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Abortion policy implementation in Ireland: Lessons from the community model of care.
Mishtal, Joanna; Reeves, Karli; Chakravarty, Dyuti; Grimes, Lorraine; Stifani, Bianca; Chavkin, Wendy; Duffy, Deirdre; Favier, Mary; Horgan, Patricia; Murphy, Mark; Lavelanet, Antonella F.
Afiliación
  • Mishtal J; Department of Anthropology, University of Central Florida, Orlando, Florida, United States of America.
  • Reeves K; Department of Population Health Sciences, University of Central Florida, Orlando, Florida, United States of America.
  • Chakravarty D; School of Sociology, University College Dublin, Dublin, Republic of Ireland.
  • Grimes L; Department of History, National University of Ireland Galway, and Social Sciences Institute, Maynooth University, Kildare, Republic of Ireland.
  • Stifani B; Department of Obstetrics and Gynecology, New York Medical College/Westchester Medical Center, New York, New York, United States of America.
  • Chavkin W; Global Doctors for Choice, New York, New York, United States of America.
  • Duffy D; Department of Social Work and Social Care, Manchester Metropolitan University, Manchester, United Kingdom.
  • Favier M; Parklands Surgery, Cork, Republic of Ireland.
  • Horgan P; Broad Lane Family Practice, Cork, Republic of Ireland.
  • Murphy M; Eldon Family Practice, Dublin, Republic of Ireland.
  • Lavelanet AF; UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
PLoS One ; 17(5): e0264494, 2022.
Article en En | MEDLINE | ID: mdl-35533193
BACKGROUND: In 2018, the right to lawful abortion in the Republic of Ireland significantly expanded, and service provision commenced on 1 January, 2019. Community provision of early medical abortion to 9 weeks plus 6 days gestation delivered by General Practitioners constitutes the backbone of the Irish abortion policy implementation. We conducted a study in 2020-2021 to examine the barriers and facilitators of the Irish abortion policy implementation. METHODS: We collected data using qualitative in-depth interviews (IDIs) which were conducted in-person or remotely. We coded and analysed interview transcripts following the grounded theory approach. RESULTS: We collected 108 IDIs in Ireland from May 2020 to March 2021. This article draws on 79 IDIs with three participant samples directly relevant to the community model of care: (a) 27 key informants involved in the abortion policy development and implementation representing government healthcare administration, medical professionals, and advocacy organisations, (b) 22 healthcare providers involved in abortion provision in community settings, and (c) 30 service users who sought abortion services in 2020. Facilitators of community-based abortion provision have been: a collaborative approach between the Irish government and the medical community to develop the model of care, and strong support systems for providers. The MyOptions helpline for service users is a successful national referral model. The main barriers to provision are the mandatory 3-day wait, unclear or slow referral pathways from primary to hospital care, barriers for migrants, and a shortage and incomplete geographic distribution of providers, especially in rural areas. CONCLUSIONS: We conclude that access to abortion care in Ireland has been greatly expanded since the policy implementation in 2019. The community delivery of care and the national helpline constitute key features of the Irish abortion policy implementation that could be duplicated in other contexts and countries. Several challenges to full abortion policy implementation remain.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aborto Inducido / Médicos Generales Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Female / Humans / Pregnancy País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aborto Inducido / Médicos Generales Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Female / Humans / Pregnancy País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos