Fatal fetal anomalies
Fetal anomaly diagnosis and termination of pregnancy in Ireland; a service evaluation following implementation of abortion services in 2019
Our service evaluation of fetal medicine clinics in two tertiary maternity hospitals between 2019-2021 emphasises the impact of legislative barriers to abortion care–and the need for policies and services that support women's access to termination of pregnancy–for major fetal anomalies.
- Authors
Hadas Miremberg , Keelin O’Donoghue
- Year
- 2023
- Journal Name
- American Journal of Obstetrics & Gynecology MFM
- Category
- Journal Article
- Keywords
- Audit / Service evaluation, Fetal anomaly, Termination of pregnancy, Termination of pregnancy for fetal anomalies
- Full Citation
Miremberg H, Oduola O, Morrison J, O'Donoghue K. Fetal anomaly diagnosis and termination of pregnancy in Ireland; a service evaluation following implementation of abortion services in 2019. American Journal of Obstetrics & Gynecology MFM. 2023. https://doi.org/10.1016/j.ajogmf.2023.101111.
- Link to Publication
- https://doi.org/10.1016/j.ajogmf.2023.101111
Abstract
The introduction of legislation for termination of pregnancy (TOP) in Ireland in 2019 for conditions ‘likely to lead to the death of the fetus’, made TOP for ‘fatal fetal anomaly’ (FFA) an option for pregnant women in Ireland. We examined all cases of TOP performed for major fetal anomaly over the first three years of service implementation in fetal medicine clinics in two tertiary maternity hospitals between 2019-2021. We compared pregnancies diagnosed with FFA who underwent TOP in Ireland and pregnancies that did not meet the legal criteria, meaning women travelled outside Ireland for TOP. We included 139 pregnancies in our analysis. Eighty-three (59.7%) cases had TOP in the tertiary maternity hospital (local), and 56 (40.3%) travelled abroad, mainly to the UK. The most common reason for local TOP was Trisomy 18, followed by anencephaly. Travelling to get abortion care was mainly because of the diagnosis of Trisomy 21, followed by other multiple structural anomalies/syndromes deemed locally as not meeting the legal criteria. Legislation for TOP for fetal anomaly, restricted to fatal diagnoses, is difficult to implement, requires significant multidisciplinary input, and can lead to limited services for pregnancies diagnosed with major fetal anomalies.