The HSE has published its first report on the termination of pregnancy services which began in January 2019.
It shows access to abortion has expanded significantly here in the last seven years.
All 19 maternity hospitals now provide medical termination under the act. GPs contracted to provide early medical abortion also increased from 310 to 480 since 2019.
The report shows 46,841 terminations of pregnancy were notified between 2019 and 2024, with annual numbers rising from 6,666 in the first year of the service to 10,852.
Dublin accounted for the highest number of notifications over the six-year period, with 17,300, followed by Cork (4,223), Galway (2,067), Limerick (1,931) and Kildare (1,907).
The report notes the trends echo those seen in England, Wales and Scotland.
Community-based early medical abortion has become the main route of care, while all maternity hospitals now provide services for women who require hospital treatment.
New national data from a pilot electronic monitoring system covering hospital-based care under Section 12 found that 81% of procedures were medical terminations and 19% were surgical.
Almost two-thirds of women were between 10 and 12 weeks pregnant at the time of the procedure, while reviews in secondary care took place within five days of referral in more than 80% of cases.
Complication rate of 6%, while serious complications uncommon
Among the 305 hospital cases examined, the HSE recorded a complication rate of 6%, with most involving suspected incomplete termination, bleeding or infection. The report says serious complications were uncommon.
The HSE also examined the operation of the review process when a termination request is refused.
Between 2019 and 2024 there were ten reviews, with five resulting in approval for a termination and five upholding the original decision.
The report highlights actions following the O’Shea Review and the Regan Review of abortion services which were in recent years.
A National Service Improvement Group was established in 2024 to oversee work like expanding early pregnancy services, improving fetal medicine pathways, increasing access to surgical abortion, strengthening national data collection and developing updated clinical guidelines.
The report includes reflections from healthcare providers and support organisations.
They identifed continuing challenges, including regional variations in access, limited availability of surgical abortion in some hospitals, barriers facing migrant women and those living in rural areas, and the impact of protests outside some GP practices.
Support groups representing families who experienced fatal fetal anomalies welcomed the compassionate care provided by many bereavement and fetal medicine teams but highlighted inconsistent experiences between hospitals.
They called for more standardised care, clearer information about legal options and better mental health supports.