In 1980 Irish fertility was 1.66% of the Western European average, however families were smaller, and fewer women were giving birth in their forties. Despite the limitations of the 1979 Act, the 1980s saw a marked increase in access to contraception, by single and married adults, and major advances in family planning training for doctors. However, surveys of mothers in maternity hospitals indicate that many pregnancies were unplanned, and access to information and contraceptives remained patchy in provincial Ireland. Legal restrictions were gradually eased from the mid-1980s, and by 1995 condoms were available without restriction, partly to counter the threat of HIV. Sterilisation was never banned in Ireland, and by the 1980s male sterilisation was readily available, but access to tubal ligation, even in cases of acute medical need proved much more difficult. In some hospitals, including Dublin maternity hospitals, the ethics committees, which were formed in the early 1980s at the behest of the Catholic hierarchy, and the hostility of nursing and other non-medical hospital staff prevented doctors from carrying out the procedure, prompting some to resort to hysterectomy.

From the early 1970s government proposals for legislation permitting access to contraception reveal a consistent dilemma for politicians: how to make contraception available to married couples while restricting access by single people. Records of consultative meetings organised by the Department of Health, suggest that by the late 1970s there was consensus, sometimes grudging, among the main churches, medical groups, and the trade union congress that contraception should be available on a restricted basis, but it was also recognised that it would prove difficult to prevent access by single people. These consultations also reveal a determination on the part of doctors and pharmacists to protect their professional interests, and an incapacity to provide family planning through the public health system. The 1979 Family Planning Act legalised access to contraception, ‘for bona fide family planning purposes’ – terminology that was not defined, and it privileged ‘natural methods’, providing state support to promote them in order to placate the Catholic hierarchy. Its restrictive nature ensured that contraception remained a matter for political contention.