Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service

This article focuses on access to early medical abortion care under Section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018, in Ireland and identifies existing barriers resulting from gaps in current policy design. The article draws primarily on qualitative interviews with 24 serv...

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Main Authors: Dyuti Chakravarty, Joanna Mishtal, Lorraine Grimes, Karli Reeves, Bianca Stifani, Deirdre Duffy, Mark Murphy, Mary Favier, Patricia Horgan, Wendy Chavkin, Antonella Lavelanet
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Sexual and Reproductive Health Matters
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/26410397.2023.2215567
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author Dyuti Chakravarty
Joanna Mishtal
Lorraine Grimes
Karli Reeves
Bianca Stifani
Deirdre Duffy
Mark Murphy
Mary Favier
Patricia Horgan
Wendy Chavkin
Antonella Lavelanet
author_facet Dyuti Chakravarty
Joanna Mishtal
Lorraine Grimes
Karli Reeves
Bianca Stifani
Deirdre Duffy
Mark Murphy
Mary Favier
Patricia Horgan
Wendy Chavkin
Antonella Lavelanet
author_sort Dyuti Chakravarty
collection DOAJ
description This article focuses on access to early medical abortion care under Section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018, in Ireland and identifies existing barriers resulting from gaps in current policy design. The article draws primarily on qualitative interviews with 24 service users, 20 primary healthcare providers in the community and 27 key informants, including from grassroots groups that work with women from different migrant communities, to examine service users’ experiences accessing early medical abortions on request up to 12 weeks gestation. The interviews were part of a wider mixed-methods study from 2020-2021 examining the barriers and facilitators to the implementation of abortion policy in Ireland. Our findings highlight care seekers’ experiences with the GP-led service provision, including delays, facing non-providers, the mandatory three-day waiting period, and oversubscribed women’s health and family planning clinics. Our findings also highlight the compounding challenges for migrants and additional barriers posed by the geographical distribution of the service and the 12-week gestational limit. Finally, it focuses on the remaining challenges for racialised and other marginalised groups. In order to provide a “thick description” of women’s lives and the complexity of their experiences with abortion services in Ireland, we also present two narrative vignettes of service users, and their experiences with delays and navigating the healthcare system as migrants. To this effect, this article applies a reproductive justice framework to the results to highlight the compounding effects of these barriers on people located along multiple axes of social inequality.
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spelling doaj-art-3fef294ff458409ea7bf18560e75eed02025-08-20T03:31:46ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972023-12-0131110.1080/26410397.2023.2215567Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the serviceDyuti Chakravarty0Joanna Mishtal1Lorraine Grimes2Karli Reeves3Bianca Stifani4Deirdre Duffy5Mark Murphy6Mary Favier7Patricia Horgan8Wendy Chavkin9Antonella Lavelanet10Postdoctoral Researcher, School of Sociology, University College Cork, Cork, Republic of Ireland.Professor, Department of Anthropology, University of Central Florida, Orlando, FL, USAPostdoctoral Researcher, Social Sciences Institute, Maynooth University, Maynooth, Republic of IrelandResearch Specialist, Department of Population Health Sciences, University of Central Florida, Orlando, FL, USAComplex Family Planning Specialist, Westchester Medical Center / Clinical Assistant Professor, New York Medical College, New York, NY, USASenior Lecturer in Global Inequalities, Department of Sociology, Lancaster University, Lancaster, UKGeneral Practitioner, Eldon Family Practice, Dublin, Republic of IrelandGeneral Practitioner, Parklands Surgery, Cork, Republic of IrelandGeneral Practitioner, Broad Lane Family Practice, Cork, Republic of IrelandCo-Founder, Global Doctors for Choice, New York, NY, USAMedical Officer, 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, SwitzerlandThis article focuses on access to early medical abortion care under Section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018, in Ireland and identifies existing barriers resulting from gaps in current policy design. The article draws primarily on qualitative interviews with 24 service users, 20 primary healthcare providers in the community and 27 key informants, including from grassroots groups that work with women from different migrant communities, to examine service users’ experiences accessing early medical abortions on request up to 12 weeks gestation. The interviews were part of a wider mixed-methods study from 2020-2021 examining the barriers and facilitators to the implementation of abortion policy in Ireland. Our findings highlight care seekers’ experiences with the GP-led service provision, including delays, facing non-providers, the mandatory three-day waiting period, and oversubscribed women’s health and family planning clinics. Our findings also highlight the compounding challenges for migrants and additional barriers posed by the geographical distribution of the service and the 12-week gestational limit. Finally, it focuses on the remaining challenges for racialised and other marginalised groups. In order to provide a “thick description” of women’s lives and the complexity of their experiences with abortion services in Ireland, we also present two narrative vignettes of service users, and their experiences with delays and navigating the healthcare system as migrants. To this effect, this article applies a reproductive justice framework to the results to highlight the compounding effects of these barriers on people located along multiple axes of social inequality.https://www.tandfonline.com/doi/10.1080/26410397.2023.2215567abortion, careservice user experiencemigrant healthreproductive justicehealth policy implementationRepublic of Ireland
spellingShingle Dyuti Chakravarty
Joanna Mishtal
Lorraine Grimes
Karli Reeves
Bianca Stifani
Deirdre Duffy
Mark Murphy
Mary Favier
Patricia Horgan
Wendy Chavkin
Antonella Lavelanet
Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service
Sexual and Reproductive Health Matters
abortion, care
service user experience
migrant health
reproductive justice
health policy implementation
Republic of Ireland
title Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service
title_full Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service
title_fullStr Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service
title_full_unstemmed Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service
title_short Restrictive points of entry into abortion care in Ireland: a qualitative study of expectations and experiences with the service
title_sort restrictive points of entry into abortion care in ireland a qualitative study of expectations and experiences with the service
topic abortion, care
service user experience
migrant health
reproductive justice
health policy implementation
Republic of Ireland
url https://www.tandfonline.com/doi/10.1080/26410397.2023.2215567
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