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.