A new study has found that remote consultations are becoming a routine part of early medical abortion services in the Republic of Ireland, prompting renewed debate over safety and regulation.
Published in the ‘British Medical Journal (BMJ) Sexual & Reproductive Health’ journal, the research examined GPs’ use of remote consultations with women seeking abortions.
Researchers concluded that remote consultations are now a “mainstream component” of abortion care rather than “an exceptional or emergency feature” as originally intended when they were introduced during the Covid-19 pandemic.
The study forms part of a wider project to collect detailed information on GP-delivered early medical abortions after Ireland relaxed its abortion laws following the 2018 referendum.
Among the 64 GPs who provided patient records, nearly half (48.4%) reported using a combination of remote and face-to-face appointments during the initial consultation, while nearly a fifth (18.8%) conducted the first consultation entirely remotely. Around a third (32.8%) relied solely on in-person appointments.
Researchers found no significant differences in the use of telemedicine based on where GPs were located, when they qualified, or how frequently they provided abortion services, suggesting remote consultations have been adopted consistently across participating practices.
When a woman seeks an abortion, the first consultation is intended to include medical evaluation, eligibility checks, and verification of how far the pregnancy has progressed before a statutory three-day reflection period. Abortion medication is prescribed at the second appointment, with a follow-up consultation confirming completion of the procedure.
The authors argue that although telemedicine is now widely embedded in clinical practice, its legal basis continues to rely on temporary approval orders rather than permanent legislation, creating what they describe as “regulatory uncertainty”.
They want the service to be formally incorporated into Irish law, and national data collection on GP-provided abortions to be strengthened.
The calls have, however, drawn criticism from the Prolife Campaign, which warned that increasing reliance on remote consultations could reduce opportunities for in-person clinical assessment.
The organisation said the first appointment involves important elements of care, including eligibility screening and counselling, and argued that remote consultations limit the ability to carry out ultrasound examinations.
It also pointed to the risk of undiagnosed ectopic pregnancy. Although rare, an ectopic pregnancy is a medical emergency, and the symptoms can resemble the effects of abortion medication.
They pointed to a 2024 case reported in the ‘Irish Medical Journal’ involving a 24-year-old woman who became critically ill after an ectopic pregnancy was not detected before a medical abortion.
The Prolife Campaign expressed concern about the increasing reliance on remote consultations.
"The fact that so many of them are increasingly not face-to-face meetings with a doctor is a very troubling trend," it said.
The group said the latest study suggests fully remote consultations are being used more widely than previous parliamentary responses had implied - in replies to questions from legislators, Irish health ministers had previously stated that abortion care was generally delivered through in-person or blended consultations, with fully remote appointments reserved for “extenuating circumstances”.
"The risks this poses to women, as well as to their unborn babies, cannot be overstated," said the Prolife Campaign.
The study comes amid continuing debate over Ireland’s abortion laws.
Earlier this year, the government faced criticism from pro-life organisations over proposals to introduce paid leave following pregnancy loss, including after abortion, while also proposing to remove the statutory three-day reflection period before an abortion.
Official figures from the Department of Health in Ireland showed that 10,600 abortions were recorded in Ireland during 2025, bringing the total since abortion services were introduced in 2019 to more than 65,000.
