POSITION PAPER on Provision of Termination of Pregnancy & enhanced Reproductive Care within the existing General Practice & Maternity Hospital setting.

And you may ask yourself, well How did I get here?

PROGRESS TO DATE April 2018- Doctors TFY Repeal the 8th WhatsApp / Meeting in UCC 25th May 2018- Repeal of 8th Amendment START Thurs 31st May meeting post Referdum and name change Regular meetings throughout summer. Thursday 19th July- Educational meeting What do we do with all this information Mid August proposal for Position Paper 10 Authors, 2 editors, 12 drafts

WHAT WE NOW KNOW General Practice is suitable for most Early Medical Abortions (EMA, LMP < 63 days). Over 63 days will need to be in secondary care. A 24/7 telephone helpline staffed by trained personnel will be an essential service to co-ordinate care, arrange appointment with providers, avoid obstructers, give reassurance or referral during TOP Most pregnant people who attend for TOP are sure of their decision. Most pregnant people who attend for TOP are sure of their dates. Ultrasound is not generally needed pre 63 days Anti-D is not needed pre 63 days

First visit Involved not complicated Discuss decision making process Decision made without coercion, informed consent Confirmation of dates, abdominal NOT bimanual exam Invx Haemoglobin essential, others (serum HCG, Blood group+ antibodies) STI screening Prescribing and dispensing medication Safety net Contraceptive plan

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NONE OF THIS CAN BE DONE WITHOUT SECONDARY CARE