Department of Anthropology, University of Central Florida, Orlando, Florida, United States of America.
Department of Population Health Sciences, University of Central Florida, Orlando, Florida, United States of America.
PLoS One. 2022 May 9;17(5):e0264494. doi: 10.1371/journal.pone.0264494. eCollection 2022.
In 2018, the right to lawful abortion in the Republic of Ireland significantly expanded, and service provision commenced on 1 January, 2019. Community provision of early medical abortion to 9 weeks plus 6 days gestation delivered by General Practitioners constitutes the backbone of the Irish abortion policy implementation. We conducted a study in 2020-2021 to examine the barriers and facilitators of the Irish abortion policy implementation.
We collected data using qualitative in-depth interviews (IDIs) which were conducted in-person or remotely. We coded and analysed interview transcripts following the grounded theory approach.
We collected 108 IDIs in Ireland from May 2020 to March 2021. This article draws on 79 IDIs with three participant samples directly relevant to the community model of care: (a) 27 key informants involved in the abortion policy development and implementation representing government healthcare administration, medical professionals, and advocacy organisations, (b) 22 healthcare providers involved in abortion provision in community settings, and (c) 30 service users who sought abortion services in 2020. Facilitators of community-based abortion provision have been: a collaborative approach between the Irish government and the medical community to develop the model of care, and strong support systems for providers. The MyOptions helpline for service users is a successful national referral model. The main barriers to provision are the mandatory 3-day wait, unclear or slow referral pathways from primary to hospital care, barriers for migrants, and a shortage and incomplete geographic distribution of providers, especially in rural areas.
We conclude that access to abortion care in Ireland has been greatly expanded since the policy implementation in 2019. The community delivery of care and the national helpline constitute key features of the Irish abortion policy implementation that could be duplicated in other contexts and countries. Several challenges to full abortion policy implementation remain.
2018 年，爱尔兰共和国的合法堕胎权大幅扩大，并于 2019 年 1 月 1 日开始提供服务。由全科医生提供的妊娠 9 周加 6 天以内的早期医疗堕胎服务是爱尔兰堕胎政策实施的核心。我们在 2020-2021 年进行了一项研究，以调查爱尔兰堕胎政策实施的障碍和促进因素。
我们使用定性深入访谈（IDIs）收集数据，访谈是亲自或远程进行的。我们采用扎根理论方法对访谈记录进行编码和分析。
我们于 2020 年 5 月至 2021 年 3 月在爱尔兰收集了 108 次 IDIs。本文借鉴了与社区护理模式直接相关的 79 次 IDIs 的三个参与者样本：（a）27 名参与堕胎政策制定和实施的主要知情人，代表政府医疗保健管理、医疗专业人员和倡导组织；（b）22 名在社区环境中提供堕胎服务的医疗保健提供者；（c）2020 年寻求堕胎服务的 30 名服务使用者。社区为基础的堕胎服务提供的促进因素包括：爱尔兰政府和医学界之间的合作方法来制定护理模式，以及为提供者提供强有力的支持系统。面向服务使用者的 MyOptions 热线是一种成功的全国转介模式。提供服务的主要障碍包括强制性的 3 天等待期、从初级保健到医院保健的转诊途径不明确或缓慢、移民障碍以及提供者短缺和地理分布不完整，特别是在农村地区。
我们的结论是，自 2019 年堕胎政策实施以来，爱尔兰获得堕胎护理的机会大大增加。护理的社区提供和国家热线是爱尔兰堕胎政策实施的关键特征，可以在其他背景和国家复制。全面实施堕胎政策仍然存在一些挑战。
