Notice of the making of this Statutory Instrument was published in

"Iris Oifigiúil" of 3rd January, 2014.

I, James Reilly, Minister for Health, in exercise of the powers conferred on me by section 4 of the Protection of Life During Pregnancy Act 2013 (No. 35 of 2013), hereby make the following regulations:

1. (1) These Regulations may be cited as the Protection of Life During Pregnancy Act 2013 (Section 20) (Notifications) Regulations 2013.

(2) These Regulations shall come into operation on 1st day of January 2014.

2. In these Regulations "Act of 2013" means the Protection of Life during Pregnancy Act 2013 .

3. The form set out in the Schedule is prescribed for the purposes of the record to be kept under section 20(1)(a) and 20(2)(a) of the Act of 2013.

4. Parts B and C of the form set out in the Schedule are prescribed for the purposes of the part of the record to be forwarded to the Minister under section 20(1)(b) and 20(2)(b) of the Act of 2013.

SCHEDULE

Protection of Life During Pregnancy Act 2013

Record of medical procedure referred to in section 7(1), 8(1) or 9(1) of the Act of 2013 carried out in respect of a pregnant woman

Please complete this form in BLOCK CAPITALS.

PART A PATIENT DETAILS

1. Full name of patient: ______________ .

2. Usual place of residence of patient: ______________ .

3. Date of birth of patient: ______________ (dd/mm/yyyy)

PART B INFORMATION RELATING TO THE MEDICAL PROCEDURE

1. Medical Council registration number attached to the registration of the medical practitioner who carried out the medical procedure:

______________

2. Please indicate whether the medical procedure was carried out in respect of the pregnant woman pursuant to a section 7 certification, section 8 certification, or section 9 certification (tick as appropriate):

Risk of loss of life from physical illness (section 7)

Risk of loss of life from physical illness in emergency (section 8)

Risk of loss of life by way of suicide (section 9)

3. (a) If the medical procedure was carried out in respect of the pregnant woman pursuant to a section 7 certification or section 9 certification, the Medical Council registration numbers attached to the registration of each of the medical practitioners who made the certification concerned:

______________

Medical Practitioner 1 (Obstetrician)

______________

Medical Practitioner 2

______________

Medical Practitioner 3 (if applicable)

(b) If the medical procedure was carried out in respect of the pregnant woman pursuant to a section 8 certification (whether made before or after the medical procedure was carried out), the Medical Council registration number attached to the registration of the medical practitioner who made the certification concerned:

______________

Medical Practitioner

4. Name of the appropriate institution where the medical procedure was carried out in respect of the pregnant woman or, if that medical procedure was a medical procedure referred to in section 8(1) that was carried out at a location other than an appropriate institution, a description of that location sufficient to identify it:

______________

5. Date on which the procedure was carried out:

______________

PART C INFORMATION RELATING TO PERSON KEEPING RECORD

1. Name of person keeping record in accordance with section 20(1) or name of person keeping record in accordance with section 20(2) as may be appropriate:

______________

2. Title of person keeping record in accordance with section 20(1) or title of person keeping record in accordance with section 20(2) as may be appropriate:

______________

Signed: ______________ Date: ______________

GIVEN under my Official Seal,

19 December 2013.

JAMES REILLY,

Minister for Health.

Protection of Life During Pregnancy Act 2013

Regulations - Notifications

EXPLANATORY NOTE

(This note is not part of the instrument and does not purport to be a legal interpretation.)

These Regulations may be cited as the Protection of Life During Pregnancy Act 2013 (Section 20) (Notifications) Regulations 2013. They have been developed under Section 4 of the Protection of Life During Pregnancy Act.

These Regulations provide for a prescribed form for the purpose of notification under Section 20 of the Act.