Five years after the abortion referendum, Ireland’s services are lagging 'woefully behind', campaigner Ailbhe Smyth has told Pat Kenny.

May of this year marked the fifth anniversary of the Repeal Referendum – yet in those years, 860 women have still travelled abroad to access abortions.

A review published this year was tasked with examining how effective Ireland’s abortion regime has been since its introduction.

It recommended 10 law changes and 60 operational changes – including making the current three-day waiting period optional and changing the laws surrounding termination in cases of fatal foetal abnormality.

No amendments have been made to the legislation, and Taoiseach Leo Varadkar has said he would be "reluctant" and "uncomfortable" to make any changes.

Providers

Speaking to The Pat Kenny Show, Ms Smyth said the provisions in the law are still "not sufficient or appropriate to meet the needs of all those who need an abortion".

"The service provision is lagging really, I can only say woefully behind where it should be," she said.

"Women can't get abortions – very often when they're perfectly entitled to legally have it."

Ms Smyth said one-in-10 GPs offer medical abortion services, and over 50% of counties have fewer than 10 doctors offering the service at all.

"In nine or 10 counties, there are fewer than five," she said.

"This means that women may have to travel for four to six hours, and then may encounter a GP who says, 'Oh, no, I don't offer that service'.

"After your nine weeks on request, a GP needs to refer you to a hospital – as it stands at the moment, only 12 of the 19 maternity hospitals and units provide an abortion service."

Recommendations

Ms Smyth said one of the review recommendations was that hospitals are "sufficiently well-staffed in order to provide this service".

"When you're dealing with very time-specific procedures, nine weeks, 12 weeks, and so on, you need to be absolutely on the button with being able to provide these procedures," she said.

"The HSE has to be, in effect, mandated to recruit staff where insufficient staff are available or where there is a conscientious objection."

Ms Smyth said the three-day waiting period between being certified and having the abortion procedure is causing "a great deal of hardship for very many pregnant people".

"The vast majority of women who go to their doctor in the first instance do want to continue with the abortion," she said.

Ms Smyth also called for the "full decriminalisation" of abortion for doctors – meaning they could not be sent to prison for helping someone obtain the service beyond current restrictions.

"A third dimension is that up to nine weeks on request is fairly straightforward if you can access the service," she said.

"Between nine and 12 weeks you have to be referred to a hospital and after 12 weeks, that gestational limit comes down very sharply, very quickly.

"It is leaving a lot of women in a very ambivalent, very difficult situation. These, by and large, are of course the 860-plus women who are travelling every year.

"[It is] much more sensible that the post-12-week period be extended to viability, on the basis of the advice of the woman and her doctor.

"That decision should be made in a way which is much more case-by-case specific, rather than having blanket definitions."