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Termination of Pregnancy Knowledge and Services

Termination of Pregnancy Knowledge and Services

What was this project about?

On 25 May 2018, Ireland voted to repeal the 8th Amendment to the Constitution, thus allowing for the regulation of Termination of Pregnancy (TOP). Now that legislation has been passed, women are entitled to access terminations for pregnancies under 12 weeks. However, many of the logistical aspects of providing a TOP service (such as staffing, funding, allocation of time and resources, etc.) had not been addressed and the future of service provision within maternity hospitals remained largely unknown.

The introduction of this service has and will impact staff, and their cooperation will be vital for its successful implementation. Most staff will not have received any training about Termination of Pregnancy as only a minority will have been exposed to TOP in clinical practice working outside Ireland.

Prior to the widespread introduction of the service, it became important to assess current levels of knowledge. Hospital staff members are also best placed to answer the questions about challenges to the implementation of this services within the existing hospital structure. 

With this in mind, this study aimed to:

  • Examine the level of knowledge on TOP, and need for training, among staff and students in high/middle income countries;
  • Assess knowledge levels of TOP procedures, complications and legislation, among staff in a large maternity unit in Ireland;
  • Investigate staff perceptions of the main challenges to implementation of TOP services;
  • Analyse the uptake of the TOP service (<12 weeks gestation) in a large maternity hospital in Ireland, during its first year and the resources required to facilitate this.

What was involved?

This research involved three main studies:

  • A systematic review of the knowledge on TOP legislation and clinical practice among healthcare professionals and students in high/middle-income countries.
  • A study of the level of knowledge on TOP among staff in a large maternity unit, the training received and main challenges to the service.
    • These were assessed using a questionnaire (modelled on interim clinical guidance and previous published research in this area) distributed to clinical staff in a large maternity hospital.
    • This audit of early TOP services involved the systematic data collection based on review of information on the medical records of all women referred to these services for an early medical TOP. The data was recorded allowing examination of areas such as estimated gestation, admission, medication administration intervals, outcomes and complications.
  • An audit of the first year of early TOP services (less than 12 weeks gestation) in a Irish maternity hospital to understand care provided, protocols followed, demands on staff and potential areas for improvement.

Who was involved?

Project team

Name Affiliation
Professor Keelin O'Donoghue Lead, Pregnancy Loss Research Group 
Dr Eimear O'Shaughnessy Medical Student, Pregnancy Loss Research Group
Dr Sara Leitao Senior Postdoctoral Researcher, National Perinatal Epidemiology Centre; Pregnancy Loss Research Group
Dr Indra San Lázaro Campillo Postdoctoral Researcher, National Perinatal Epidemiology Centre; Pregnancy Loss Research Group

Dissemination activities

Journal articles

  • 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.
  • O'Shaughnessy E, O'Donoghue K, Leitao S. Termination of pregnancy: Staff knowledge and training. Sexual & Reproductive Healthcare. 2021;28:100613.
  • Leitao S, O'Shaughnessy E, San Lazaro Campillo I, O'Donoghue K. Healthcare professionals and students’ knowledge on termination of pregnancy legislation and clinical practice: a systematic review. Sexual & Reproductive Healthcare. 2022;33:100762100762.

Policy brief

Project status

Completed: 2020 to 2022

Further information

Please email Dr Sara Leitao:


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,