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.