Three-day abortion wait hits women in ‘straitened circumstances’ hardest, HSE says

Women in “straitened circumstances” are more affected by a mandatory three-day wait for abortions than those who are better off financially, according to the HSE. An Oireachtas committee considering a new law that would lift the mandatory 72-hour delay heard evidence on Wednesday that international studies have shown that such policies do not change abortion rates or birth rates, and that mandatory waits contribute to “financial, emotional” costs for women. The Health (Abolition of Three Day Wait Rule) (Amendment) Bill, which Sinn Féin introduced in May, would scrap the mandatory three-day waiting period that was included in Ireland’s new abortion law following the repeal of the Eighth Amendment. Under the current law, a woman has to wait 72 hours between requesting an abortion under 12 weeks at a first appointment and accessing one at a second appointment. READ MOREThe Oireachtas health committee is hearing evidence on the effect of the three-day wait, in advance of deciding if it will refer the Bill to committee stage. [ Go-slow or proper scrutiny? The divide over Bill scrapping three-day wait for abortionOpens in new window ]Experts from both the HSE and the Department of Health appeared before the committee on Wednesday. Dr Cliona Murphy, the clinical director of national women and infants health at the HSE, told politicians that the three-day wait may not make “too much of a difference” to women who have financial means. “But we do know that it affects those of more straitened circumstances, those who have to arrange childcare, those in more marginalised communities and, certainly, it does make a higher impact on those who are closer to timing out,” Murphy said. “The combination between our strict 12-week cut-off and the three-day wait, I think, does impact some women who, maybe through no fault of their own, found out about the pregnancy later, or maybe weren’t aware. There are still people who aren’t aware of the legislation, and so it does affect those disproportionately. And the medical practitioners can do nothing in that situation.”[ Patients would contribute more for drugs under proposed policyOpens in new window ]Murphy said there was “plenty of research that shows that women have actually made a considered decision before approaching a doctor”.Fine Gael TD Colm Burke asked about a figure that showed that there were 10,000 more first appointments than second appointments for abortion services between 2019 and 2024. Murphy said many women may not have returned for second appointments as they may have gone to another doctor, been referred to a hospital or may have miscarried. She said that research by the Irish Family Planning Association (IFPA) showed that only 1.8 per cent of women had chosen to continue with the pregnancy after their first appointment. Dr Aoife Mullally, the national clinic lead for termination of pregnancy at the HSE, told the committee there is “overwhelming evidence” from the World Health Organisation against mandatory waiting periods, including a meta-analysis of 33 different studies. “Seven studies show that mandatory waiting periods do not contribute to any changes in abortion rates, unintended pregnancy or birth rates in general. One study showed that among minors, mandatory waiting periods are associated with an increased risk of reporting an unwanted birth,” Mullally said. “And 18 studies reported that mandatory waiting periods contributed to financial [and] emotional costs, such as logistical burdens, emotional stress, financial cost, travel time and out-of-state travel. “For most women, mandatory waiting periods do not impact the woman’s certainty in abortion decision. And certainly, as an abortion care provider, that is something that I would see very clearly when I meet women.”[ Analysis: Bill to remove three-day abortion wait likely to pass despite division in GovernmentOpens in new window ]The Department of Health recommended to the committee that any change in the law would “preserve” the right of women to have an optional reflection period before accessing an abortion, even if the mandatory requirement is removed. Prof Mary Horgan, the chief medical officer at the Department of Health, was asked why the mandatory three-day wait policy was included in the 2019 abortion law. It was included “in the context of a new service that was being rolled out that had particular, I suppose, different opinions”, Horgan said. [ Chief medical officer Mary Horgan interview: ‘People often forget how bad infections were; our memories sometimes are short’Opens in new window ]“My understanding is that it was a legal safeguard put in at the time.” The Health (Abolition of Three Day Wait Rule) (Amendment) Bill was introduced by Sinn Féin in May. Government TDs were given a free vote, and it passed the second stage of the Dáil in June. A majority of Fianna Fáil and Fine Gael TDs voted against the Bill, but it was supported by Taoiseach Micheál Martin, Tánaiste Simon Harris and Minister for Health Jennifer Carroll MacNeill.