Termination of pregnancy services: a year in review in a tertiary maternity hospital

Audit of 1st year of TOP in a large maternity hospital shows variation in time between mife and misoprostol administration and inconsistent management of pregnancy tissue. Clear protocols and staff education vital to ensure high-quality service and welfare of staff and women.

Eimear O'Shaughnessy, Sara Leitao, Keelin O'Donoghue
Journal Name
BMJ Sexual & Reproductive Health
Journal Article
Termination of pregnancy
TOP Knowledge and Services
Full Citation
O'Shaughnessy E, Leitao S, Russell N, O'Donoghue K. Termination of pregnancy services: a year in review in a tertiary maternity hospital. BMJ Sexual & Reproductive Health. 2021;47:231-232.
Link to Publication


In 2019, a new termination of pregnancy (TOP, or abortion) service was introduced in Ireland. Due to the short time between approval of this legislation and launch of these services, healthcare professionals expressed concern regarding the ability of maternity hospitals to provide care without sufficient planning, funding or resources. We conducted a review of all cases of women referred to these services in a large maternity hospital. We examined data from all cases of early pregnancy medical terminations (abortions with <12 weeks gestation and completed by taking prescribed medication) during the first year of the service. Differences were observed in the TOP care received by women, in the time intervals of medication administration and management of complications related to placental or fetal tissue retained in the uterus after the TOP was performed. This audit also highlighted the small number of participating consultant doctors and a limited involvement of doctors in training. Our findings reflect difficulties faced in hospital care to adapt services, organise resources, and provide training. It is vital that clear protocols, procedures and necessary resources and staffing are in place to ensure a high-quality standardised delivery of care that protects the well-being of both staff and women.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,