier.
In order to achieve a reduction in the number of crisis pregnancies, the Relationship and Sexuality Programme in schools should include comprehensive information on the various methods of contraception. This should be accompanied by a national network of contraceptive provision, including a number of choices for adolescents. The emphasis should not only be on availability, but also on accessibility, especially for the young, the poor and the socially deprived, it said.
The submission also recommends research into the uptake of contraception, the reasons why abortions tend to be later among Irish women, and what methods of contraception would be most acceptable to women at risk of crisis pregnancy.
On the question of legislating for the judgments in the X and C cases, according to which the termination of pregnancy is constitutional in Ireland when there is a risk to the life of the mother, the Adelaide urges the Government to address the question of the medical indication for a termination, the upper gestational limit and the normality or otherwise of the foetus.
If the working group decides not to recommend legislating for medically-indicated abortion, the Adelaide Hospital Society urges it to consider establishing a clinical liaison service for women having abortions in the UK. This would address their need for post-abortion medical care.