Besides a fleeting protest in Galway, abortion has become available in 22 of Ireland’s 26 counties with barely a fuss

This article is more than 1 year old

This article is more than 1 year old

Ireland voted by a landslide to legalise abortion – but turning that social revolution into medical reality has fallen largely on the shoulders of just 200 GPs.

Apprehension on all sides before launch of Irish abortion services Read more

That is the approximate number, representing 5% of all general practitioners, that have signed up to perform the service which started rolling out on 1 January.

Ethical qualms, doubts about clinical readiness and fear of protests have deterred the rest, leaving the abortion providers to face potential isolation, stigma and harassment from the remnants of Catholic Ireland.

So far that has not happened. There has been minimal backlash.

“We’re going around wondering, ‘are they planning something we’ve missed?’” said Mary Favier, a prominent pro-choice campaigner and GP who provides abortion services in Cork. “But we can’t see what it’s going to be.”

Besides a fleeting protest in Galway – half a dozen people with placards picketed a surgery for a few hours – abortion has become available in 22 of Ireland’s 26 counties with barely any fuss.

“People have been pragmatic and got on with it,” said Tom O’Dowd, who has a surgery in west Dublin. “US-style picketing doesn’t seem to work here.”

While speaking to the Guardian in his county Kildare surgery this week Brendan O’Shea’s phone rang: it was a fellow GP from a neighbouring county seeking misoprostol, an abortion pill, for a patient. O’Shea obliged. A scene not long ago unimaginable is now becoming commonplace.

Facebook Twitter Pinterest Brendan O’Shea at his GP practice in county Kildare. Photograph: Rory Carroll/The Guardian

“Irish history is moving rapidly at the moment,” said O’Shea, who at 57 can recall a colleague who was prosecuted in the 1970s for supplying condoms in breach of a contraception ban. “It’s not Catholic Ireland any more. It’s a creatively disrupted society undergoing rapid evolution.”

In a referendum last May two thirds of voters opted to lift a near-total constitutional ban on abortion, a landmark victory for women’s rights. The Health (Regulation of Termination of Pregnancy) Act was signed into law just before Christmas.

Under the new system GPs provide abortions to women up to nine weeks pregnant and hospitals perform terminations at between nine and 12 weeks, after which abortions are allowed only in exceptional circumstances. The GPs hope to end a three-day “cooling off” period for women seeking abortions, calling it a restriction without medical reason.

The service is largely free, with the state paying GPs approximately €400 (£358) per patient. Previously an average of about 3,000 Irish women travelled to England each year for abortions.

Women from Northern Ireland, where abortion remains banned, can access the Republic’s new service but must pay.

In addition to the Galway GP office, some anti-abortion activists briefly picketed a hospital in Drogheda. Others set up potentially misleading websites that mimic the state’s unplanned pregnancy support service.

It's like a whole new medical process that we've never really got our heads around GP Sarah Fitzgibbon

Such tactics appear to have fizzled out even among people who voted against legalising abortion. The archbishop of Dublin, Diarmuid Martin, urged protesters to be cautious, saying the church should focus on educating people and helping women in crisis.

“Some of the GPs in small towns are finding it difficult because the clergy have been looking for them, wanting a word in their ear, but they’re not egging on protests,” said O’Dowd.

A bigger challenge has been the speed of rollout, which has left many GPs lacking proper information, guidance and training.

“We have no experience either through undergraduate or postgraduate training,” said Sarah Fitzgibbon, a Cork-based GP who will not sign up until she feels better prepared. “It’s like a whole new medical process that we’ve never really got our heads around.”

Abortion care providers find solidarity in groups like Doctors for Choice and the Southern Taskgroup on Abortion and Reproductive Topics (Start). They share tips through WhatsApp.

“We have set up buddy systems so we can all talk to each other. Everyone is encouraged to ask questions,” said Favier.

O’Shea, the Kildare GP, expressed confidence more colleagues would sign up as the service settled down. Ireland, he said, could take pride in its path to abortion rights: a citizens’ assembly, a referendum, legislation and service rollout. “It has been quietly inspiring.”