Irish abortion laws

[crumpet]

In all the publicity about the gay marriage referendum Aibu to wonder why there hasn't been mention of the abortion laws? Have I missed discussion on this?

No one can say that. Risk from surgery, risk of infection , negligence. She may or may not have died - according to the notes, she first requested the termination on the Tuesday.

I think if they hadn't been negligent she wouldn't have died.

"But they also knew that legally they couldn't until she showed signs of infection. So they actually had to wait until she started to be ill before they could intervene. Under what circumstances is that acceptable?"

None, but I'm beginning to think there's no point in arguing. Clearly the only problem was misdiagnosis of early sepsis and not the fact that doctors had to take into account an entirely vague, badly worded bit of the constitution before making decisions about patient care.

They had to think she was at risk of developing infection.Actual risk not theoretical risk. That does not mean the same as 'waiting for her to develop an infection'. Unfortunately, due to their negligence, she did actually develop an infection.

And just to be clear - she was clearly at risk and they should have acted sooner. I've said that a few times now.

Yes, thye should have acted sooner. They were negligent. But they were also not able legally to act until she started to be ill. Sepsis can progress frighteningly fast. They would have had to catch it just as it started. And all it would have taken is a missed obs, or a change of shift for that negligence to happen. A hideous outcome for both patient and HCPs. Which could have been avoided if only..............

They could have acted sooner in accordance with the law. She was at risk. They didn't act.

I've told this story before but just so I can show again how awful it can be to be an Irish woman here goes

I was 6 weeks pregnant in 2010. I started to bleed, had a scan told baby was fine come back in four weeks.
I was told four weeks later that the amniotic fluid surrounding the baby was gone, that my waters must have broken when I was bleeding.

Me an dp obviously devastated. I went home to digest the information. I thought I would be taken into hospital and a d&c preformed. Oh how wrong was I.

I was told the foetus has a heart beat so as long as this is the case I would continue to be pregnant.
I had to wait for my baby's heart to stop beating before anything could be done for me.
I knew my baby was in pain (a lovely doc at the hospital helpfully informed me ) I was still bleeding heavily and my mental health was shot. I had a 2 year old dd and a job and I could barely function.
Each time I went to the hospital my baby still had a heartbeat. I was sent home and told won't be long now
I once asked a doc how long could this go on for and I was told a pregnancy like this could get to 7 months! I was 12 weeks pregnant as this stage.

I managed to get to 19 weeks when finally my baby's heart had stopped beating. I was told I'd be brought back in to be induced after the weekend. That night my baby started to leave my body while i was on the toilet. I had an awful delivery at the hospital and didn't even get to see or hold my baby boy. He died from an infection that had entered my body while my cervix was dilated, this infection was present in my body for about a week and all that time I was at risk from infection too. Now he didn't ever have a chance at life but imagine he died from an infection because Irish law said my hospital couldn't intervene when they knew he would die anyway. It actually reads like a made up joke about Ireland.

Sorry for the epic story but this is the reality in Ireland today. Women are expected to put up and shut up. Why did this happen to me and why is it happening to other women and their families?

I will repel the 8th amendment with every ounce of my being to protect my daughter, my neighbours daughter and even your daughter Bumbley

Bumbley no matter what way you attempt to frame it, you cannot deny that it was the law, which prevented the medics from providing the necessary treatment, which caused poor Savita's untimely death. Had she been given the abortion at the beginning of her miscarriage it is highly likely that she would be alive today. The fact that the 8th prevents a woman from having a termination until there is a serious threat to her life is unacceptable and inhumane.

Lucy

Sorry for your loss Lucy

BabyFace, actually, yes, I can deny it was the law, as others (including pro-choice people) have done on this thread before me and as other people do in real life - because it's the truth whether you like it or not. The law would have allowed for Savita to be given an abortion. They were legally allowed to perform that procedure because she was at risk. She was at increasing risk of infection from when her waters broke on the Sunday night. They could, legally, have acted sooner. They did not.

Key Causal Factor 2:
"Failure to offer all management options to a patient experiencing inevitable miscarriage of an
early second trimester pregnancy where the risk to the mother increased with time from the
time that membranes were ruptured. "

She was at risk - increasing risk. One of the management options available was an abortion. They did not offer her this even though they could have.

Do you not think that blaming it on 'the law' is actually letting the doctors - who refused to give her medical treatment that she was legally allowed - off the hook a bit? "Oh, they were worried about the law." BS. The law was clear that she could have been offered it when her life was at risk. The report found that she was at risk - she could have been given an abortion and they didn't offer it to her.

And why was it not offered? Because the medics were unclear where they stood with regard to the 8th. Which has also been stated many times on this thread.

And the reason that they didn't notice that she was at risk?

Key causal factors 1 & 3:

"Inadequate assessment and monitoring that would have enabled the clinical team to
recognise and respond to the signs that the patient’s condition was deteriorating due to
infection associated with a failure to devise and follow a plan of care for this patient that was
satisfactorily cognisant of the facts that:
? the most likely cause of the patient’s inevitable miscarriage was infection and
? the risk of infection and sepsis increased with time following admission and especially
following the spontaneous rupture of the patient’s membranes. "

And the reason she died?

"Non adherence to clinical guidelines related to the prompt and effective management of
sepsis, severe sepsis and septic shock when it was diagnosed. "

You've just said there yourself that it is the mere existence of the law which ultimately caused the delay! If the 8th was repealed the situation would be clearer and such a delay would not happen as there would be no confusion.

No, because they were 'unclear' that she was actually at risk - see key causal factor 1.

The law didn't cause the delay. The law would have allowed her to have an abortion given that she was at risk. Doctors not picking up on the fact that she was 'at risk' caused the delay.

Anyway, this has all been said before. Nothing will convince some of you otherwise - especially if it's coming from me!

Had the pregnancy been terminated when Savita was admitted her risk of infection may not have increased and thus sepsis may not have occurred.

That would have mitigated the need for the medics to adhere to the clinical guidelines related to sepsis as it would have been less likely to have occurred in the first place.

And once again I say, a woman should not have to be 'at risk' before her life is given priority over the foetus she is gestating. Something which is all thanks to the 8th.

Well from Key causal factor 1 - " the most likely cause of the patient’s inevitable miscarriage was infection"

So she may have already had an infection at that point. Also, as discussed earlier, performing a surgical abortion also carries risks of infection higher than non-surgical management so it wouldn't have entirely eliminated the risk of infection and it wouldn't have removed her from the poor medical care that she received.

From the report -

"Our investigation established that hospital guidance assumes four-hour monitoring of patient observations for patients with premature rupture of membranes. However, in this case
monitoring of the patient who had prolonged rupture of membranes was less frequent (See
Appendix F). There was inadequate assessment and monitoring that would have enabled
the clinical team to recognise and respond to the signs that the patient’s condition was
deteriorating due to infection, together with non adherence to guidelines for the prompt and
effective management of sepsis, severe sepsis and septic shock when it was suspected or
diagnosed. The modified Obstetric Early Warning Score (mOEWS) observation chart was
not in use in some hospitals at the time of this incident for pregnant women on gynaecology
wards.
We considered that the patient’s condition involved prolonged rupture of membranes, which
is associated with increasing risk of infection with the progress of time. In this case, the
patient’s condition was rare and serious. There was a lack of recognition of the gravity of the
situation and of the increasing risk to the mother which led to passive approaches and delays
in aggressive treatment.

I forgot how frustrating engaging with you was bumbley

Why? Because I don't just agree with you? I don't expect you to agree with me but I will try to explain why I don't agree with your opinion/interpretation of something. I don't expect you to change your mind though.

Agreement has nothing to do it, it is fact that Savita was denied a termination due to the abortion laws. She wasn't considered"ill' enough until she collapsed with sepsis - and then it was too late.

You can call that purely medical mismanagement if you like bumbley, but a country with no such abortion laws would have given that termination immediately, and given Savita a much better chance of survival.

for Lucy, BabyFaced, and every other woman this has affected.