Box 2.

Quotes from the providers of liberalised abortion care in the Republic of Ireland in support of Theme 2 – Lessons from the service implementation

The “teething problems”
Initial service demand “I had thirteen requests in the first week. It was madness and I absolutely wasn’t prepared for it, and I had to take my name off the public list for a while so, you know, our practice wasn’t prepared for it, I wasn’t prepared for it.” [3-GP] Conscientious Objection “It was quite traumatic for the girls here sometimes on a weekend when they couldn’t get a doctor to write a medication or that some of the consultants were clearly having nothing to do with these women, like they were dirt. And that really upset me, and I didn’t let it go, because regardless of any woman’s decision, everyone deserves to be treated correctly. So that’s been the hardest part for me.” [12-M]
Varying levels of service integration and normalisation
Within General Practice “I think it was important and it was pivotal for a very robust service to come into primary care … and it’s been profound to have the feedback again from the women we are privileged to treat to say “I felt so normal, nobody knew why I was there,” you know? “You called in an old man before me, a couple of kids running around, and no one knows why I’m here”. That’s huge.” [4-GP] “I think that the proof of the pudding is out there, that a lot of the international commentary is praising the Irish system for community provision.” [9-GP] Within Hospitals “I’ve been involved in abortion care in each of three Dublin hospitals, each of them has their own distinct ethos when it comes to everything and while they all follow the same guidelines, because they’re the national guidelines, they’ve been issued, you know, they’re based on the WHO guidelines which are available to everybody in the world, there are different approaches to the development of a service in each of those hospitals.” [8-Ob] “With the more open environment, there is a chance to discuss [abortion care] with colleagues who maybe don’t or haven’t thought much about it, you know, which is often the case. So people just kind of think, “Oh well, I don’t want to be involved in that,” but never sort of sit down and think why or what are my reservations.” [10-Ob] “They’re your colleagues and you’re all supposed to be doing somewhat similar work and what, they’re getting an extra break? … there’d be no like “Oh I’ll come, you have a break now, you go and have your twenty minutes that I had there.”” [6-N] “We have [to] look after the providers in this service, I think that’s really more important. And the unions would be very much all about the conscientious objectors … we know the people that are conscientious objectors, and they know their limits, but, you know, our role is expanding all the time too so it’s not easy for us as the providers and I think we just need a lot more support out there to help us in the service.” [11-M]