International Women's Issues

Savita Halappanavar: Update

The death of Savita Halappanavar from septicemia after a prolonged miscarriage has caused shockwaves in Ireland and around the world: but if those in power were hoping the controversy would die down, they have so far been disappointed.

An interview with Savita Halappanavar’s husband, Praveen, was broadcast on main TV station RTÉ last week. In it he was calm and dignified, saying:

She will rest in peace if justice is done and the law is amended.

The Irish Times also published a timeline of the events leading up to Savita’s death.

Savita dancing in last year’s St. Patrick’s Day parade in Galway, and footage of the vigil in Galway for her.

More women have come out publicly and talked about the consequences of Ireland’s abortion law in situations like Savita’s:

Jennifer said GPs and four consultants met her separately after work in their own time for scans, only to tell her “you need to make a decision immediately” due to the impact on her health. 

She said one said to her mother: “I know what I would do if it was my daughter, you need to read between the lines. You need to do it urgently.”

… Her mother travelled with her to Britain.

They have also discussed their choices to have abortions in other circumstances hereOther women have talked about how Ireland’s abortion law makes them less likely to want to continue a pregnancy:

If I did become pregnant, I have an extremely high risk of having miscarriages and if I don’t miscarry I have a high risk of having a baby with a disability….Since I am living in a country where there is a huge grey area regarding women’s reproduction, I’m afraid I’ll have to be on the plane to England. Since I do have a high risk of miscarriage I won’t be waiting for a hospital to dither over whether or not my life is in danger while they wait to do something. I won’t risk leaving my husband without his wife, my parents without their daughter and my sister without me. Ireland, the bastion of life, makes me more likely to have an abortion. – Jennifer Dalton.

Anti-choice organisations continue to argue that the status quo (abortion law based on an 1861 statute, interpreted through the 1983 and 1992 amendments to the constitution) is enough and doesn’t need to be ammended through legislation. In contrast, the masters of Dublin’s major maternity hospitals (the Coombe, the Rotunda, and Holles Street) have called for legislation to clarify their medical position; medical journal The Lancet also called for clarity.

Dr. Jen Gunter wonders how sick do you have to be to qualify as entitled to an abortion: the X-case judgment on which current practice is based distinguishes between a woman’s health and her life.

I can easily argue that Savita’s life was at risk the moment her membranes ruptured at 17 weeks. However, does Irish law mean a different kind of risk? And if so, how would doctors judge that risk to be present? Ruptured membranes and fever? Shaking chills? Bacteria in the amniotic fluid? Positive blood cultures? Sepsis? Cardiovascular collapse? How sick must a pregnant woman be in Ireland be for a doctor to state that her life is at risk?

Even a woman with cancer is not guaranteed her rights: Michelle Harte, a woman with cancer who was denied an abortion or cancer treatment in Ireland while pregnant because she wasn’t sick enough, received compensation from the state last year; Michelle died a few months later. In the US, Catholic hospitals are similarly restricted as in Ireland, but they can send their patients to non-Catholic hospitals for the treatment they need: Irish hospitals do not have that option.

Interestingly, Ireland’s low maternal mortality rate – often held up by the anti-abortion lobby as evidence against introducing abortion law – is likely to be higher, perhaps double the currently quoted rate, which is based only on death certificates. A wider investigation by Maternal Death Enquiry, based at Cork University Maternity Hospital, showed that the rate may be up to 8 women per 100,000. This is still very good, ahead of the UK and USA, but behind countries like Sweden, Australia, the Netherlands, and Japan.

A Health Services Executive inquiry into Savita’s death was set up; upon learning that three of the seven members of the inquiry were doctors from Galway University Hospital, where Savita died, her husband Praveen refused to co-operate with the inquiry. These three members were replaced with other doctors, but Praveen has said he wants a fully independent investigation and will not meet with the Chairman, UK obstetrician Professor Sir Sabaratnam Arulkumaran, a move urged by Taoiseach Enda Kenny in an effort to obtain Praveen’s co-operation.

The HSE then requested that HIQA (Health Information and Quality Authority) set up its own investigation; which together with the hospital’s own internal inquiry plus an inevitable inquest, makes four separate inquiries into Savita’s death. Through his solicitor, Praveen has already stated his concern that Savita’s medical notes do not document her repeated requests for a termination. Praveen did meet with the Minister for Health, Dr. James Reilly, this week.

Senator Susan O’Keeffe is calling for the hospital’s own inquiry, which would have been completed before news of Savita’s death broke, to be made public.

There was a protest march from the Garden of Remembrance to the Dáil in Dublin last Saturday. It is estimated that up to 20,000 people attended.

Other protests were held in London and New York. There was a further protest outside the Dáil on Wednesday 21st, the third since news of Savita’s death become public. Protestors called for the repeal of the 8th amendment (which guarantees an equal right to life for the “unborn”). It was held at the same time as the Sinn Féin party introduced a motion calling for the immediate publication of the Expert Group report and legislation for X last Wednesday. The government amended the motion to remove the necessity to legislate immediately, as expected, and it was passed.

However, it was heartening to hear  some TDs, at least, during the debate saying the kinds of things they should have been saying twenty years ago:

Government cannot leave doctors in a position where they have no option but to treat human beings in a way a vet wouldn’t treat a dog… the only truly culpable people in this whole debate are us, we here in the Oireachtas now, and those who went before us….her death is at our door, nobody else’s. – Olivia Mitchell, Fine Gael TD for Dublin South.

Another protest is planned for this Wednesday, to co-ordinate with the re-introduction of Clare Daly’s bill to legalise X, amended from earlier this year, which she is describing as an interim measure until the goverment can table legislation based on the Expert Group report.

Clare Daly speaks at the 17th November protest.

Unless government TDs are given a free vote, it is unlikely to pass as the government will likely want to wait for the Expert Group report to be officially made public. Some of it was leaked to broadcaster RTÉ last week, and is said to be extremely negative about options that do not include legislation. The report is due to be discussed at Cabinet on Tuesday, and the government are due to give their plan of action to the Council of Europe by the end of November.

President Michael D. Higgins has even commented, an unusual move for a President, which is a non-political role:

My wish, frankly, is that there be some form of investigation which meets the needs of the concerned public and meets the needs of the family and meets the need of the state.

Also on Wednesday it was being reported that an undeclared anti-choice organisation was robo-calling landline phones as part of a “survey” on abortion in Ireland in probable contravention of communications and data protection laws. One phone line has been shut down by ComReg, but the calls have continued. You can listen to one here.  As of writing, no anti-choice organisation has claimed responsibility for the calls.

At the moment, it’s a waiting game: waiting for the Expert Group report, waiting for the HSE and HIQA report, but I feel certain that the public pressure on the government will be kept up.

9 replies on “Savita Halappanavar: Update”

Also well worth reading on this is why X-case legislation isn’t enough:

“We already have abortion on demand. If you’re pregnant and don’t want to be, then as long as you have the money and don’t have to worry about visas, you can get an abortion [abroad]….. The demand for abortion already exists, and it is being met. This is not something that Irish people are unaware of. In 1992, we voted to guarantee the right of Irish people to obtain information about overseas abortions and to travel for them.”

Clare Daly’s bill failed, as expected, to pass tonight, as the government has issued strong statements in support of legislating for X following the publication of the Expert Group report yesterday.

Alan Shatter, Minister for Justice, Equality, and Law Reform:

“there is no impediment to men seeking and obtaining any required medical intervention to protect not only their life but also their health and quality of life. I am, of course, not only Minister for Justice and Defence but also Minister for Equality and it can truly be said that the right of pregnant women to have their health protected is, under our constitutional framework, a qualified right as is their right to bodily integrity. This will remain the position. This is a republic in we proclaim the equality of all citizens but it is a reality that some citizens are more equal than others.”

and he added the next day:

“when men in this country require medical treatment there are no barriers to their obtaining it. In these particular areas, for example, there are barrier to women obtaining treatment and in that sense they are less equal as citizens in one particular area of our life.”

The 8th amendment to the Constitution – which gave the ‘unborn’ a right to life equal to a woman’s – is emerging as a barrier to further reform of the abortion law (e.g.: to termination where a woman’s health is at risk or when the fetus has no chance of survival i.e.: the laws that TFMRI are campaigning for).

Short answer: I don’t know.

Longer answer: the 1983 constitutional amendment is a stone wall in the way of progress. But more people are speaking out – like Dr. Rhona Mahony, the Master of Holles St Maternity Hospital:

“When she comes in at 12 weeks gestation she may be very well but I am looking at the effect of this pregnancy as it progresses,” says Mahony, who does not believe it is clear exactly when, in such a case, she is permitted to intervene.

“Do I have to wait until she is unwell, critically ill – at what stage can I make provision to offer her good, sensible healthcare? I do not want to wait until she is dying before I intervene, I want to protect her. I take into account her wishes as well.”

To say that women in Ireland never choose to terminate their pregnancy to safeguard their own health is inaccurate, she says. Some, who feel the risk of pregnancy is too great, will travel to a different jurisdiction to terminate it – before the risk to their life is closer to an “almost certainty” that permits termination here.

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