RIP Savita

Yesterday, the news broke of the death of 31 year old Savita Halappanavar, who died of septicaemia in hospital in Galway on 28th October after doctors apparently refused to remove the foetus she was in the process of miscarrying because it still had a heartbeat; termination of pregnancy being illegal in Ireland unless the life of the mother is at real and substantial risk.

Savita, a dentist, was 17 weeks pregnant. She went to hospital on 21st October with back pain. On examination, Savita’s cervix was fully dilated and amniotic fluid was leaking. Miscarriage was inevitable.

In pain, she requested removal of the foetus. Detecting a foetal heartbeat, doctors refused. For three days she repeated her request. According to her husband, the couple were told that ‘this is a Catholic country’ and that while a heartbeat was present, doctors could not act.

The foetus was removed on 24th October, once a heartbeat could no longer be detected. At that point, Savita had collapsed the night before, and had started antibiotics.

Last night over 2000 people attended a vigil at the Dail for Savita. A smaller vigil was held at the Irish Embassy in London. I attended the London vigil, and spoke to several Irish people about what the law means in effect over there.

They spoke of friends having to travel to England alone for abortions, unable to fund a companion to go with them. They also spoke of women who, having had medical assessments at 20+ weeks which determined the foetus wasn’t viable or had a medical condition which the women decided they and their family wouldn’t be able to cope with, having to quickly organise travel to England, hoping that their dates were correct and they would arrive within the window which exists here, all the while coping with the grief such news entails.

They told of women with cancer, who would be told on the news they were pregnant that treatment would halt to save the foetus, their life not being in danger at that precise time, regardless that it may well be in the future due to delayed treatment.

The reality of the law in Ireland is that women are treated as irrelevant vessels, regardless of the damage carrying their cargo may do to them. It is trite to point to pro-life laws and ask exactly whose life they are pro, but that is sadly the situation.

Whilst before Savita the pro-life lobby may have been able to claim that the pro-choice lobby was being dramatic, in that a woman could clearly be saved under the law if there was a real and substantial risk to life, Savita’s death has demonstrated that it isn’t that simple.

Savita’s doctors may have been negligent – it may transpire that they misread the legal and/or medical situation and failure to act appropriately caused her death.

They may well have been acting within the strict letter of the law – that while her initial infection caused her pain and suffering, it was not a real and substantial risk to her life until it turned into sepsis, at which point it was too late, and there were no indicators while the foetus had a heartbeat that her infection would turn into life threatening, and ultimately fatal, sepsis.

However, just pausing for a moment, just look at that scenario. She was miscarrying – that was inevitable given her presentation. The foetus was not going to survive. But while that foetus had a heartbeat, Savita was expected to endure pain and suffering. While many women go through incredible medical issues while pregnant, they cling to the fact that a baby at the end will make it worthwhile. There was not going to be a baby at the end for Savita. The law expects her to endure that suffering for nothing.

The law relating to the termination of a pregnancy in Ireland currently states that all termination is illegal, unless the life of the mother is in real and substantial danger.

The Eighth Amendment to the constitution was passed in 1983, which states that from conception a foetus has a right to life. In 1992, the then Attorney General Harry Whelehan, attempted to use the Eighth Amendment to prevent a suicidal 14yo rape victim from travelling to England to seek an abortion. He sought, and was granted, an injunction. On appeal, the Supreme Court held that a woman was entitled to an abortion if there was a real and substantial threat to her life. The case, known as X, led to three referenda on November 25th 1992, which in turn led to the Thirteenth Amendment – that women could travel out of the State to seek abortion; and the Fourteenth Amendment, which meant information about abortion being available outside of the State could be distributed. The Twelth Amendment, that the prohibition on abortion should include suicidal women, was rejected. That Amendment arose again in 2002, and was again rejected on referendum.

While the Thirteenth and Fourteenth Amendments are relatively clear, the Eighth Amendment causes difficulties surrounding what a real and substantial risk to life is. In a fluid medical scenario, determining the point at which the risk exists brings with it the very clear danger that the mother’s health has deteriorated past the point at which her life may be saved.

Successive governments have refused to consider legislation to clarify the Eighth Amendment. That lack of clarification has been held to violate the European Convention on Human Rights. In a case known as A,B and C v Ireland, the court held in 2010 that while there is no right to abortion under the convention, a woman should be able to easily determine whether she qualifies for an abortion under Irish law. An expert group has been appointed to report on the issues raised in the case later this year.

While there remains a lack of clarity as to whether the current legal regime in Ireland is responsible for Savita’s death, to some extent that lack of clarity is irrelevant. Savita’s legacy is that she turned the world gaze to Ireland and how she treats her pregnant women – that treatment requires no clarity. It’s now for us to ensure the glance wasn’t fleeting, and that real change occurs.

*Please note, there is a second vigil/protest at the Irish Embassy in London on Saturday, 17th November, from 4pm. Details from Abortion Rights  here.

 

 

 

 

 

 

12 thoughts on “RIP Savita

    • Trolling? One woman being denied her rights is the business of every single other woman. If it happens to her, it could happen to us. Got it now? Troll less, think better.

  1. Great piece as always!

    On the surface this seems like a needless and easily preventable death – something that should not happen in a modern society at all. This medieval attitude to reproductive rights has to change.

    I’m sure more facts will emerge over time, and I hope this tragedy leads to lasting change for the better in Ireland, her women deserve better than this.

  2. Good piece. I keep forgetting to pop in here but bookmarked now. Also, this is just sad. I remember being in Ireland in the mid-90s during the case of the little girl who couldn’t come over for an abortion. I distinctly remember the massive public uproar about that within the country and the dialogue it started. By no means were the Irish I was hanging out with or came across in any way supportive of women not getting their rights. Not at all. I remember protests at Trinity College, leaflets for changes in contraception law going up all over, long and long-cheered diatribes from awesome Irish poet/feminists (a most wonderful hybrid) in bars on O’Connell Street. The whole shebang. Pretty awesome to see.

    So yeah, this is just miserable. So much later and it’s still going on. Still, I have a lot of faith in the Irish. Even if it means going against their own or collective religious sensibilities, I am sure they will do the right thing. This may just be the impetus they need to galvanise them for good.

  3. Wiggy, I really like your blog, but the last couple of posts have demonstrated a rather worrying tendency to shoot from the hip.

    This Irish case has been pressed into service in an ongoing political argument, but information on it appears to be rather limited. You can correct me if I’m wrong about this, but it appears to me that the only real source of information at the moment is the account given by the bereaved family.

    Now it could be that, when the hospital give their version of events there will be nothing that they can say that mitigates, or even complicates, the apparent awfulness of their behaviour. However stories that generate widespread public anger often turn out to be less straightforward than they initially appeared. There have been a number of instances of that in recent years, and you have actually commented on some of them.

    The law on abortion in Ireland is awful, and I fully support actions to change it, but I’m worried at how quick out of the starting blocks campaigners have been with this case. There are real people to consider here. The doctors involved have been more or less accused of religiously motivated malpractice, and even the woman herself might, if she were still with us, have a more complicated story to tell.

    I think that, in this case, it would be wise to make sure that your pitchfork and burning torch are in working order, but I’d be inclined to wait for more information before joining the angry mob.

    • Hey there,

      I am sorry you feel I am shooting from the hip. I had hoped the piece made clear that we do not yet know the full story from either a medical or legal point of view. However, the aim of the piece was, in a nutshell, to say whatever happened in Savita’s case, what it achieved is that we all looked at Ireland’s abortion laws, and how, in 2012, they are unfit for the women they are supposed to serve.

      With regard to the other piece, I am assuming you mean Little Lolitas. Again, the point of the piece was not to comment on the case directly, but to look at the comments about the perceived facts, and the culture that exists. If you think I missed the mark in both pieces, I can only apologise, and look at whether in future, I need to be even more clear.

      Thanks for your comment, and for reading.

      • Hi Wiggy,

        Glad to see you are still talking to me. I was worried that my comment sounded a bit snarky.

        My feeling that you are rushing to conclusions stemmed partly from the last post, and partly from the 1 in 4 statistic that you gave in the previous one. You have yourself commented on the careless use of statistics in that area, so I was a bit surprised that you pulled that one out without making sure that you had a good primary source.

        My unease about the Irish case is, as I said, that there appears to be only one source of information at the moment, namely the bereaved husband. I’m sure that he is perfectly honest, but the poor man has just lost his wife. If my wife had died in similar circumstances I really doubt that I could be relied on to give a full and accurate account of the circumstances.

        Even when less emotion is involved, two accounts of the same event can differ significantly without any dishonesty being involved. To see this you only have to look at the way in which reports of the Irish case that appear on the internet have started to evolve. For example you write:

        “In pain, she requested removal of the foetus. Detecting a foetal heartbeat, doctors refused. For three days she repeated her request. According to her husband, the couple were told that ‘this is a Catholic country’ and that while a heartbeat was present, doctors could not act.”

        The original Irish times article that broke this story (at least I think that was the one that broke it, anyway it is at http://www.irishtimes.com/newspaper/frontpage/2012/1114/1224326575203.html) quotes the husband as saying

        “Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.

        This differs from your account in two significant ways. Firstly, the Irish Times article says that Mrs. Halappanavar first asked doctors to speed things along on Monday morning. This was two days before the eventual removal of the foetus on Wednesday lunchtime, not three. Given the timescales involved, one day, or even part of a day, is a big difference.

        Secondly, the Irish Times article says that the request she made on Monday was to have delivery induced, not for the foetus to be surgically removed (I assume that is what you meant by saying that she had requested its removal). I am not a doctor, but I think that induction and surgical removal are very different procedures, and there might be purely medical reasons not to induce. Induction fails completely in at least 10% of cases. Even if it does work it does not work immediately. I believe it generally takes 12-24 hours, so it wouldn’t in fact have speeded up things by much if it had worked. Also I think (again I am not a doctor) that the drugs used for induction are contraindicated in cases of sepsis and pelvic infection.

        I’ve no idea whether you are right and the IT are wrong, or vice versa, but you do not seem to be saying the same things, and you both have time and leisure to check your facts.

        There are a number of people whose feelings should be considered before people weigh in on this subject. The first is the husband. If people attribute to him things that he did not say or if, in the heat of his grief, he himself has honestly said something that will turn out to be inaccurate, how will he feel?

        Secondly there are the doctors involved. It must feel to them as if the whole world is baying for their blood, even if that is not the intention of the demonstrations. Maybe their blood thoroughly deserves to be bayed for, but I don’t think we know that yet, and I feel uncomfortable about the way that the publicity around this case has developed.

      • It is also worth pointing out that there was a case in Galway a few years back in which a consultant got into trouble for being too quick to decide that a miscarriage was inevitable and to recommend surgical removal of the foetus.

        http://www.dailymail.co.uk/news/article-1286226/Surgeon-linked-major-childbirth-negligence-cases-regrets.html

        He wasn’t in trouble over that because of the Irish law on abortion, which doesn’t seem to have featured in the case. The woman involved was just, understandably, a bit cross when she got a second opinion and was told that the baby was fine.

        I’ve no idea whether there is any connection between these two cases, but it’s the sort of thing that might incline a doctor to hesitate. It is possible that Irish abortion law was not the only factor in play here.

  4. During my University days in the seventies I had a contemporary who had worked on the Liverpool-Dublin ferries and told me that the crews could always spot the girls going to England for an abortion or coming back afterwards. Those coming back were referred to as “the empties” which was even by the standards of that time in execrable taste – but they made a point of finding them a seat however crowded the ship and if necessary would get them into the lounge which generally cost more – whether they had paid more or not.

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