Reproductive Rights (Amendment) Bill 2026: Second Stage [Private Members]

Deputy Holly Cairns

I move: “That the Bill be now read a Second Time.”

Eight years ago, Ireland voted overwhelmingly to repeal the eighth amendment. People voted for compassion and to end the cruelty of forcing women onto planes and ferries. They voted because we believe women should be able to access abortion here at home, with their families, doctors and support systems around them. While enormous progress has been made since then, the promise of repeal has not been fully realised. Many women who receive devastating diagnoses of fatal foetal conditions, often after the 20-week scan, are still forced to make that long, lonely journey to the UK. The mandatory three-day waiting period continues to create unnecessary distress and delay despite having absolutely no medical basis. The continued criminalisation of abortion creates fear among clinicians and stigma for patients.

These issues were all identified in the Government's expert review of the law three years ago. Three years later, women are still waiting. This is why the Social Democrats are bringing forward this Bill which is based on a very simple principle, namely that women deserve compassionate, timely and evidence-based healthcare not stigma, shame and barriers but healthcare. A few weeks ago on Leaders' Questions, I raised the case of Denise Whitmore who nearly died travelling to England for a termination after receiving a fatal foetal diagnosis. After everything they had already endured, Denise and her husband, Mark, were advised to smuggle their daughter Éadha home in the boot of their car in order that they could bring her home to Ireland. The result of our current legislation is that grieving parents are being made to feel like criminals for wanting to bring their daughter home. That is not what Ireland voted for in 2018.

As legislators, we do not get to look away from the reality because it is uncomfortable or complicated. We are the only people in this country with the power to fix laws that are causing harm. Right now, our law only permits a termination where the condition is likely to lead to the death of the foetus before birth or within 28 days of birth. Doctors, families and advocacy groups have repeatedly told us that this threshold is too narrow and too rigid. Doctors are being placed in an impossible position, and women are still travelling as a result.

The mandatory three-day waiting period is another example of a barrier that exists not because of medicine but because of politics. Once again, it is women who pay the price. The World Health Organization has been very explicit that mandatory waiting periods create barriers to care and should be removed because women are capable of making decisions about our own healthcare. We know from IFPA research that 98% of women return after the three days, so what does the law actually achieve? It does not improve healthcare or protect women. In some cases, it is pushing women beyond the 12-week limit entirely, forcing them to travel abroad again. This Bill would make a reflection period available to any woman who wants more time but would no longer force women who have already made up their minds to delay their care.

We also need to talk honestly about criminalisation. The World Health Organization is clear that abortion should be fully decriminalised and treated as healthcare, yet healthcare professionals in Ireland can still face up to 14 years' imprisonment. That matters because criminalisation creates a chilling effect whereby doctors must consider legal risk rather than focusing solely on the patient. Decriminalisation does not mean deregulation. There will be safeguards and accountability, and doctors will still be governed by professional standards and medical ethics. Healthcare should be regulated as healthcare as opposed to through the threat of criminal sanction.

I ask Members across this House not to close their minds to this legislation before the work has even begun. Allow this Bill to move to Committee Stage, because that is where we can do our best work, where we hear from experts and clinicians and where we can test and improve legislation and strengthen it. This Bill is not the final product; it is the start of improving a system we know is failing too many women. The gaps in our law were identified three years ago in the O'Shea review. Women are still living with the consequences of our failure to act. They deserve better.

Deputy Pádraig Rice

I thank my colleague Deputy Cairns for her leadership on this issue and for bringing forward the Bill. There are three things I would like to discuss which I think will come up during the course of our debate in the House this morning. The first is what the referendum was or was not about. For those of us on the progressive left who campaigned on this issue day after day, month after month and year after year, we are really clear about the what the referendum was and was not about. It was about listening to women, providing care and compassion, ensuring that no woman would have to travel abroad for healthcare and taking this issue out of the Constitution and into the hands of legislators to legislate in respect of it. It was also about reproductive rights and freedom, and that is what our Bill is about. For far too long, we looked away as women travelled abroad. That has to stop. We have to ensure that nobody is forced to go abroad. The referendum was also about smashing the shame, stigma and silence. We have to ensure that continues and that we have legislation which is robust and which works.

The second thing is that people will say there are difficulties with the Bill. That always happens with Opposition legislation. People they say that things need to change. To that, I say that the Minister should come back with amendments. That is why we have a ten-step legislative process. This is Second Stage. On Committee Stage, Report Stage and in the Seanad, the Bill can be amended and improved. Matters can be teased through on Committee Stage by the select committee. We can debate matters and fix things if they need to be fixed, and we can have a Bill that works for everybody. I am sure the over 600 officials who work in the Department of Health will work with the Minister on drafting amendments. Every time Bills - even Government Bills - are introduced, they are vastly amended on Committee Stage and on Report Stage. That can happen with this Bill too if, as has been reported, the Minister has difficulties with it.

The final thing I will is about the process of progress. When we had the Repeal referendum, it was not frozen in time. There was always going to be a review. The review of the legislation was built into the legislation. We now have the review. We need to act on it. In the same way as marriage equality, that was not the end of the campaign for LGBT rights. The repeal referendum was not the end of the campaign for reproductive rights. We will continue to campaign on this issue. If we do not with the vote tonight we will be back because the women of Ireland deserve better.

Deputy Gary Gannon

I will start with a simple premise which I imagine will be repeated by other speakers today - eight years ago, Irish people voted overwhelmingly to repeal the eighth amendment. One of the central promises of that campaign, a promise that moved many people, was that women would no longer have to travel abroad when they received a devastating diagnosis of fatal foetal abnormality. Today, eight years later, many women still have to make that traumatic journey. That is a starting point for this debate; it is not about ideology or politics. The 2018 Act contained a provision for a review to take place after three years. That review happened. Marie O'Shea conducted it. She found serious systemic problems. That was three years ago. The Oireachtas has not acted since.

The Bill before the House is designed to fix three of those problems, the first being that the mandatory three-day waiting period has no basis in medical evidence. The WHO is unambiguous on this. It recommends against mandatory waiting periods, finding no evidence of benefit and clear evidence of harm. Some 98% of women who attend services proceed after the wait. It does not change minds, it just delays care. It disproportionately punishes women who are already vulnerable, women in rural Ireland, women in abusive relationships, women who can least afford another trip, another day off work, another arrangement. The 28-day rule forces clinicians to predict with certainty how long a baby will survive after birth. That is not something medicine can reliably do and because clinicians cannot certify, some women are then turned away. They are forced to travel. They go through one of the most devastating experiences of their lives alone abroad and that cannot continue.

Ireland has a 14-year criminal sanction on medical practitioners. It is one of only three countries in Europe at that level. The WHO recommends full decriminalisation. That sanction creates fear in our hospitals. It drives conservative decision-making in grey areas and causes harm. I will be clear about what we are asking for today. We are not asking for everybody to support every line of the Bill in its final form. We are asking for it to go to Committee Stage in order to scrutinise it, test it and amend it where needed. Where a Government-commissioned review has already found systematic failures in primary legislation, refusing further scrutiny is not a neutral act. That is a choice to leave things as they are. Leaving things as they are means more women travelling, and we were elected to do better than that.

Deputy Jen Cummins

I thank my colleague, Deputy Holly Cairns, for the work she has done on this legislation. When I grew up in Ireland in the eighties and nineties, abortion was absolutely not allowed. It was not spoken about and was portrayed as something only certain types of women did, and there was a massive stigma to it. When I went to college there was no availability of information for people about safe and accessible abortion services here or abroad. Everything was hush-hush. If you got pregnant and there was a crisis pregnancy you were left to figure it out. If you found yourself in that situation and tried to find someone who might help you, it was almost impossible to find that information. Throughout the course of my career, I have worked with women who have been in crisis pregnancies. I worked with a 15-year-old girl who got pregnant and needed to have a termination. She had to travel for that termination. I worked with a woman who had a fatal foetal abnormality and had to make the heartbreaking decision to terminate her much-wanted pregnancy. It absolutely broke her heart. Abortion is one of those topics that is so divisive. It is uncomfortable to talk about it, and I think that comes from an era where women's rights were just put to the side. Now, it is 2026 and we need to have a situation where women should be treated with respect, dignity and trust. Irish legislation needs to trust women to know that the decision they are making is the correct decision. We need to protect them, and we also need to protect the medical workers who will give that care to the women.

This legislation seeks to ensure that women who receive a devastating diagnosis of fatal foetal abnormality no longer have to travel for care. It removes the three-day mandatory waiting period and provides more certainty about abortion in cases where a woman's health or life is at risk. It also clarifies the law when it comes to conscientious objection and removes the criminalisation of medics. As uncomfortable as some people may find this legislation and topic, it is imperative that we allow this legislation to move to Committee Stage to scrutinise it and make amendments and improvements that help women access the care they need.

Deputy Liam Quaide

I commend my party leader, Deputy Cairns, and her colleagues in the party, including Ellen Casey, on taking a lead on this Bill. Eight years ago, people in every part of this country voted to remove the eighth amendment from the Constitution. They did so because they had listened to women. They listened to women who had been sent away from their own country at moments of profound grief, fear and medical crisis. One of the central issues in that campaign was the tragedy of fatal foetal abnormality. Women and couples told the country what had happened to them. They described receiving devastating diagnoses in Irish hospitals and being told the care they needed could not be provided here. They described booking flights under a cloud of shame, travelling abroad, navigating an unfamiliar health system and trying to stave off the effects of the trauma they were living through before returning home carrying grief that had been made worse by the actions of this State. Those stories changed Ireland, yet years later some families are still being put through versions of the same ordeal. The recent public testimony of Denise Whitmore brought this home with painful clarity. Denise learned at a routine scan in 2024 that her baby had a fatal condition. Instead of being able to receive care in Ireland, Denise had to travel to Britain. Her experience is a warning that the law is still failing people in the precise circumstances the referendum campaign asked us to address.

The problem is the current legislation's narrow and inflexible parameters. In cases of fatal foetal abnormality doctors must operate within a framework that requires a level of certainty that is simply not possible in all instances. In real clinical situations, that level of certainty may not be available. Families facing devastating diagnoses should not be left in limbo because the law demands a level of precision that clinicians cannot realistically provide. The result for clinicians is fear and hesitation. Doctors are left worried about the legal consequences of acting. Families are left waiting for certainty that may never come, and some women are still forced to leave the country for healthcare. This is not what people voted for in 2018. This Bill would make the law more workable, more compassionate and more true to the complexity of real-world experiences of fatal foetal abnormality. It would provide clear legal space for care where there is a fatal condition affecting the foetus. It would also address the chilling effect of criminalisation of doctors who are providing healthcare in good faith. No decent healthcare system should force clinicians to practice under a spectre of fear when dealing with complex, sensitive and time-critical cases. No woman should be told in the middle of a pregnancy ending in tragedy that the Irish health system cannot care for her because the wording of the law is too narrow.

This Bill is not about reopening the referendum. It is about honouring it and taking on the recommendations of the Government's own review. Repeal was not meant to replace constitutional callousness with legislative obstruction. It was meant to ensure that women could access compassionate healthcare in their own country. We should allow this Bill to progress.

Deputy Eoin Hayes

I am proud today to support my party leader, Deputy Holly Cairns, in this Bill to implement much-needed changes to legislation governing terminations of pregnancies. There is a worthwhile history lesson we should remember in this debate. The people of this Republic made their decision on access to abortion care in 2018 by an overwhelming majority in the affirmative. Many opposed to this Bill will say that the electorate in that referendum made its decision on the basis of the terms set out in the Bill passed into law in 2018. If that is the position, what must also be acknowledged is that in keeping with the spirit of the referendum, this House agreed to reviewing the operation of the Act in a debate in late 2018. Section 7 of the 2018 Act legalising abortion in Ireland provided for review and, by implication, for future adjustments to the law. That section was introduced after the referendum, on Committee Stage via amendment on 6 November 2018 by the then Minister for Health, and current Fine Gael leader, Deputy Simon Harris. The amendment was agreed without objection and without a vote on both Committee and Report Stages. It stands to reason that all Members of the House, of all parties, agreed that a review of the legislation should be carried out, adjustments to the law made on foot of such a review and that this would be in keeping with the will of the people expressed through referendum. At the instruction of the Department of Health and under section 7 of the Act, Marie O'Shea issued her review of the Act three years ago in 2023. The Bill being introduced by my party leader today gives effect to the recommendations of that review. Upon introducing the concept of the review in November 2018, after the referendum had been passed, Deputy Simon Harris said:

It seems to me it would be wholly irresponsible for us as legislators to pass legislation on such an important issue to do with women's health and not keep it under review on the basis that our job is done. It is good practice to keep legislation under review.

He further said that it is important we check the Act, which is about access and women's healthcare and make sure it is working for women and the medical profession. Fianna Fáil and Fine Gael representatives in the debate agreed with the Minister. Even Deputy Tóibín, who was present at the time, did not object to the review amendment and did not call a vote on it. He agreed with it.

There is no conceivable argument therefore that this legislation before us, based on the output of that review, is not in keeping with the will of the people or the Dáil in 2018. In fact, it is the full interpretation of the will of the people and the Dáil in 2018. Any contention to the contrary is nonsensical and revisionist. As such, it is incumbent upon us to implement these provisions as recommended by the Dáil-sanctioned and Government-commissioned review and to do so as a matter of urgency to bring this forward to Committee Stage. Anything less would be a gross dereliction of duty to the constitutional role with which we have all been charged.

Minister for Health (Deputy Jennifer Carroll MacNeill)

I begin by acknowledging the women who have had truly heartbreaking personal circumstances in pregnancy and whom I know are the motivation behind this Bill by the Social Democrats. Many Deputies in all parties, both in government and in opposition, know people who have struggled with the worst news in pregnancy. I think of all of those women who inspired the Bill, the Social Democrats' work on it and this debate. I truly respect all Deputies' commitment to raising these issues. I always vote to enable debate. I worked in government in 2017 and 2018 to support the repeal referendum.

I thank the Social Democrats Members for meeting with me last Friday, along with the State's interim Chief Medical Officer, the deputy chief medical officer and officials from my Department, to discuss the Bill. I am grateful to them for that very constructive discussion. It gave me a much better opportunity to understand exactly what was being put forward, as I had some concerns and questions about the way in which the Bill was drafted. I am always reluctant to criticise the drafting of Bills because I was a drafter in opposition for Fine Gael for three years. I know how difficult it is and I really respect that process.

I agree that most legislation can be fixed if there is agreement on principles across the Houses and through the different Stages. In this case, however, I am afraid I cannot agree in that way because the issues are based on principles, which I will discuss presently, that are so fundamental they go beyond what I can agree here and fix later. I am asking colleagues to consider a different approach with which we could potentially work. I ask them to consider whether we could, for example, facilitate an engagement with the national women and infants health programme, NWHIP, and with the doctors who are discussing the improvements made since the O'Shea report, which Deputies opposite correctly relied on in the intent and drafting of this Bill. I ask that they consider how we could create a more structured engagement with any Deputy who wishes to understand exactly what has changed and how it is working from their perspective. That offer remains open irrespective of what happens today or at any other time.

The reality is that when it comes to legislation, words matter. We are here as legislators and the courts presume that we mean the impact of the words we say. This Bill raises both significant legal and operational concerns and I have to bring those concerns to the House. It proposes five major changes to the existing legislation. I see policy difficulties with four of those changes and legal difficulties in all cases. I do not believe in my heart that those difficulties are all necessarily intended, which is why I am so careful around the question of drafting. I have done what colleagues opposite are doing, namely, brought something forward to be debated, which is the purpose of this House in many ways. However, it is also its purpose to enact legislation and I must point out the difficulties in that regard.

The first and least problematic of the five issues concerns the amendments relating to the three-day waiting period. The arguments for and against the removal of that provision have been well aired in the public domain. I personally do not see any difficulty with the requirement. That is my personal position. It is a policy choice. The HSE has advised that the current model of care is safe and that it is reliant on it, but that could change were the Oireachtas to make changes in legislation. As I said, I consider this the least problematic issue.

The only drafting issue with this proposal, which could be fixed, is that it makes reference to a statutory right to a reflection period, which does not exist. There is no reflection period that exists anywhere else. There is no such statutory right. However, that is policy and it is fixable. I will not comment further on this matter, as I have already spent longer on it than I intended, other than to make the point that a woman is already entitled, as a matter of ordinary medical law and practice, to take any such time as she deems appropriate to consider her decision on whether to avail of a procedure. I do not believe that creating a specific statutory right of reflection is helpful. It is not a panacea. As I have indicated, the issue with this proposal is just a drafting one and can be fixed.

The other issues are more difficult. The second is the proposal for a reduction in the number of doctors making decisions. That applies in two areas. First, the Bill proposes to amend the statutory language to remove the requirement for two clinicians to be involved in the decisions regarding a termination where the life or health of a mother is at risk. There are really practical and clinical reasons that the input of more than one clinician is relevant in this decision-making. Doctors work as a team. Where, for instance, a woman's life or health is at risk because of psychiatric illness, a cardiology issue or a neurology issue, that will, of necessity, see the involvement of both a cardiologist, say, and an obstetrician. That is just the practical medical reality. Removing or changing that requirement creates an uncertainty I do not believe is helpful. The courts will interpret this later and that is meaningful. I do not have time to go into exactly how meaningful it is.

In section 11, it is proposed to change the number of doctors involved in the decision about a fatal foetal abnormality by not requiring both of them to do an examination. It is a subtle nuance and there is potential for dependence on notes. Again, the practical reality is that two doctors are necessary. There would be an obstetrician involved but there would also be a geneticist or neonatologist, who would be the other doctor identifying the fatal foetal abnormality and the trajectory of it. Changing the threshold from examination to potentially including notes brings in a measure of uncertainty for the courts later. Questions might arise as to how far back the notes go. There is an extra element of uncertainty. My understanding is that Deputies opposite are trying to reduce uncertainty, not create it.

I wish I had more time to go through this but, in practical terms, the dual professional signature is a fundamental principle of safety that is widely practised in healthcare. It is a critical safety mechanism for high-risk actions and serious decisions, and this is a serious decision. I am very aware of the unintended or tragic outcomes that have already occurred where core principles of safety have not been adhered to in that way. That is the difficulty with this proposal.

In addition, legally, the Bill provides that both those sets of decisions would be based on reasonable opinion formed in good faith and based on knowledge available at the time. That language is taken from the O'Shea report. I accept it is correct and I understand the motivation behind it. However, with all respect, Ms O'Shea is not a drafter. The good faith test is already well understood by the courts. Adding words to that introduces more complexity.

The third issue is with the ministerial clinical guidelines proposed in sections 9, 10 and 11. In short, I do not believe it is appropriate for me as Minister, or any Minister, to make clinical guidelines in any context. It is an interference in the independence of the medical profession. There may be a sort of assumption by Deputies opposite that every Minister is going to make guidelines that align with their view of the world. We already know that is not the case in respect, for example, of the heartbeat law that was introduced in Hungary in 2022. If a Minister were to bring in something similar here in clinical guidelines, it would require a woman to listen to the heartbeat before having a termination.

If the Social Democrats Members are on the progressive left, then I am on the progressive right. However, there are other Members of this House who take a very different view and I do not want any of them being Minister for Health and having the capacity to make ministerial guidelines. I do not believe we should bring that concept into legislation. I do not think it adds to what we are trying to do, which is to make things easier for women. Additionally, for doctors, it introduces more uncertainty because it says to them there are statutory rules and then there also are these ministerial guidelines. Which will the courts test? How does that work? We in this House are presumed to intend the impact of the changes we make in law, and that is the view the courts will take. I cannot support that concept. First, I do not want to create a precedent whereby we interfere in the medical profession in any area of clinical practice, whether it is obstetrics or cardiology. Second, I do not want to give a different Minister the opportunity to do something that would be very different from my world view. I do not believe it is a concept we should embed in legislation.

The fourth issue is the decriminalisation of medical practitioners. This would be a very substantial policy and legal change. At present, a doctor's decision does not have to be correct. Doctors do not have to be right; they just have to have made their decision in good faith. That is the defence. A question arises as to why a doctor who carries out a termination unreasonably or acting in bad faith should be exempt from criminal sanction. What is proposed is a blanket decriminalisation and it is not confined to the woman's treating doctor but to any doctor. That is a very significant change. It is not just a drafting issue that could be fixed.

I have only one minute remaining in which to deal with the most important issue, namely, fatal foetal abnormality. It is an extremely complex issue that raises many different ethical issues. I totally empathise with what the Bill is trying to achieve in this regard. I have met with and spoken to women who have faced unimaginable and harrowing circumstances. I want to explain why the Oireachtas took the approach of having the 28-day provision. I know these decisions are not easy. In fact, it is desperately difficult for anybody who falls outside that timeframe. It is only that I have just one minute remaining that I am not spending more time on this. I ask colleagues to forgive me for that. If I had time, I could detail some of those stories, as they have done.

I do not mean to cause any upset to anyone but the reason the limit is set at 28 days is that where there is a condition that results in the death of a live-born infant, that death nearly always occurs in the first 28 days. Those first four weeks are known as the neonatal period. Of the approximately 190 infant deaths that occurred last year, about 150 of them were within that period. It is not a figure chosen at random. It was chosen because it is related medically to the period in which an infant is most at risk.

Beyond that, the issue is extremely complicated. Members of the Social Democrats, People Before Profit and others have argued the period should be up to a year. However, if a baby can live for two, three or four months, I do not understand how we would pick a timeline for that. I would ask Deputies opposite to pick the number of days that are appropriate beyond 28 days. I personally find it impossible to do so. Instead, the Deputies have created the idea of a fatal condition the foetus might have.

That is the most expansive position that anybody has ever taken, and not just in this House. It impacts any condition that an infant or child might have. It goes way beyond the neonatal period. A fatal condition in the foetus is also one that a child would have, and there are a whole range of conditions. We know, as Members of the Oireachtas, that for people who are living to seven, eight, nine, ten or 20, these are fatal conditions. There is no point in Deputy Cairns shaking her head at me. This is the reality. This is true, and I really regret it. I am asking Deputies to come with me, to take a different approach and to take up my offer of meeting NWHIP and debating this issue in a different chamber. I do not want to be in a space against this when I know what the Deputies are trying to do is to resolve the cases of many women who have had such difficulty, but it is complex-----

An Cathaoirleach Gníomhach (Deputy Darren O'Rourke)

Time, Minister.

Deputy Jennifer Carroll MacNeill

-----and I need more time and space to explain that.

Deputy Jennifer Whitmore

I thank the Minister for her contribution and for meeting with us and the interim Chief Medical Officer, CMO, and the deputy CMO. She has gone through all of the reasons this is not going to work. She gave technical details. However, we can agree on the principle of what we are trying to achieve. We want this to go to the next Stage where we can have that in-depth discussion. We need to bring the experts before the committee. We need to bring people with lived experiences before the committee. We need to have this discussion in committee and that is why we are asking the Minister to support this Bill. I know it is complicated and complex, but the 240 women who had to travel for terminations outside the State last year do not want the Minister's empathy. They want her to legislate. They want her to ensure that no other woman has to do that and no other woman has to make the incredibly difficult decision with her family to terminate a baby that is wanted and loved. They do not want any other woman to have to make the decision to go to the UK to get the medical care that she requires. They do not want any other woman to have to make the decision as to whether to hide her baby in the boot of her car or to tell the ferry or airport that she is trying to bring her baby home. They do not want any other woman to have to leave her baby in the UK because she is afraid of bringing her baby back into the country illegally. They do not want any other woman or her family to have to go to Aldi to pick up ice - excuse me - so her baby can get home. They need the Minister to legislate. I know it is complicated, but that is the Minister's job.

I am sorry, but I cannot continue.

Deputy Sinéad Gibney

I thank Deputy Whitmore for her impassioned contribution. I thank the Minister for being here.

Just shy of eight years ago, we celebrated the repeal of the eighth amendment. I use the word "celebrated" in a measured way, because although this is a grave and serious issue, it was an issue on which views on both sides of the campaign to repeal the eighth amendment were deeply held. I respect the views of those who campaigned against the repeal of the eighth amendment. We celebrated because it was a milestone for women's rights and gender equality in this country. It was a tough campaign. I was chased down a street in suburban Dublin being told that I had blood on my hands. During the campaign, it was clear that the voices that spoke most clearly to the public were the voices of those women who had suffered fatal foetal abnormalities and their experience was one of the reasons that many people chose to repeal the eighth amendment.

We, as a State, built into that legislation a mechanism for review. Indeed, I contributed to that very review in my previous role. Within that review, there are clear recommendations as to what needs to be done to implement the repeal of the eighth amendment, yet this Government has failed to bring forward that legislation. So we have done exactly that. The Minister spoke about the principles that needed to be addressed. She spoke about legal and policy difficulties. She also mentioned subtle nuances. I urge her to work with us and bring this to Committee Stage so that we can work through those legal and policy difficulties, those subtle nuances, and arrive together at legislation that finally addresses this issue.

Here is the issue: it comes back to choice. I respect anybody's choice to take a three-day waiting period, but I do not respect the imposition of that three-day waiting period on me or anybody else who chooses to move ahead. Women know their bodies. They know what they are doing. They know when they make the choice to terminate a pregnancy exactly what they are doing. All that these measures represent is the hangover of an infantilistic and misogynistic approach to women's health that prevailed in this country for many decades. Indeed, in some areas, it still prevails. Women know. Women need to be trusted and to be given the choice to proceed with their healthcare and their reproductive rights in the way that they wish. I urge all Government TDs to vote for this legislation and bring it forward to the next Stage so that we can get past the Minister's subtle nuances-----

Deputy Jennifer Carroll MacNeill

That is not fair.

Deputy Sinéad Gibney

-----and legal and policy challenges. Those were the words the Minister used.

Deputy Jennifer Carroll MacNeill

That is not fair. I said there was a fundamental problem.

Deputy Sinéad Gibney

My point is that this legislation is on the books right now, ready for the House to debate it. The Minister said that it needed to be debated in other chambers. Where are those chambers? This is where it needs to be done. It needs to be debated at the health committee and in the Dáil so that we can finally legislate for what people voted for on 25 May 2018.

Deputy Aidan Farrelly

I thank the Minister for being here this morning, for her detailed contribution and for meeting the party in advance of this debate. I also commend Deputy Cairns and my friends and colleagues in the party for bringing forward what is, as we have said, the wording from a report commissioned by the Government. This is what we are trying to do.

In my political naivety, I thought the days when we asked women to share personal stories of trauma in order to enact legislative reform were behind us. Notwithstanding many of the meritable contributions in the Minister's speech, we cannot ignore some of the basic limitations to the legislation as it stands. We have spoken about the recommendations and the stance of the WHO on the three-day wait and the 28-day piece, but also the criminal sanction that is faced by practitioners and the fear that creates within that occupation.

I only appeal to the Minister on one issue. Similar things seem to be being said by people on either side of the House. The Social Democrats are asking the Government to work with us on this legislation. She has pretty much said the same thing to us. She is asking the Social Democrats to work with her on this legislation.

Deputy Jennifer Carroll MacNeill

Yes, but do not press a vote.

Deputy Aidan Farrelly

Did the Minister say it would not pass a vote?

Deputy Jennifer Carroll MacNeill

I am sorry. No, that is not what I said.

Deputy Aidan Farrelly

I ask for clarification.

Deputy Jennifer Carroll MacNeill

I am asking the Social Democrats to come and meet NWHIP with me to hear more of the reality. There are not 240 women travelling because of fatal foetal abnormalities. There are some, but there are many women travelling for other reasons because there are different thresholds in the UK and Ireland. Some who are travelling will never meet the threshold in Ireland because the UK threshold is about serious handicap and others. The group of women does not number 240. It is a much smaller number. They are very case specific. Some of them will not be fixed by legislation of this kind. I am asking the Deputies for that meeting and to really get into that detail. We will never be able to fix this for every single situation. That is what I am trying to say. That is practically impossible in this context.

Deputy Aidan Farrelly

What I have learned, as a still relatively new TD, is that when legislation such as this comes before the House, the Government either amends it into an abyss or it goes to the next Stage to have what I think we can all agree is something of a meritable debate. It needs to debated further. We all have different opinions and conclusions. As part of that, we bring in the expertise and the different stakeholders and talk it through. It would be deeply regrettable to say "Goodbye" to this legislation when a committee room would be the appropriate next chamber for us all to work on it together.

That is why I again appeal to the Minister, notwithstanding what she said in her contribution, to agree that there are many points in what we are saying today that make sense and there is significant evidence that backs that up. To me, that measure merits further conversation and legislatively that happens on Committee Stage. I again appeal to the Government to reconsider and allow the Bill to progress in order to have a debate on Committee Stage.

Deputy David Cullinane

I welcome the opportunity to debate the shortcomings in abortion services in Ireland. My priority is access for women to the services which were voted for and endorsed by the people in 2018 and the too many barriers which remain. One of those barriers is the three-day wait. Sinn Féin supports removing the three-day wait. We never supported the three-day wait in the first place. We have tabled legislation to remove the three-day wait and have always been clear that this waiting period does not provide care or support or make the service safer. Rather, it simply makes access harder.

We do, however, have significant concerns about the proposed new definition of a condition likely to lead to the death of the foetus, which is not grounded in the recommendations of the review of the Act and ignore the intention of a clear and tight definition. We are also concerned by proposals to decriminalise medical practitioners who knowingly and wilfully act illegally beyond the scope of the Act. We have a long history in this country of scandals in women's healthcare. The law is the law and medical practitioners should not be given carte blanche to act outside of the law.

I want to address each of these points and the other provisions in the Bill in turn. The provision of termination of pregnancy services was endorsed by the Irish people by referendum, with a clear picture of what those services would look like. The Act was put in place with a clear understanding that the legislation underpinning these services would continue to be reviewed for operational effectiveness. The review of the operation of the Act was published three years ago. It highlighted serious imbalances in access to care, significant geographic variation in access to services, the underdevelopment of regional services and barriers such as the three-day wait. My priority is that the services which were voted for and endorsed by the people in 2018 are fully operational and accessible to all women. Women should be able to access the services which were voted for democratically, yet there are still barriers for access for many, as identified in the review.

There is a postcode lottery in access to care. One of the biggest barriers identified in the review was a lack of GPs providing access to early medical terminations and the fact that regional centres and multidisciplinary teams are not fully operational. This creates a postcode lottery in access to care. Only 10% to 15% of GPs provide early medical termination services, which means fewer than ten GPs in some counties as of early last year. The review recommended a geospatial analysis of services to identify the biggest gaps. I am not aware of the Department ever conducting or publishing such a review. Maybe it exists and the Minister might come back to me on that. The review provided 75 recommendations to be worked through. Most do not require legislative change. It is important that the House receives an update on the steps the Minister is taking to improve services, to ensure access to services through community providers and to ensure hospital-based services are accessible in a timely manner. The Oireachtas did not intend for the Government to carry out a review and leave it on a shelf. The Minister for Health and the Taoiseach need to step up and implement the findings of the review. The Minister should bring forward a progress report on the consideration and implementation of the recommendations of the review.

Moving to the Bill before us, I note it proposes to remove the three-day wait, instead obliging doctors to inform a woman of her right to a reflection period, to be exercised at the woman's discretion, and I support that. The Bill proposes to replace the death within 28 days prognosis-based definition for a condition likely to lead to the death of the foetus, otherwise known as fatal foetal abnormality, with an open to interpretation, circular and untested definition, namely "that there is present a fatal condition affecting the foetus". That is not grounded in the O'Shea report and the review of the Health (Regulation of Termination of Pregnancy) Act. The Bill further proposes to remove clinical provisions for medical practitioners who knowingly and wilfully provide abortions, access to terminations or advice on terminations which are outside the scope of the Act and which are, and would remain, illegal in this State.

The Bill proposes to require practitioners or health professionals who are conscientious objectors to ensure access to abortions in an emergency. This is already provided for in the Act where there is an emergency threat to the life of the mother. This amendment, at best, seems to be redundant.

The Bill seeks to remove the requirement for two medical opinions for access to a termination on risk to life or health grounds, to allow access following consultation with a single practitioner and to require the Minister to, within six months, issue guidelines to provide clarity to medical professionals in carrying out procedures under risk to life or health in an emergency and a condition likely to lead to the death of a foetus grounds. Finally, the Bill seeks to require a further operational review of the Act within three years.

As I have set out, Sinn Féin supports removing the three-day wait for access to abortion services and replacing it with a right to a reflection period. We never supported the three-day wait. This waiting period does not provide care. It simply makes access harder, especially for women in difficult circumstances, whether they are victims of coercive control or domestic violence, rape or sexual assault or simply find out about their pregnancy too late and face timing out of access to care due to the mandatory wait. It particularly puts women who are subject to controlling or abusive partners and are from marginalised backgrounds in a difficult position because the first appointment may be the only appointment they get.

The clear feedback from women and the review of the Act was that some women were also being pushed beyond the 12-week threshold by the three-day wait, which denied them their choice to end the pregnancy. We have always said that when it comes to personal decisions such as abortion, we need to trust and support women when they are making these decisions.

We have all recognised in law and policy that women should have access to abortion services in the first trimester on the basis of their own free choice. This is the compassionate position put before the people in 2018 and it is the basis on which services have been provided since. Sinn Féin has tabled a targeted Bill to remove the mandatory three-day wait. We think that this Bill strikes the right balance. It is the right change to make. It respects women's decisions. It removes an unnecessary barrier to care. Removing the mandatory three-day wait does not provide remove a woman's ability to take more time if she wants to. That option will always remain open to her, and rightly so. Our Bill removes the requirement that the State must force every woman to wait, regardless of her circumstances, decision, health or needs. This is something that can be done quickly and should be done during the course of this Dáil term.

We fully agree with the need for robust clinically sound statutory guidelines to protect and direct clinicians in providing lawfully permissible services. The absence of guidelines was identified as a serious barrier to many clinicians providing care. Guidelines are essential to address issues identified with the operation of terminations under sections 9 and 10 relating to risk the life of the mother and section 11 of the Act where a condition is likely to lead to the death of the foetus. Terms such as "risk" and "serious harm" and the lack of reliable pathways were identified as problematic due to the lack of legal definition which asks clinicians to make philosophical judgments and puts them at risk of acting beyond the Act and illegally.

This Bill makes the same mistake with its definition of a fatal condition. We do not support the proposed definition for a condition likely to lead the death of the foetus, otherwise known as fatal foetal abnormality. This amendment is not grounded in the statutory review of the Act, which recommended a review with stakeholders to consider alternative grounds that would be clear to apply in practice and in keeping with the spirit of the legislation. The proposed definition in the Bill is untested and circular. The term "fatal" is not defined. There are no limits on it. It leaves the philosophical question of life and the balance of probabilities entirely to clinicians, which is not right and an abdication of our duty in this House. Most problematically, the amendment ignores the intention of a clear and tight definition and the process recommended by the review is ignored.

We should not insert untested and loosely drafted definitions into the Health (Regulation of Termination of Pregnancy) Act without having followed the right process. The review recommended the convening of stakeholders, including medical practitioners, other relevant healthcare professionals, patient representatives, lawyers and, of course, women, in order to obtain a better understanding of the challenges in section 11 and ensure that the multidisciplinary foetal medicine teams are properly resourced with the appropriate skills mix.

In the context of late-term abortions for fatal anomalies we are talking about pregnancies a person wants to keep, and made the choice to keep during the 12-week period. For these pregnancies we need to work with clinicians on guidelines to give effect to the intentions of the current definition, to consider only minor amendments to that definition to improve its operation and not its scope, and to work together to improve health services for children to ensure that where a family elects to continue a pregnancy they are supported if their child is born with a condition. There are many conditions that can be recognised as fatal under the proposed definition, not because they have to be but because the services to save the child's life are not present or functioning. They are fatal because successive Governments have failed to put in place the health services those children need to survive. Many conditions are present at a higher level in Ireland than in other jurisdictions, because instead of providing families with the supports and services they need for their child to survive and thrive, they have the option of an abortion because the child has an anomaly. I do not support that. I support families who have chosen to keep the pregnancy to have the best chance for their child. I support those children being able to live a good and healthy life. We do not support any slip into the territory of abortion on possibly fatal grounds. We do not believe that disability is a ground for an abortion or that this is in any way a progressive position.

I agree that no woman should be forced to carry an unviable pregnancy. I also agree that no woman should be forced to travel for services that should be lawfully available on this island, but it would be wrong to insert such an open-ended, untested and loosely drafted definition that puts families and children in a position where abortion is an option not because the child will not survive, but because the child might die because the State has not invested in the care the child needs.

We are concerned by proposals to remove offences for medical practitioners who knowingly and willfully act illegally beyond the scope of the Act. Abortion services in Ireland are decriminalised for an early pregnancy and otherwise for risk to the life or health of the mother or in the case of a condition that is likely to be fatal. We have a long history in this country of scandals in women's healthcare and the treatment of women and children by some parts of the health service. The criminal provisions retained in the 2018 Act are there to ensure that medical practitioners do not knowingly and willfully act illegally outside or beyond the scope of the Act. The law is the law and the medical practitioners should not be given carte blanche to act outside of the law. That would be ludicrous. Criminal sanctions were included in the Act to ensure that only those services endorsed by the people and by the Oireachtas are made available in this State. The way to address issues of criminalisation is through the application of clear, robust statutory guidelines on the provision of services under each different ground. That is how we balance protections for clinicians, parents and children. We acknowledge people's right to conscientious objection and the importance of protecting that, while ensuring that in emergency cases the life and health of the mother must take priority.

I am not convinced of the need for the proposed amendment on this issue. The point is already addressed in the existing law. The issue here again is a lack of statutory guidelines. We need to be very clear on this issue. When there is a risk to the life or health of the woman, there is an obligation on medical practitioners to try to save her life. We need to avoid any repeat of the tragedies that happened under the old system, like what happened to Savita Halappanavar. Her story is part of why we have the legislation we have today. In a repeat of those circumstances there should be no barriers or objections to saving a woman's life.

It astounds me that the Bill clearly goes far beyond the recommendations of the review. It disrupts the consensus-based approach that brought about repeal and presumes to rip up many of the safeguards that were presented to the people in order to convince them to repeal the eighth amendment in the first place. A genuinely constructive approach to improving services for women would have involved engagement across the Opposition to support the targeted Bills that are on the Order Paper for removing the three-day wait, tabled by me, Deputy Coppinger, and others, who have been trying to be constructive in removing the three-day wait period.

This Bill has no democratic legitimacy. It is not productive. It is not designed to become law. It proposes to significantly undermine the legal framework that was put before the people. Tremendous work was done by the committee on the eighth amendment and then by the health committee of the Thirty-second Dáil to bring this legislation together and to deliver services for the women of Ireland, which also addressed the concerns of people on safeguards and protections, in particular, for children with disabilities. We have approached this constructively.

We will work constructively across this House on the recommendations of the review, which need to happen to ensure the services we voted for are fully operational and accessible so that women who choose to avail of an early-pregnancy abortion have access to GP-led services; that where there is a risk to life the mother is prioritised; and to ensure that where there is a fatal condition affecting the foetus that women are not forced to carry unviable pregnancies, but that where a child can live and the family has elected to keep the pregnancy during the 12-week period, that the child is given every chance to survive and indeed thrive.

Deputy Ann Graves

I welcome the opportunity to speak on an issue that affects women's reproductive health right across the State. I acknowledge that we have come a long way. We have a lot done but there is a lot more to be done. We are in a society now that is far more caring and considerate than the one I grew up in, but we had to fight every step of the way for what we have. From the contraception trains in the 1970s, the campaign against the eighth amendment in the 1980s, criminalisation in the 1990s, right up to the campaign for women's right to choose in the noughties, we had to fight every single step of the way. I was proud to stand with women in making the changes on many of these campaigns.

The 2017 Citizens' Assembly on the Eighth Amendment of the Constitution was hugely important in moving the debate on, with 64% of participants voting in favour of unrestricted access to abortion and substantial support for the 12-week gestational limit. The referendum that followed was a turning point for women in Ireland. Finally, they could access reproductive healthcare, including abortion, without being criminalised or ostracised. Unfortunately, the legislation passed by the Oireachtas imposed a three-day wait for an early-pregnancy abortion. The review of the operation of the Act was published three years ago. It highlighted serious imbalances in access to care, significant geographic variation in access to services, the underdevelopment of regional services and barriers such as the three-day wait. It is time for us to make further progress.

One of the biggest barriers identified in the review was the lack of GPs providing access to early medical terminations. This creates a postcode lottery in access to care. Only 10% to 15% of GPs provide early medical termination services, which is less than ten in some counties. The review recommended a geospatial analysis of services to identify the biggest gaps. Sinn Féin supports the abolition of the mandatory three-day wait for an early-pregnancy abortion. We introduced legislation that would remove the mandatory three-day wait for access to an abortion during early pregnancy. It would represent practical and compassionate change. It puts women in a difficult position and it is not compassionate to those who suffer rape or sexual assault, those who learned of their pregnancy late or those who were subject to controlling or abusive partners for whom the first appointment may be the only appointment they can get.

We are concerned by proposals in the Bill to decriminalise medical practitioners who wilfully act illegally beyond the scope of the Act. We have a long history in this country of scandals in women's healthcare. The law is the law and medical practitioners should not be given carte blanche to act outside the law.

Deputy Donnchadh Ó Laoghaire

I welcome the opportunity to have this debate. It seems clear to me that while the referendum and the legislation that followed it was a watershed moment, it does not represent the end of the discussion by any manner or means. It also seems clear to me that further reform is needed - reform that is evidence-based, thoughtful and compassionate - that will deliver better, less stigmatising access to abortion for women who need it for what it is, that is, healthcare.

Sinn Féin supports removing the three-day wait period and replacing it with a right-to-reflection period. I welcome the opportunity to debate the shortcomings that exist in abortion services in Ireland, of which there are many. My colleagues have mentioned the postcode lottery. It is undoubtedly the case that in large parts of the country women are not in a position to access abortion services. That clearly needs to be addressed.

The three-day wait period, which Sinn Féin did not ever support, creates an unnecessary obstacle. It puts women in difficult situations, in particular women from minority backgrounds, or perhaps most of all those who are in a coercive control relationship, who may experience domestic abuse.

Therefore, accessing any appointment is a challenge, not to mention having to access frequent appointments or multiple appointments. Our priority is access to services, which were voted for and endorsed by the people, and too many barriers currently remain. Tá gá é sin a réiteach.

The proposals to decriminalise medical practitioners who knowingly and willfully act illegally beyond the scope of the Act is an issue that we find problematic and troubling. Unfortunately, we have a long and troubling history in this country of scandals in women's healthcare right up to recent years. The law needs to be clear and there should not be carte blanche. The provisions in this legislation could have significant unforeseen and unintended consequences. We believe there is scope and a need for constructive engagement to ensure thoughtful legislation to address the issues and in particular to ending the three-day wait, which is an unnecessary obstacle to services.

Deputy Marie Sherlock

My thanks to Deputy Cairns for bringing forward this Bill, which the Labour Party supports wholeheartedly. Compassionate care for women in real difficulty has been an issue for our party for many decades, long before it was mainstream for people to be talking about this. Indeed, many in the Labour Party were ostracised for many years. It is important to say at the outset that progress has been made over recent years in terms of the greater number of maternity units that are now providing access to termination of pregnancy. We know from this legislation that Deputies Cairns and Whitmore and others have brought to this House, that we still have a journey to travel.

When two thirds of all voters cast their vote in favour of repealing the eighth amendment eight years ago I passionately believed that they were not voting for a situation that would continue to see over 1,500 women travelling for healthcare in subsequent years. They were not voting for the continued criminalisation of healthcare professionals or for couples with much-wanted pregnancies being forced into impossible circumstances due to the uncertain 28-day rule. In 2023 the latest available data available from the UK Department of Health and Social Care showed that 240 women from Ireland travelled to the UK for termination of pregnancy. I believe the people in this country voted to stop exporting our Irish problem abroad. We voted to ensure that women could get the necessary healthcare here and yet they are still having to travel. They are having to travel because of very specific difficulties and flaws within the legislation.

When we voted eight years ago the legislation was put in place. People voted to take abortion, termination of pregnancy, and reproductive health out of Bunreacht na hÉireann and put it into the hands of the Oireachtas where representatives of the electorate could respond to the challenges or the issues that emerged. That is what we are doing here today. It is very regrettable to hear the Minister come in here and sympathise and acknowledge the issues and yet bring forward no plan or proposal as to what she is going to do.

The electorate eight years ago backed a process where we would have a legislative review after three years. Marie O'Shea's report was a year-long process. It was detailed, methodical and expert led with extensive consultation with over 7,000 submissions. It detailed professional academic research into the experience of service users. To my mind this report has been undermined and ignored by this arrogant Government. There was a commitment that the Government would have the review. It took way longer than necessary to publish that review and three years on we have had nothing. There is a key question for the Minister today. The Minister has said she is going to fix the three-day wait. Why is the Minister not bringing forward her own legislation into the Dáil? While all very welcome, frankly it is not good enough to be offering meetings. Why is she doing that now? The Minister has been backed into a corner and this Government has been backed into a corner where it has no answer on commitments that it made to the Irish electorate that it would have a review and act on that review. There are accusations out there that those of us in the Opposition are now trying to change the goal posts. In reality, it is actually the Government trying to change the goal posts by failing to respond to Marie O'Shea's very detailed recommendations that were issued over three years ago. That is the undemocratic part of what we are talking about here today.

With regard to the three-day period, we know from talking to doctors and to women that it is an unnecessary, impractical and stigmatising barrier to accessing the care that women need. When women go to their GP to say that they want to terminate their pregnancy they have already thought long and hard about it. They do not need to have a time to reflect. It is downright demeaning and degrading to be told go away for three days. While we acknowledge and respect that the Social Democrats have brought forward a particular mechanism with regard to the three-day wait, we in the Labour Party would be actually in favour of abolishing it altogether. It is much more straightforward. The World Health Organization has said very clearly that mandatory waiting periods can have the effect of delaying care - and I know that is the intent of is being proposed here - which can jeopardise women's ability to access safe and legal abortion services. Luxembourg and the Netherlands have entirely removed mandatory waiting periods. It is also important to say that we have overstretched GPs out there. From talking to many GPs, I know that they want to be able to support and help those women but finding those appointments within the three-day period is extremely difficult. If the Minister will not accept this Bill, we need her to bring forward her own Bill as soon as possible.

With regard to the 12 weeks, again we know from so many women and from doctors how women time out unnecessarily from the 12-week limit. Marie O'Shea was very clear about the barrier put up by the 12-week gestational limits and that there was no provision for the completion of the incomplete termination of pregnancy, where medicines had already been taken. There were women who had undertaken consultation but then fell out of the 12-week period. There is no provision for them in the Act and we need to see a change in that. On the criminalisation of those providing care, we have an utterly bizarre situation in this country where those trying to provide abortion care have the prospect of criminalisation hanging over them while those who obstruct and disrupt can act with impunity. These are not my words, they are the words of Marie O'Shea in her report.

With regard to the 28 days, of course as medicine and science develops there is always going to be an ambiguity and a lack of certainty about the length of time for a fatal foetal abnormality but I believe that when people were voting in 2018 they voted to trust women and particularly to trust doctors. We have to listen to the clinicians out there who tell us about the grave difficulties in having that firm cut-off period of 28 days. We in the Labour Party believe this needs to be looked at.

I have been really struck over the past 18 months by the women who approached me telling me their stories and their successful stories of going through the Irish health system. There are good things happening out there but it is absolutely unacceptable for 240 women to be travelling abroad because they cannot get the care here. This needs to change. I commend the Social Democrats on bringing forward this Bill.

Deputy Conor Sheehan

I welcome the Bill and the opportunity to speak in this debate. I used to work for a TD who sat on the Joint Committee on the Eighth Amendment of the Constitution. I remember when that legislation was going through and how politically difficult it was. I also remember all the stuff that went into the legislation in order to get the legislation through the Dáil and to get the referendum passed. While the eighth amendment referendum brought us in out of the cold and stopped us being so abnormal and so cruel it was never meant to be a ceiling. It has not gone far enough.

I welcome the intention of this Bill. As Deputy Cullinane alluded to, we never had a consensus approach to these things. This country had to be dragged kicking and screaming by activists. Somebody had to die. Savita Halappanavar had to die in 2012 before this country would move on this issue. While I welcome the Bill I think that in many ways it does not quite go far enough. We will still have women who are going to be forced to travel and the narrow distinction around the 28 days puts doctors in such an unenviable position. It is a no-win position. We know the 72-hour clause is paternalistic and we know why it was put into the legislation.

The fact is that when we are too prescriptive when talking about a very narrow distinction around fatal foetal abnormalities and very severe non-fatal foetal abnormalities, somebody always gets lost. Somebody always falls through the cracks and somebody is always forced to travel elsewhere to get the healthcare they need. I have had people come to my clinic who, nine year on, are still absolutely traumatised. The Government has the O'Shea review, which has been published. The recommendations are there. It falls to an Opposition party to bring forward legislation to deal with that, because the Government does not have the political gumption or courage to implement those recommendations. To be fair, the Social Democrats have had to come in here on a Wednesday morning and use their Private Members' time to deal with this matter. That is ridiculous.

Deputy Paul Murphy

I thank the Social Democrats for bringing forward this Bill, which People Before Profit supports. It really is the bare minimum the Government should be doing to implement the recommendations of its own official review of the abortion law. The review recommended decriminalising abortion, reviewing the treatment of fatal foetal anomalies in order that women in this terrible situation are not forced to travel and abolishing the patronising and medically useless three-day wait. The Bill mostly does all of that. There are details that could be ironed out on Committee Stage. We would prefer to abolish the three-day wait entirely rather than making it optional. Women are perfectly capable of taking as much time as they need to make their own decisions without needing for that to be legislated for. We also favour deleting section 23 in order that abortion is fully decriminalised in line with other medical procedures.

People Before Profit would go further. Neither this Bill nor the official review actually gives pregnant people the right to choose. That right is still strictly time limited, ending abruptly at 12 weeks. That is regardless of when the woman finds out they are pregnant or even if they know that they pregnant at all. A relationship could break down after 12 weeks. Intimate partner violence - which happens in the case of one in eight pregnancies in Ireland - is more likely to begin during pregnancy. The woman could lose her job or become homeless. One of her other children could be diagnosed with a serious illness. She could find out that the foetus has a severe but non-fatal anomaly that means their child would need around-the-clock care for their whole life. None of that matters as far as our abortion law is concerned. Twelve weeks and that is it. After 12 weeks pregnant women in Ireland are still treated as vessels with no right to bodily autonomy, even though the foetus will not be viable for months. After 12 weeks, pregnant people are still forced to travel. The Government refuses to act. By 2030, over 1,300 women will be forced to travel. We have to stop that happening. We need a renewed abortion rights movement to do it. Just like Trump in the US, the far right here, the conservative politicians in Fianna Fáil, Fine Gael, Aontú and Independent Ireland and many Independents want to take away women's hard-won rights. They want to turn them back into handmaidens. We have to take the fight to them, and that means fighting for the right to choose and nothing less.

Deputy Richard Boyd Barrett

People Before Profit believes that it is a woman's right to choose and that we should trust women to make choices about their bodies, lives and futures. That is it; anything less is not good enough as far as we are concerned. However, we understand the logic behind the Social Democrat's Bill. It takes us at least a step forward from where we are in that it is essentially trying to make provision in line with the review that was promised when the referendum was passed, which the Government has and which it has refused to act on. On that basis, we are happy to support the Bill.

The three-day waiting period is an insult and is exacerbating the difficulties in accessing termination that women in the country are having to endure. The criminalisation is an absolute disgrace. Associating women's right to have a termination and to control their own bodies with some sort of criminal act is an absolute disgrace and should be struck from the Statute Book.

Regarding the issue of fatal foetal abnormality, the fact that women and couples, when they have a wanted child but when it has a fatal foetal abnormality, have to go to Britain for abortions is absolutely disgraceful. My ex-partner and I lost a child to fatal foetal abnormality. We are strongly of the view that it is up to parents as to how they deal with that situation. If they feel they cannot go through the trauma and they need a termination rather than face it, that is their choice, and it should happen here. The idea that people are to be sent abroad still is an absolute disgrace.

Deputy Roderic O'Gorman

On behalf of the Green Party, I am pleased to support this Bill. I thank Deputy Cairns for bringing it forward. During the 2018 referendum, I joined with representatives from other political parties, Independents and people who have never been involved in a political campaign before in our local Together for Yes organisation in Dublin West. The central case we made on every door as we campaigned was that Ireland needed to listen to women and respect their decisions about their bodies. When the referendum was passed decisively, Ireland understood that we were finally listening to women. However, the continuation of the three-day rule does not do that. Instead, it carries on the paternalistic view that women do not know their own minds.

Those who are going to vote against this Bill this evening have to ask themselves who that vote will serve? It will not serve the women of Ireland. We know from work done in the National Maternity Hospital and through Women's Aid that pregnancy is a high-risk time for women who are in controlling or abusive relationships. If a woman gets out of her house to see a doctor, is she going to get a second opportunity to come back in three days' time, knowing that she is in increased danger? We know it is difficult to get GP appointments in many parts of the country right now. What about women who are at the edge of the 12-week period? Those three days could be enough to force them to bring a pregnancy to full term or see their healthcare provider be criminalised for giving them access to abortion pills. I cannot think of another healthcare issue where a person's bodily autonomy is so blatantly ignored. We have to ask ourselves why the decisions that women make about their own bodies not be trusted.

I welcome the fact that the Government is permitting a free vote this evening. However, I have real worries that the concerns the Government has raised in the media about this Bill will be used subsequently to delay and ultimately derail the core policy goal behind it. Such an approach cannot be accepted. It is vital that this Bill gets the support of Dáil Éireann and that it is not sidelined and left to rot in committee. It must be engaged with. If the Department has concerns, let them be fleshed out on Committee Stage. We need a commitment from the Government, and particularly the Minister, that a positive vote on this Bill tonight will see the Government engage seriously with the question of removing the three-day wait, bringing this matter back to the Dáil rapidly in order that this paternalistic treatment of women in our law can finally be ended.

Deputy Ruth Coppinger

Eight years ago, we were pounding pavements and having thousands of conversations. We won the most important right to bodily autonomy for women in this country in history by means of the efforts of a grassroots movement. Now, some people seem to think that they can roll back that right. We are seeing signs of this even in the Dáil today in some of the comments being made.

I want to talk about what the Government has said about legal nuances. In the context of someone travelling in the case of a fatal foetal abnormality, there never should have been a distinction between fatal foetal abnormality and severe foetal abnormality in the first place. There is no such distinction in any other country. It is unscientific because doctors cannot predict it with surety. In other countries, they are just abnormalities. Because of cowardly and conservative politicians and in order to get Simon Coveney and others to agree to vote for repeal, that distinction was put in place here. However, that is still no reason to vote against the Bill. Let us be clear, parties and individuals opposing this Bill favour forced birth because, basically, they are saying that anyone who is pregnant - outside of the existing strict criteria - should just be forced to continue with the pregnancy but that there is also the safety valve of the UK and other countries. I was very disappointed but not a bit surprised to hear Deputy David Cullinane say that he does not agree. Who cares if he does not agree? It should not be his decision to tell a pregnant woman what to do with her life and her situation.

I found it very arrogant of Deputy Cullinane to stand there and say that. I was not surprised because I saw Sinn Fein rushing through a Bill here last Thursday on a three-day wait. I had a Bill on the three-day wait. It is great that Sinn Féin has one eight years after repeal. I knew it was doing it. I feared that and my cynicism proved correct that it would not vote for this Bill tonight. Sinn Féin would say it has its Bill and they did not need to vote for this Bill. It is cynical. It is conservative. It is a shift to the right by Sinn Féin-----

Deputy George Lawlor

Hear, hear.

Deputy Ruth Coppinger

-----because it supported Bríd Smith's Bill in the previous Dáil and now it is responding to the far right and other individuals who criticised it on the vote recently. Now, it is circling the wagons and women's rights have to pay the price. It really is shocking but it is good to bring clarity for people as to where parties stand.

Let us be clear: decriminalising is to prevent women being criminalised as well for taking an abortion pill after 12 weeks or whatever in their bedroom. However, it is also to get rid of the chilling effect that prevents doctors from acting to save lives and save health, and it is also forcing doctors to send women abroad with abnormalities because they are not deadly sure. That is why it is decriminalising. Stop pretending that it is protecting women and, really, that nonsense where it tries to say that it was because of that. It is very disappointing to hear that Sinn Féin is going to basically scupper this Bill tonight. We have to put pressure on it to change tack.

Deputy Conor Sheehan

Hear, hear.

An Cathaoirleach Gníomhach (Deputy Darren O'Rourke)

We will move to the Independent Technical Group. The first speaker is Deputy O'Flynn.

Deputy Ken O'Flynn

There is a moment in politics where the language we use in this Chamber becomes so sanitised and so carefully engineered that we risk losing sight of what we are actually talking about and debating. This is one of those moments because today we are not debating an administrative change or paperwork. We are debating whether the State should remove one of the last remaining safeguards before deliberation of ending an unborn human life. Before this House votes to dismantle that safeguard, we should ask ourselves some very uncomfortable questions. Why are the Social Democrats so determined to remove even a three-day reflection? If abortion is such an unquestionable, clear decision, or a very easy case, then we must also ask why HSE figures show that 10,000 women did not return after the initial consultation of the three-day waiting period between 2019 to 2024. That is 10,000 women; 10,000 moments when somebody stepped back; 10,000 moments when doubt entered that room; 10,000 moments when women realised that they needed more support or more time or that there were other options available to them; and 10,000 moments when a life had been saved. That matters, and it is important we put that on the record.

Let us stop pretending that this debate exists in a moral vacuum. Last year alone, more than 10,800 abortions took place on this island. That is over 10,000 unborn children, not statistics, not medical episodes or procedures and not lines in a spreadsheet but human lives. It is tiny hearts that beat, tiny hands, tiny faces - children who under other circumstances would be here today playing in classrooms and parks, celebrating birthdays and growing up in Irish families.

Deputy Conor Sheehan

Disgraceful.

Deputy Ken O'Flynn

Yet, there was an argument before this House that does not remark on the tragedy of the loss of 10,000 human lives. The argument is that there is too much time to hesitate and we must remove that time. If the position of the Social Democrats is a moral certainty, then the question for it is why is it afraid of three days? That is three days for reflection, three days for people to speak to their family, three days to seek counselling and three days to escape the panic, fear, coercion or pressure that person may be put under. The reality is that for many women facing crisis pregnancies, those decisions they are making are not in calm circumstances. Some are very frightened, some are abandoned, some are financially desperate, some are under intense emotional pressure and some believe they have no supports or no alternatives available to them. Instead of this House building a society that says we will help them, stand beside them and be there because they and their child matter, the answer increasingly offered by the State is remove the pause and accelerate the process.

Deputy Richard O'Donoghue

I am a father and a grandfather and also a public representatives. As a public representative, father and grandfather, I support families and people in all their decisions. I have listened to the debate today. I have listened to the debate outside the Chamber. We have to listen to everyone and all their concerns. The concerns I have come from the people I have listened to. HSE data show that between 2019 and 2024, 10,426 women who attended the first abortion appointment did not return on the third day. That means that some of those people may have left the country to have an abortion. Some of those people had the children. Regardless of what decision people made, our choice here is to support them and give them the time and support they need. That is the job we have. Whether we agree with it or not is not the point. The point is that we support people in the decisions they make.

A person has a three-day wait to make a decision to do something. If it is a financial issue or if they are in a relationship they do not want to be in, give them the three days to reflect and see if the supports are there. If they want them or if they do not, then that is a decision they have to make themselves. Regardless of what decision they make, I am here to support them.

My position is that I am a pro-life person. Regardless of anyone's issues, I will be there to support them as a person on the decisions they make. My choice is my choice but I support everyone in their choices. That is what we all should do.

Deputy Michael Collins

This Bill will widen the grounds for abortion after a baby is diagnosed with a life-limiting condition. Currently, the law allows abortion if the baby is not expected to live longer than 28 days after birth. This would be changed to allowing abortion if there is a fatal condition affecting the foetus, which is a more broad and general phrase. It is hard for most of us to imagine just what it means for parents who had been happily looking forward to the birth of a new baby to hear that something is seriously wrong. Scans and tests can do a lot to diagnose and predict what to expect but they are not crystal balls. It can happen that mistakes are made in diagnosis. Abortion is not something that can be undone, and the couple whose baby boy was aborted in Holles Street after they were wrongly told by doctors that the baby had a life-limiting condition have spoken about the interminable sadness and grief they live with every day. How many other unborn babies, like baby Christopher, have lost their lives under Ireland's new abortion laws following a misdiagnosis? A child's chance at life, even during a short lifetime after birth, can be incredibly significant for parents to be able to meet their child alive and spend time as a family, maybe even to bring their child home briefly. Even with a correct diagnosis, medicine does not have a crystal ball to be able to say with confidence how long a particular child will live. For many babies diagnosed with trisomy 13 or trisomy 18, for example, it is a very short time but sometimes they can have longer and a better quality of life than what they were told to expect. Parents in this tragic situation deserve the best of support and care throughout the rest of their pregnancy and their child's life and death, at whatever point that comes. Irish hospitals have a wealth of experience in palliative care for babies to keep them comfortable. Instead of normalising abortion, we should be making this kind of support available and known to those who need it.

Deputy Peadar Tóibín

Last year, there were 10,852 abortions in Ireland. That is the lives of 10,852 individual living human beings that were ended last year, and that is the highest figure on record. It is equivalent to 400 classrooms of children, and it is absolutely heartbreaking. In 2018, there were 2,879 abortions and since that law was deregulated, the number of abortions in this country has surged. It is incredible. So high now is the rate of abortion in this State that is affecting the birth rate. For sure, the housing crisis and cost-of-living living crisis are also affecting the birth rate but the birth rate is collapsing in part because of the high abortion rate in this country.

Abortion is a massive decision. It is irreversible. A child cannot be brought back. It can also lead to a lifetime of regret for the mother. In the case of any big decision, reflection is key. There are very few elective procedures that can be done in one day. People cannot get a mole removed or cosmetic surgery or be sterilised without a wait to reflect. We also know that three-day wait period is actually working for families. We know that 10,000 mothers attend the first abortion meeting and they did not attend the second one.

There are thousands of children alive in their homes today as a result of that three-day wait period. When the abortion review was being discussed in the health committee in the previous Dáil, I asked the chair of that review a direct and important question. I asked her, before she recommended getting rid of the three-day wait, whether she had spoken to one woman who had decided to keep her child and take those three days to reflect and she admitted that she had not spoken to one woman who had taken that time. That is an incredible admission and it completely undermines the evidential nature of the review itself. One in six mothers who attended their first abortion appointments did not attend the second one and I have no evidence that the Social Democrats or any other political party here has spoken to those women to ask them what their views are on the three-day wait.

I also want to talk about the so-called "chilling effect" in terms of criminal penalties. That is a fiction in this country. The opposite is actually the case. Baby Christopher was a fully healthy unborn child. His life was terminated at 16-weeks gestation. His parents were wrongly told that he had a fatal foetal abnormality, and it was not an accident. This was not a mistaken diagnosis in this situation. Their child was taken from them. There have been no efforts, by the law or this Government, to follow up in any way in relation to that. Baby Christopher is not unique. Many other women and mothers have lost their children in similar situations.

Eighty-five percent of mothers have abortions for socioeconomic reasons. There is nothing in this Bill to provide economic supports to mothers so that they can raise their children to their full potential. There are dozens of women giving birth in this country homeless.

An Cathaoirleach Gníomhach (Deputy Darren O'Rourke)

Go raibh maith agat.

Deputy Peadar Tóibín

There is nothing in this Bill to provide supports to those mothers who need a home.

We were told eight years ago to accept the democratic will of the people. I would ask these parties to do the same.

An Cathaoirleach Gníomhach (Deputy Darren O'Rourke)

I move to other Members. First up is Deputy Grace Boland.

Deputy Grace Boland

I welcome the opportunity to contribute to this debate. This is an issue that evokes deeply held and personal views across Irish society and it is important that we approach it with sensitivity, compassion and respect for differing opinions. There will be strongly held views expressed in this debate, and I respect that. However, I believe as legislators that we have a responsibility to carefully consider the evidence presented in the comprehensive and evidence-based O'Shea report, the improvements made since the report, and the lived experiences of women, families and clinicians.

While aspects of this Bill may require amendment and careful scrutiny, I believe that the essence of what it seeks to address deserves debate and consideration by this House and the health committee. I say that for the following three reasons. First, this is fundamentally about women's healthcare. We know there are women in Ireland who are still being forced to travel abroad for care in cases involving fatal foetal abnormalities because clinicians cannot provide certainty within the narrow legal definitions contained in the 2018 Act. As a mum to two daughters, I do not believe that compassionate care should stop at the airport gate. Second, the O'Shea report concluded that aspects of the law were not operating as intended and were causing real distress to women and clinicians. Third, the O'Shea report questioned whether the mandatory three-day waiting period was evidence based and recommended that it be optional.

Figures have been cited here today regarding women who did not proceed with a second appointment. However, it is important that we are careful and evidence-based in how we interpret those figures. We do not know why they did not proceed. It may be that they miscarried, travelled, exceeded gestational limits or experienced other barriers accessing care, and we know that those in coercive relationships and in the postcode lottery that our healthcare system is have unequal access to healthcare. That is why this issue warrants examination by the health committee and further examination by this House.

Deputy Barry Heneghan

I welcome the opportunity to speak in this debate. In my opinion, there is one simple choice. Do we trust women?

This is a very personal decision, it is a healthcare decision and women must be placed at the centre of it. An abortion is not something any woman or any couple enters into lightly, and by the time that decision has been reached, there has already been reflection, and there has already been discussion, fear, emotion and heartbreak. This is why the mandatory three-day waiting period is wrong.

For many women in my constituency, this was a huge issue that they spoke to me about on the doorsteps. The reflection has already happened, so this requirement can feel infantalising. It can feel like a judgment on them for coming to a decision about their body. For many women, those three days occur during an incredibly painful time. Also, there are the people who are financially unable to leave the country. We are just punishing them. The reflection period can push women further along medical timelines and reduce the options available for procedures of care.

I welcome the Bill's decriminalisation of healthcare workers who are helping these women.

We must remember that every one of these circumstances is different. Some of them might be facing huge stress or in abusive relationships where they are forced into an act that they do not want to do. Do we trust women or not? The only person who can fully understand the woman is the woman herself.

We should welcome this Bill and the opportunity it presents to bring in enactments and change, as we said during the referendum. Dublin Bay North, which is my constituency, had over 500 campaigners and the largest turnout and delivery of "Yes" votes in the country. We won by a three-to-one result in favour of repeal. To all the campaigners, I say, "Go raibh maith agaibh."

Deputy Danny Healy-Rae

I have listened to this debate continuously this morning. Indeed, I remember it so well eight and nine years ago.

I suppose I have to say I am pro life and I think that when a baby is born, it is the most majestic, natural and beautiful thing in the world. I am lucky that, in my time, Eileen and I have had six children, and now we have eight grandchildren.

We have to think of the baby in the situation they are in and we have to talk about them. I believe they have a right to live, and to wait three more days to give the mother a chance to reflect on her position is not too long to wait. That is my honest, humble belief.

I have nothing personal against the proposers of this motion but I cannot agree with or subscribe to it.

There are many couples in the country and, indeed, in the world who would love to have a baby, and when they cannot, at least to be able to adopt one.

I cannot agree with this Bill. I am sorry, but I have my own personal beliefs. I think the baby is entitled to a chance to get a shot at this world.

Deputy Carol Nolan

I will be opposing this Bill not merely on the grounds that I have profound conscientious difficulties and objections with the legislative intent driving it, but also because I sincerely believe that if it was implemented, it would represent an impoverished health policy that would fail to protect women and, of course, the lives of the unborn children that it will impact.

In fact, it was on the basis of information released to me through numerous parliamentary questions that we can confirm that the three-day waiting period prior to having an abortion has played a critical and life-saving role in the lives of thousands. In fact, over the five-year period since the law was introduced, 10,426 women did not return for a second appointment after the three-day waiting period. This was between 17% and 18% of women.

I have to be clear. From where I stand, any attempt to eliminate the three-day reflection period can now be seen for what it is - a morally reckless extension of an abortion ideology that many people find deeply troubling. Why the clamour for more and more abortion? Why the rush to annihilate all protections in the law for the baby in the womb? The Irish people did not give us a blank cheque to go on eliminating all protections for the unborn child until no such protections exist at all. To claim that they did is fundamentally flawed.

As political representatives, we should be prioritising the provision of positive support for women in unplanned pregnancy, including access to practical assistance and counselling, rather than seeking to weaken the existing protections.

No woman should be rushed into a life-changing decision but I am of the view that all children born and unborn have a fundamental right to life.

Deputy Mattie McGrath

I, too, am opposing this Bill. I recently listened to the leader of the Social Democrats speaking on RTÉ radio about the importance of listening to women's abortion experiences. I want to ask Deputy Cairns this question directly today. Before bringing forward this Bill to abolish the three-day wait and widen the grounds for late-term abortions, did she accept or ignore the request to meet women who deeply regretted their abortions? Did she take the time to speak to women who benefited from the three-day reflection period and ultimately chose to keep their babies? These are not unreasonable questions. Pro-life groups and others have asked those questions in recent days and nowhere have I seen Deputy Cairns or anybody from her party answer them.

It is well documented from replies to parliamentary questions that thousands of women have availed of the three-day wait and have gone on to keep their babies. With that evidence before us, I cannot fathom how any party would seek to abolish such a life-saving provision. There are 11,000 abortions taking place in Ireland each year, which is an unbelievably sad reality, yet today a political party in this House is seeking to remove one of the last provisions that offers a small glimmer of hope that the life might be saved.

We are still in the first half of 2026 and already two men have received lengthy prison sentences for their involvement in coercive forced abortions. These cases and other evidence show that the number of coercive abortions is rising at an alarming rate. Will the Social Democrats rush to scrap the three-day wait instead of working with others in this House to try to deal with the issue of coercive abortion? We have soaring abortion numbers, including coercive abortions, and we need to deal with that issue also.

Minister of State at the Department of Justice, Home Affairs and Migration (Deputy Niall Collins)

As my colleague the Minister, Deputy Carroll MacNeill, has done, I too acknowledge the women and families who have had heartbreaking personal circumstances in pregnancy and who have been the motivation behind this Bill. There are, of course, many perspectives involved in the issue of termination of pregnancy services. As legislators, it is important that we facilitate open and frank discussion and consideration of issues. We must respect the input and views of all in this House. Constructive debate is always helpful.

I do not need to repeat all of the information the Minister has outlined but I will aim to make some critical points. The Government is committed to increasing access to safe termination of pregnancy services. In this regard, considerable progress has been made. I refer to the comprehensive body of work being undertaken by the national termination of pregnancy service improvement group. Work arising from the independent review of the legislation, the O'Shea review, and the HSE-commissioned review of section 11 of the Act, the Regan review, is being progressed across ten dedicated work streams.

Significant service development has taken place since the publication of the reviews. All 19 maternity hospitals now provide termination of pregnancy care, supported by designated clinical leads and co-ordinators. More than 490 community providers are delivering early medical abortion. The national governance structures have been strengthened through the relevant structures and governance group. A national electronic termination of pregnancy dataset has been established to support service improvement and workforce planning. Education and training activity has expanded, with multidisciplinary education, foetal medicine study days and workshops, and the development of patient information leaflets. A programme of work is also under way to provide a suite of national clinical guidelines and patient information booklets.

The feedback received directly from clinicians indicates that the service is working well. This is particularly significant if we take account of the fact that this was a new service built from the ground up. While it is acknowledged that a number of women continue to travel abroad for termination services, this figure has significantly reduced from 3,053 in 2017 to approximately 240 in 2023. As the Minister outlined, women travel for a variety of reasons, not all of which are related to fatal foetal abnormality.

I acknowledge the motivation for proposing this Bill. Nonetheless, as drafted, it will not achieve its stated objectives and ultimately may prove counterproductive. As the Minister pointed out, the amendment as drafted to remove the mandatory three-day waiting period has the potential to cause problems for existing medical law, but perhaps that is an issue that could be explored further.

On the issue of clinical guidelines, the HSE, in consultation with the relevant professional bodies, is the competent authority to develop such guidelines. It has the requisite knowledge and experience. Moreover, this process is already established. A national clinical guidelines programme of work has been agreed between the national women and infants health programme of the HSE and the Institute of Obstetricians and Gynaecologists of the Royal College of Physicians of Ireland. In March of 2021, Professor Keelin O'Donoghue was appointed as clinical lead for guideline development in maternity and gynaecology, responsible for the review update and production of national clinical guidelines in relation to maternity and gynaecological services.

It is impossible not to be deeply affected by the stories in the cases where there is a fatal foetal abnormality. However, I must stress that the proposed amendment would not bring clarity to the law. Rather, it has the potential to create ambiguity on which conditions would qualify and could lead to wide variation in its interpretation and application. I am sure that this is not the intention of Deputy Cairns or her party colleagues. Furthermore, it would include genetic conditions that are fatal later in life. This marks a significant policy shift and a huge departure from the commitments given to the Irish people prior to the repeal of the eighth amendment.

The proposal to decriminalise medical practitioners would represent a very substantial policy and legal change. A medical practitioner would no longer be subject to criminal sanction under the law even in instances where a termination had been carried out by acting unreasonably or acting unreasonably and in bad faith. Moreover, it would substantially weaken the powers of the committees established to review decisions to refuse terminations under sections 9 and 11 of the 2018 Act. The requirement that the conscientious objection would not override professional obligations in medical emergencies is already effectively and coherently addressed in the 2018 Act.

In conclusion, nothing is solved by politicising this very sensitive area. It does not serve one woman and it would not save one child's life. The Minister has indicated her willingness to engage constructively on the issues raised in the debate. We urge the Social Democrats and other Members of this House to take up that offer. By doing so collectively, we can do right by all of the women in Ireland.

Deputy Cian O'Callaghan

Gabhaim buíochas le Holly Cairns as an reachtaíocht seo a thabhairt chun cinn. I thank Holly Cairns for bringing forward this legislation. I thank all the Deputies who have spoken during this debate. I take the earlier contribution by the Minister for Health in good faith. However, what is missing from what the Minister said is any commitment to bring forward legislation to address the very serious flaws in the existing legislation that were identified in the review. Also missing from what the Minister said was any commitment that these legislative flaws and gaps would actually be addressed. We have received no firm commitments from the Government today that it will actually do anything to fix the very serious issues identified in the review. The Minister said that the situation of women being forced to travel abroad would not be fixed for every situation. She did not say that she would fix the very grave situation of fatal foetal abnormalities where women are still being forced to travel to the UK in the most horrific circumstances, as my colleague Jennifer Whitmore spoke about earlier.

I want to summarise the current situation. In 2018, an overwhelming majority of Irish people voted to repeal the eighth amendment. This explicitly gave the Oireachtas the remit to legislate for abortion. It also explicitly included a commitment from the Government to review the legislation. The barrister Marie O'Shea, who conducted the review, said that vulnerable women who continued to be forced abroad for terminations were being treated like criminals.

She said that a lack of action on the many legislative recommendations in her report meant that some pregnant women are being left to face profoundly sad conditions. The review found a number of very serious flaws in the legislation, including that doctors find the law unclear and fear clear criminal sanction, leading to defensive medicine and denial of care. The prospect of criminal sanction and adverse media scrutiny has likely led to women being denied care. Criminalisation is not theoretical; it is actively harming patients.

The mandatory three-day waiting period has a physical and psychological impact on women. It is particularly onerous for people in marginalised groups and those living in rural areas. The waiting period is not neutral. It causes measurable harm and pushes women past the 12-week limit. It is worth noting that the UN Committee on the Elimination of Discrimination Against Women has called on the Irish Government to abolish this mandatory three-day waiting period.

It is also worth saying that middle-ground voters in the referendum were particularly concerned about women who needed terminations for medical reasons being forced to travel abroad, and they wanted to change this. Despite the review commissioned by the Government, which was published more than three years ago, what we have is inaction. It is clear today from the Minister's comments that this inaction will continue.

Deputy Rory Hearne

I thank Deputy Cairns and my Social Democrats colleagues for bringing forward this Bill. It is not a simple area of legislation but our job as legislators is not to shy away from the difficult conversations and to respond to the difficult realities that citizens and people in this country are living through. This is a deeply emotional topic. As a father and a partner, I have experienced the pain of pregnancy loss. I have close friends who had to travel due to a fatal foetal abnormality. They had to put their child in a cardboard box in the car and bring it home on the ferry. When Independent Ireland talks about tragedy and trauma, what about the tragedy and trauma inflicted on the more than 200 women, their partners and others who go through this?

The reality is that our families, people we know and friends in our communities are having abortions because they choose to and they need to. That is the reality. This proposal and legislation are about providing abortion care to women who need it. A vote against this Bill is a vote against a law that fully respects the bodily integrity, autonomy, equality and dignity of women. This is about trusting women. It is about giving women their autonomy.

The Act, as it stands, imposes an unnecessary mandatory three-day waiting period for abortion care. The legislative review, the O'Shea report, recommends the removal of section 23 from the legislation. I spoke to a researcher involved in that review who pointed out that the need for the removal of the criminalisation of abortion is because it is a reason that GPs are not opting to provide the care that is needed.

Independent Ireland and Áontu also made an accusation relating to women in homelessness. No one has pushed for action on women and children in poverty, in homelessness, in domestic violence and with disabilities more than the Social Democrats. That is just a red herring, trying to draw attention away from what this legislation is actually putting forward.

The O’Shea review was informed by the ICGP and the Institute of Obstetricians and Gynaecologists, and represents the recommendations of practitioners for best practice in healthcare provision. To enact these recommendations would follow the principle of evidence-based policy, which is at the core of what the Social Democrats are about. This Bill is drawn from good practice, as recommended by healthcare providers, legal experts and, most importantly, the women and patients themselves. Abortion care is about time-sensitive healthcare. The imposition of a mandatory three-day wait is in direct opposition to that.

Deputy Holly Cairns

We all know that this law is causing harm, and we have a responsibility to change it. We know women are being hurt by the gaps in our legislation in maternity hospitals, on overnight ferries and in hotel rooms in England, far away from their loved ones. Everyone in this Chamber knows about it, and everyone in this Chamber needs to address that reality.

We have heard repeated references today to caution, to limits and to concerns about changing the framework too much. There also needs to be caution about the harm caused by inaction, concern for the women who continue to fall through the cracks in this legislation, and limits to how long that evidence can be ignored, because none of these issues are new. The problems with the 28-day rule, the mandatory waiting period and the criminalisation of doctors were all identified years ago but nothing was done.

There is a tendency, when abortion is discussed, for there to be an undercurrent of suspicion - suspicion that if barriers are removed, women and doctors simply could not be trusted. I was shocked today that the Minister for Health and Sinn Féin are in favour of criminalisation. When politicians create obstacles in abortion care, it is women who suffer. The continued existence of criminal penalties sends a message that abortion is something morally wrong, something dangerous, something outside the bounds of normal healthcare, and that affects how a service develops. It affects how clinicians feel about providing care. It affects stigma. It affects access. You cannot build a genuinely supportive healthcare system while simultaneously threatening doctors with a 14-year prison sentence. The World Health Organization is clear that it does not agree with this.

People who fought for repeal will be stunned at the approach that Sinn Féin is taking. I am stunned too. Putting forward a proposal for the bare minimum - removing the three-day wait - Deputy Cullinane said that this strikes the right balance. I have to ask: for who? It is safe to say it is not the women who are forced to travel for a termination for medical reasons. Deputy Cullinane went as far as to say that our legislation lacks democratic legitimacy. That is an absolutely outrageous thing to say. It is based on an expert review of the law.

Irish people expect a healthcare system based on science and compassion, not ideology and shame. The public also expects the Oireachtas to respond when flaws in the law become obvious. That is what this Bill seeks to do: to address clear and identifiable legislative gaps. That is why I am asking Members today not to shut down this debate on Second Stage. If Members believe that parts of this legislation can be strengthened, then come forward with amendments. If Members believe that safeguards should be clarified, make those arguments. However, refusing to even engage with reform when we already know the harm being caused is irresponsible.

The women directly affected by these laws deserve better than that. They deserve a Dáil that will take this issue seriously because, at the end of the day, women will do what they need to do in order to access a termination. The question is whether we ensure they can do that safely in Ireland, or whether we continue to force them abroad; whether we listen to women who told us that the law failed them, or whether we choose to ignore them again. I encourage the Minister, if she means what she says, and if she actually wants something to change, to come forward with something concrete on what she would do about that. I would encourage a Committee Stage debate.

Question put.

An Ceann Comhairle

In accordance with Standing Order 85(2), the division is deferred until tonight's voting bloc.

Before we move to Leaders’ Questions, I welcome the teachers and TY students from the Salesian College in Pallaskenry, County Limerick. They are with independent Councillor Tommy Hartigan from Adare-Rathkeale municipal district, who travelled with the group as a past pupil of the school. They are most welcome. There are also a number of staff from Mallow General Hospital here with Deputy Eoghan Kenny. Deputy Cathy Bennett would like to welcome the exchange students from Monaghan and also Monaghan u3a.

Dáil Éireann díospóireacht - Wednesday, 13 May 2026

Reproductive Rights (Amendment) Bill 2026: Second Stage [Private Members]

Dáil Éireann díospóireacht -
Wednesday, 13 May 2026