Professor Joan Lalor

Summary

In May 2018 the Irish people voted to repeal the 8th Amendment to the Constitution and paved the way for the rollout of abortion services in 2019, heralding a radical change in clinical practice as well as in law. A major challenge that has emerged in abortion provision is how to accommodate the right to conscientious objection while ensuring equitable access to abortion services. The right of conscientious objection allows a person refuse to engage in a particular task by reason of their personal moral objection to it. The Health (Termination of Pregnancy) Act 2018 provides for a right to conscientious objection. Anecdotal evidence suggests that right is quite widely relied upon, with the result that access to abortion may be limited in some locations. However, the right does not extend to certain persons who may strongly object to abortion, such as health care assistants, hospital administrators, and pharmacists. The objective of the CORALE Study is to investigate, for the first time, the operation of the right to conscientious objection in abortion services in Ireland and to develop a coherent framework for situating conscientious objection within a system of access to abortion services in a manner that is proportionate, effective and legally robust. To investigate this complex question, an interdisciplinary approach is inherently necessary, because it seeks to understand how a legal right operates in the reality of clinical practice. The Project Team spans the disciplines of law, midwifery and ethics. Building on a sophisticated theoretical framework, the Project will employ interviews, focus groups and surveys with those involved at the frontline of abortion provision. The Project will produce evidence and recommendations that will inform abortion law and policy in Ireland, but also generate important contributions to international scholarship and policy debate on conscientious objection in abortion services.

Funding Agency

Irish Research Council

Programme

Coalesce

Summary

Unlike other sources of trauma, perinatal or birth-related trauma is relatively unrecognised. Evidence suggests up to 30% of women describe their birth experience as traumatic and experience some symptoms of intrusion, avoidance or hyper-arousal. Meta-analyses show post-traumatic stress disorder (PTSD) affects 4% of women after birth and up to 18% of women in high risk groups. Rectification of this situation is essential. In 2016, 5.11 million babies were born in Europe, indicating that up to 1.5 million women may have had sub-optimal birth experiences and over 200,000 may have developed PTSD as a result. Developmental research has firmly established that the quality of infant-parent relationships is a critical factor in early and later childhood development, consequently, a family-centred approach to any investigation of birth-related trauma is critical, as trauma can be transmitted within the family system. Given the enormous economic burden it places on women, health systems, and particularly children, relatively small improvements in services to prevent, detect and treat this problem can benefit society significantly. The main aim of this Action is two-fold. The Action will establish an international multidisciplinary network of researchers, clinicians, NGOs and SMEs to 1) consolidate and disseminate current evidence and coordinate a joint effort to seek ways to prevent, minimise and resolve birth-related trauma, and to optimise emotional and psychological outcomes for parents and families and 2) accelerate the translation of that knowledge into best practices that can be shared across Europe to reduce the societal and economic burden arising from birth-related negative/traumatic experiences.

Funding Agency

EU Cost Action 18211

Programme

COST

Project Type

Network

Person Months

48

Summary

Being pregnant and having a baby is a time of huge physical, psychological and social changes for women. It is therefore a period of rapid transition and adaptation. Although the birth of a baby is viewed positively in most cultures, research suggests between 20 and 40% of women find childbirth traumatic and 3-4% of women may develop post-traumatic stress disorder (PTSD) as a result. Birth trauma and PTSD have a substantial impact on women and their families. Postpartum PTSD is highly comorbid with depression and fear of subsequent births, as well as reduced breastfeeding, poorer child development and strain on the couples relationship. The INTERSECT study The INTERSECT study works in collaboration with principle investigators across the world, with an emphasis on working with under-represented countries in South-America, Asia and Africa. The protocol has been publicly registered and is available here. Principle investigators in each country have the responsibility of conducting the INTERSECT survey with postpartum women in their country. The INTERSECT project will thus result in cross-cultural information on the prevalence of postpartum PTSD, as well as cross-cultural variation in the etiology and manifestation of childbirth-related PTSD worldwide. This research aims to study childbirth PTSD in an international context. Specifically to: Determine the prevalence of birth trauma and PTSD across countries and cultures. Determine differences in symptom presentation across countries and cultures. Determine the etiology of childbirth-related PTSD symptoms across countries and cultures. Prof Lalor is the principal investigator for Ireland working with doctoral student Ursula Nagle.

Funding Agency

Global Challenges Research Funding provided by Research England.

Summary

Maternal and fetal interests often seem to be framed opposing each other, even in the absence of a legal framework supporting fetal rights. This study sets out to explore how women approach decision-making where a perceived or real conflict between fetal and maternal wellbeing exists and how they navigate the moral-ethical space of their symbiosis. A grounded theory study is designed for this purpose using vignettes as an additional means of investigation. Conducted in Ireland where the legal status of the fetus has only recently changed, it is hoped that the emerging theory will help promoting maternity services in which maternal autonomy and -rights are safeguarded in the interest of both mother and baby.

Funding Agency

1252 PhD Student Scholarship

Programme

PhD programme

Project Type

doctoral

Summary

This is a mixed methods study which investigates the prevalence of birth related trauma and subsequently explores with a sub group of women with a previous history of trauma to explore the impact of that experience on their birth.

Funding Agency

SNM PhD Scholarship Fund

Programme

PhD programme part time

Project Type

doctoral