More than 80 per cent of those in the medical profession believe early abortion training should be mandatory, a first of its kind Irish study has found.
Currently, Irish GPs can provide Early Medical Abortion (EMA) in pregnancies less than 10 weeks gestation, but currently there is no published data regarding education for community EMA amongst undergraduate medical students and GPs in Ireland.
Of the 261 individuals working in this area, 60 per cent had received EMA education. 81 per cent believed that EMA training should be mandatory. 92 per cent were medical students, 75 per cent of trainees and 54 per cent of trainers. 18 per cent of undergraduates and 29 per cent of trainees had sat in on an EMA consultation.
Of these, 90.5 per cent of undergraduates, 97.2 per cent of trainees and 100 per cent of trainers, reported that attending a consultation made them think about their involvement in such abortions.
The study co-authors, which is published in this month’s Irish Medical Journal said: “EMA is now part of GP services and the medical curriculum has not been universally updated to reflect this.
"This study highlights that many doctors believe EMA education should be part of the curriculum irrespective of intention to provide and shows there are knowledge gaps,” when it comes to such care."
The study, Early Medical Abortion - Education and Training Experiences, examines the education experience of Irish undergraduate medical students, GP trainees and trainers, regarding EMA, and assesses their knowledge and attitudes to the topic.
Prior to 2018, pregnancy terminations could only be carried out in the case of a real and substantial risk to the life of the pregnant person. In May 2018, the Referendum on the 36th Amendment of the Constitution was passed by a majority and subsequently the Health (Termination of Pregnancy) Act was passed and came into effect on January 1st 2019.
The study refers to section 12 of the Act where abortion is permitted up to 12 weeks of pregnancy without restriction.
The Health Service Executive (HSE) model of care allows for community provision of EMAs by GPs up to 10 weeks gestation.
The Act also includes a mandatory three-day wait for service users. The three-day wait begins on the day that a doctor certifies that in their reasonable opinion formed in good faith, the pregnancy does not exceed 12 weeks gestation.
In the UK, where abortions have been legally provided since 1967, one in three women will have an abortion by the age of 45. This makes abortion a routine part of reproductive healthcare.
The co-authors added: “This study is the first of its kind in Ireland assessing undergraduate medical students, GP trainees and GP trainers' attitudes towards early medical abortion education. It intentionally does not analyse ethical considerations and instead focuses on attitudes toward education.
“The study shows that more education is being delivered at an undergraduate level than in previous years with GP trainers having received the least education in the area.”
While 81 per cent of respondents said EMA education should be mandatory at undergraduate level, this view was held least among GP trainers.
"This may suggest a generational gradient in the view that abortion is part of healthcare, mandating the provision of education in it. The main gap in knowledge highlighted was that many participants were unaware of who can certify, the three-day wait, how to certify, and medications used,” the authors concluded.
“The lack of GP trainers providing the service is mirrored in the result that only 29 per cent of GP trainees had the opportunity to sit in on an EMA consultation. This has implications for the training of future providers and thus the future provision of the GP delivered community abortion service.
“Overall, this study highlights that EMA education is an important and necessary part of undergraduate and postgraduate medical training and that most participants believe EMA education should be mandatory irrespective of intention to provide”.
This article was amended at 4.15pm on March 25th, 2024.
