THE WOMEN COME with everything. Contraception needs, infertility, threatened miscarriage, recurrent pregnancy loss.
Pregnancy can be a cherished planned life event or an unwanted crisis. Women can now access abortion care in my practice. They are not “othered”. When under 12 weeks gestation, they are not relegated to silence and shame and online pills and hurried hushed decisions made around Ryanair flight schedules to Manchester, Liverpool, Amsterdam.
We have had the abortion debate in this country. The issue was examined and discussed in detail and the democratic will of the people was heard. Many were unhappy with the outcome of the referendum and they have a right to protest, appropriately, in the correct political space. What they do not have a right to do is target patients as they attend healthcare appointments.
We now have legislation and a legal framework for the termination of pregnancy in Ireland. There is a holistic wraparound GP care, a helpline called “my options” for counselling. We provide follow up and contraception plans. Hospital backup provides a safety net. Most patients are clear and resolute in their needs and decisions; others need time for consideration of their options. All need respect and space and safe access to healthcare.
Community care comes first
When a patient comes to see their GP, they bring with them all manner of stories, issues and worries. What they absolutely do not deserve as they do so is to be confronted by a group of anti-abortion protesters at the gates, holding placards, coffins and other often distressing paraphernalia.
General Practice is by its nature the heart of community care. That means everyone – your mothers, fathers, siblings and friends and these patients come with every imaginable issue. They cross the same threshold and pass through the same gate. Prostatism, abusive relationships, terminal illness. Embarrassing illness. Stress. Erectile dysfunction. Menstrual irregularities. Menopause. Rashes, STIs, Baby checks. Covid. Certification for minor illness and work absence.
Some are collecting death certs for loved ones. There are teens with suicidal ideation and self-harm. Older people with dementia. Screaming babies, anxious first-time parents attending for baby checks and injections. Chest pains, Shortness of breath, family planning, panic attacks, depression. Addiction, poverty, influenza, affluenza, warfarin checks.
Illness in the prodromal phases before it is defined, long since diagnosed named and treated recurrent maladies. The whole kit and caboodle of human frailty and vulnerability and everything in between. They do not need to see protestors with placards and their value judgements.
There are patients who have spent time in Magdalene laundries, or who remember friends, sisters, cousins being spirited away to such hushed places to live out their fates and atone for their “sin” and shame.
We have clergy and devoutly religious people who attend for their own private medical needs. There are women who have their own abortion stories. A lady attends an annual summer visit with her older parents. We co-consult and safety net for the “what-ifs” that may befall her parents when she goes back to her life abroad.
A fleeting visit is all she can stomach in Ireland. She has stayed away since Irish society relegated her “a fallen woman” for getting pregnant out of wedlock in her teens.
Hints of our dark past
A retired midwife tells me about giving out wedding rings on the wards to the single mothers in the Coombe hospital long ago. Carefully secreted rings were kept in a quiet place by a kind ward sister and placed on trembling unwed fingers lest they incur undue scrutiny, disdain or wrath.
‘Illegitimate’ babies were wrested from loving mothers or sometimes abandoned by petrified girls. The righteous had unshakeable beliefs underpinned by resolute certainty of moral high ground. Maternity care was policed and “manned” by religious zealotry. Shame was weaponised for control of women and their bodies.
We have come so far in Irish healthcare. There is still much to protest about such as inequitable access to doctors, lack of resources, A+E trolleys and waiting lists. We need free contraception for all those who need it.
However, amid all these changes and while we, clinical staff in surgeries try our best to help people through all of this, in a global pandemic, we are also faced with continuous and inappropriate protests around abortion care, taking place right outside our door. This cannot continue, for the sake of patients, staff and our wider society.
Obstruction and intimidation of staff and patients outside our surgeries and hospitals needs to be illegal. Picket the Dáil or the Government Offices, but not patients trying to quietly see their doctor as they navigate private life cycle health events.
This is General Practice. For many, the clinic is a sanctuary and respite from their difficult lives. The crises, the diseases, they come and go, the patients stay. The protestors need to stay away.
Dr Brian Kennedy is a Gp in Nenagh, County Tipperary and a member of START (Southern Task Force on Abortion and Reproductive Topics).
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