Background The Republic of Ireland has one of the world’s most restrictive abortion laws, allowing abortion only to preserve a pregnant woman’s life. We examined the impact of the law on women’s options for accessing abortion, their decision-making regarding whichpathway to follow, and their experiences with their chosen approach.
Methods We conducted semi-structured in-depth interviews with 38 women who had either travelled abroad to access abortion in a clinic or had self-managed a medical abortion at home using online telemedicine, between 2010 and 2017. We coded interview transcripts according to an iteratively developed coding guide and performed a thematic analysis to identify key themes.
Results We identified four key themes: (1) self-managing a medical abortion at home using online telemedicine can be a preference over travelling abroad to access abortion services; (2) regardless of the pathway chosen, women experience a lack of pre- and post-abortion support in the Irish healthcare system; (3) feelings of desperation while searching for safe abortion care can lead to considering or attempting dangerous methods; and (4) Irish abortion law and attitudes have impacts beyond physical health considerations, engendering shame and stigma.
Conclusions Despite the country’s restrictive abortion law, women in Ireland do obtain abortions, using methods that are legal and safe elsewhere. However, the law negatively impacts women’s ability to discuss their options with their healthcare professionals and to seek follow-up care, and can have serious implications for their physical and emotional health. This study’s findings provide evidence to inform public and policy discourse on Ireland’s abortion laws.
- online telemedicine
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Contributors ARAA designed the research question and the study approach. ARAA, DMJ, KB and EP all contributed to the design of data collection instruments, data collection, and data analysis and interpretation. ARAA, DMJ, KB and EP all contributed to writing the first draft of the manuscript, and all read and revised subsequent drafts for intellectual content. ARAA, DMJ, KB and EP all approved the final draft of the manuscript for submission and accept responsibility for the article as published.
Funding The study was supported by funding from a Junior Investigator grant from the Society of Family Planning, a grant from the European Society of Contraception and Reproductive Health, and a grant from the HRA Pharma Foundation (ARAA was the Principal Investigator for all grants). The study was also supported in part by infrastructure grant P2CHD042849, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Society of Family Planning, the European Society of Contraception and Reproductive Health, or the HRA Pharma Foundation. None of the funders had any role in the conduct of the research or preparation of the manuscript.
Competing interests None declared.
Ethics approval The study received ethics approval from the Institutional Review Board at the University of Texas at Austin.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
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