Northern Ireland

New Northern Ireland abortion guidelines published

Health
Image caption Medical staff hope the new guidelines will offer clarity and legal protection

Northern Ireland's latest guidelines on abortion were published late on Good Friday evening with little fanfare.

They appeared on the Department of Health's website, perhaps a deliberate move to delay the inevitable public debate and debacle.

While it is a highly emotive and contentious issue, many hope this latest guidance will help women faced with a traumatic pregnancy.

Medical staff also hope the guidelines will offer much needed clarity and legal protection when faced with this medical issue.

So what's new?

Image copyright Science Photo Library
Image caption The guidelines acknowledge that the abortion pill is in circulation in Northern Ireland

While the abortion law remains unchanged, what these latest guidelines offer is a much more liberal interpretation of how that law currently stands.

For instance if an abortion is requested, while good practice remains a priority, there's now greater emphasis around a clinician's judgement as opposed to a psychiatric assessment.

Problems

Also, while staff are still legally required to report an abortion has taken place, the guidelines say it's acceptable for staff not to for reasons of patient confidentiality.

However, according to Dr Fiona Bloomer from Ulster University, it's particularly significant that the guidelines acknowledge that the abortion pill is in circulation in Northern Ireland.

When a woman takes it, the pill can trigger symptoms similar to a miscarriage.

That can lead to problems when the woman seeks help at a hospital.

But, Dr Bloomer said the guidelines take the chill factor out of dealing with such circumstances.

"It (the guidelines) acknowledges that if a woman presents in hospital having taken the abortion pill the symptoms are the same as if she had a natural miscarriage," she said.

"It's almost like a 'don't ask, don't tell' approach.

"The hospital staff won't have to ask and the woman won't have to tell or declare she has taken an abortion pill."

It remains that fatal foetal abnormality on its own is not a case for termination and still needs to be considered on the grounds of the woman's mental health.

Image caption Previous guidelines placed more emphasis on psychiatric assessment, which some woman like Sarah Ewart (pictured) said was unfair

Also, the guidelines maintain that two doctors should sign off on an abortion despite the law elsewhere saying that just one doctor is required.

However, it states each case should be treated separately and should be subject to both good practice and clinical assessment.

Priority

Previous guidelines placed more emphasis on a psychiatric assessment which some women, such as Sarah Ewart, had claimed was unfair as it would be always contained on medical records.

According to Dr Bloomer the language throughout the document is more measured.

For instance it uses "woman" and "foetus" more as opposed to "mother" and "baby."

The language used is more in line with medical terminology, added Dr Bloomer.

The guidelines also note that if a pregnant woman is ill, and the impact of treatment might affect the foetus, then health professionals should attempt to protect both - but, ultimately, the woman takes priority.

Bernie Smyth from anti-abortion group Precious Life welcomed their publication.

"I am very pleased that the guidelines on abortion in Northern Ireland have clarified that the sole purpose of the law on abortion in Northern Ireland is the the protection of both the mother and her unborn child," she said.

"I am hopeful that these guidelines will be used by the medical profession in Northern Ireland to insure that both lives are treated and respected equally."

Endanger

The Family Planning Association and clinicians have been campaigning for more than a decade for guidelines to be issued on abortion for the Health and Social Care service in Northern Ireland.

Clinicians have said they were operating under a blanket of fear with the possibility of facing criminal prosecution.

Guidelines state there is no statutory right to have a conscientious objection to participation in a termination.

However, and this is new, the guidelines say that health trusts should always seek to accommodate staff who feel such action goes against their beliefs but this must not endanger a woman's life.

Especially in an emergency situation where a woman's life is at risk.

In another development, the guidelines say that a woman who has received an abortion outside of Northern Ireland should be entitled to counselling when she arrives back in the country.

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