Savita’s Law and the Sorry State of Reproductive Rights in Ireland

QoBInternational Women's Issues6 Comments

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Ten months after Savita’s death, has anything changed for women in Ireland?

Protection of Life During Pregnancy act

The government introduced new legislation to codify the X-Case judgment. The new law was debated in the Dáil (lower house of parliament) and the Seanad (the Senate) over several long and frankly torturous weeks. 165 amendments to the bill were tabled by both pro-choice and anti-abortion members of the Dáil and Seanad during the debates. I wish I could un-hear some of the things said by those politicians who purport to represent me. There was much pious concern, for example, about women faking suicidal thoughts to get an abortion; still, the hoops a woman has to jump through to get an abortion if she is suicidal are worse than those for a woman with a physical health emergency requiring termination.

Protestors at a rally in memory of Savita, November 2012. Photo by William Murphy.

Protestors at a rally in memory of Savita, November 2012. Photo by William Murphy.

The President then convened the Council of State to help him decide whether to refer the law to the Supreme Court. President Higgins is on record as being pro-choice, but had he referred the law to the Supreme Court and they had backed it, it would have made the law immune to any further attack through the courts. However, he decided against this, and the bill was officially made law on the 30th July.

The law allows for a prison term of up to 14 years for women who have an unlawful abortion or anyone who assists them in having one. Bad news for the likely thousands of women importing abortifacient drugs every year. Practically speaking, the law will not change anything for the vast majority of women who want or need abortions in the Republic of Ireland.

Catholic hospitals may not comply with the law

It’s not over yet, however: the law names 25 hospitals where such terminations can be carried out. Most if not all of them are run by Catholic boards, and several board members of one hospital, the Mater in Dublin, have said this week that they will not support terminations of pregnancy being carried out in their hospitals.

“The Mater can’t carry out abortions because it goes against its ethos. I would be very concerned that the Minister [for Health, James Reilly] sees fit to make it impossible for hospitals to have their own ethos.” – Fr. Kevin Doran, as quoted in The Irish Times.

Bear in mind this is life-threatening pregnancies we’re talking about. Thankfully there are some people shouting back:

“Is Father Doran going to stand by her bedside in the intensive care unit and prevent the doctors from giving the care she needs to save her life? …. There’s too long of a history of the Catholic Church interfering in the care of women, particularly in the area of reproductive health in this state and they really need to back off and leave it to the doctors. It’s absolutely intolerable that a hospital would deny somebody life-saving treatment in the 21st century in a Western country.” -Dr Peter Boylan

“Once again, we are being told that publicly-funded hospitals have a right to impose their Catholic ethos on their patients, it’s dominant religious teaching winning out over civil rights for all citizens.” – Emer O’Kelly, writing in the Irish Independent

It remains to be seen if these hospitals will co-operate with the law, and what legal action the government can take if they don’t.

The next campaigning focus for pro-choice organisations in Ireland is to repeal the amendment that both killed Savita Halappanavar and enabled this law to be passed: Article 40.3.3, AKA the 8th amendment to the constitution, which states:

The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.

Without repeal of this article, no other laws can be passed for terminations of pregnancy in any other circumstances other than direct threat to the life of the pregnant woman. There has been great awareness-raising campaigning work done by Termination for Medical Reasons Ireland and they have the support of Minister for Justice Alan Shatter.

Savita’s case has not been forgotten, either: Praveen Halappanavar has stated he intends to take a case to the European Court of Human Rights, and that Savita’s parents are taking a case against the Health Services Executive for negligence.

“It just happened”¦so it can happen again. Women who will not get the publicity or limelight we got. I am really concerned. The whole family doesn’t want any woman to go through want Savita went through. That is our motivation at the moment.” – Praveen, as quoted by thejournal.ie

A woman died in London after being refused an abortion in Dublin

She and her husband had decided on terminating the pregnancy as her previous pregnancy had been complex and difficult. However, as abortions are not legal in Ireland, they had to wait to get the money together to travel to England, thus requiring her to have a later-term abortion, which carries higher risks. Like Savita, she and her husband were not from Ireland but legally resident there.

“I think if this was an Irish or a British woman, we would know what happened to her. But I am still waiting for answers,” [the woman's husband] told The Irish Times. He also said he was frustrated at the lack of assistance from some Irish authorities in seeking an abortion for his wife…. “She was sick, but we were told that nothing could be done in Ireland.”The Irish Times.

A police investigation is ongoing into the exact circumstances of this woman’s death (she has not been named), but news reports say she died as a result of internal bleeding.

Even if you’re having the baby, your rights aren’t respected

Elsewhere on the spectrum of reproductive rights, Aja Teehan is taking a court case to allow her chosen midwife to attend the planned home birth of her second child.

A tweet from Aja Teehan, reading:  "I've launched a High Court challenge against the HSE and the Dept of Health seeking judicial review of their refusal to grant me a homebirth"

Aja Teehan, pictured with her husband Charles Brand on her Twitter page.

Aja’s daughter was delivered by Caesarean six years ago, and current practice guidelines say if her midwife, Philomena Canning, cares for her at home she will be committing a criminal offence. Most reaction I’ve seen so far can be summarised as, “The baby is more important than her! She should be a good girl and listen to the nice doctors!” No word on an adult woman’s right to informed consent, informed refusal, and choice in medical care (a good factual rebuttal of some criticisms are listed here). Her local hospital has a Caesarean rate of over 35%, and an episiotomy rate of nearly 18%. Judgment in the case is due on the 13th of August.

Campaigner Jane Travers is also attempting to publicise sub-standard maternity care in Ireland through sharing women’s stories on her Twitter @maternityire.

Sigh. We’ve got a long way to go with reproductive rights and consent culture in my country.

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QoBSavita’s Law and the Sorry State of Reproductive Rights in Ireland

6 Comments on “Savita’s Law and the Sorry State of Reproductive Rights in Ireland”

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    1. Profile photo of Karo
      Karo

      I would imagine it’s homebirths after c-sections that are the problem. Correct me if I’m wrong though. For me, this one is a difficult issue, because is anyone’s “informed choice” really as informed as a doctor’s experience and advice? But perhaps I better go and read up on the subject now…

      1. Profile photo of QoB
        QoB

        Yes and no. It’s homebirths after c-sections that the HSE (the Health Services Executive, the state body that has the authority to idemnify independent midwives) has an issue with. But in terms of evidence that a home birth after prevous c-section is “too dangerous”, it’s not strong. The HSE also forbids a home birth if, for example, the woman has asthma. Their policy isn’t based on rigorous evidence assessment, or, indeed, ethics.
        http://www.irishtimes.com/life-and-style/health-family/home-or-hospital-the-politics-of-birth-1.1492055

        Good starting point for more research: http://www.childbirthconnection.org/article.asp?ClickedLink=293&ck=10212&area=27 (a US site).

        On a patient’s informed choice -v- doctor’s advice, this is a good post:
        http://drjengunter.wordpress.com/2013/08/13/listeria-and-pregnancy-when-discussing-risk-its-all-perspective/

        “Risk means different things to different people. When I was pregnant with triplets I knew based on statistics that the average gestational age is 32 weeks and the odds that I would take 3 babies home from the hospital was 87%. If I had a selective reduction the average gestational age for my now twins would have been 36 weeks and the odds that I would take both home from the hospital was 88%. Difficult stats. High stakes situation. I chose not to reduce and of course I was in the 13% who loses a baby and was on the wrong end of the gestational bell curve delivering my surviving sons at 26 weeks. However, I don’t regret my decision one bit because I made an informed decision.”

        The main point is that few choices are risk-free: her caregivers should explain the risks as fully as possible but it has to be up to the woman to choose which set of risks is preferable to her.

      2. Profile photo of Sharon
        Sharon

        Catching up with some posts after being away and I agree Ireland’s got a long way to go! I was on holidays and missed the drama of the home birth case (the home birth has since been refused).

        I work in an Irish hospital and I find that doctors are not necessarily overflowing with experience and advice. I don’t mean to say that they are bad doctors (well ok, some of them aren’t great) but there is just so much information out there and new drugs, new trials, new guidelines are coming out all the time. So a doctor may not always have the most up to date info. And medicine is not cut and dried: there can be lots of conflicting evidence about any particular intervention. Also younger doctors don’t have as much experience, but some older doctors are more likely to stick with the way they have always done things regardless of changes to best practice.

        If the mother has done her own research then she may very well be as informed as her doctor about the area. As far as I understand, the problem is that the HSE will not allow their midwives to assist this woman’s birth. I can’t help but note that most midvives are female and most obstetricians are male. Relevant, perhaps?

        Between unnecessary symphisiotomies and hysterectomies without consent, Ireland’s track record on women’s health is woeful and it looks like change will continue to be painfully slow :(

        1. Profile photo of QoB
          QoB

          Yes, I agree – I think doctors sometimes have the attitude of “this is how it is” and don’t have an appreciation of evolving research. But it’s the disrespect of Aja’s agency that makes me angriest – does anyone honestly think that any random internet commenter cares more about her baby than her and her husband?

    2. Profile photo of QoB
      QoB

      There are ~20 midwives who attend home births in the whole country; they’re not very common, so I suppose the HSE thought no-one would complain. Heh.

      If we could answer that question, we could solve a lot of things…

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