Ireland: Woman denied termination dies in hospital

[WidowWadman]

FFS - how is that defensible in any way shape or form? My thoughts go out to her family.

www.irishtimes.com/newspaper/frontpage/2012/1114/1224326575203.html

it had me in tears grimble. :(

The worse thing is, that a woman researching it will be trying to save her pregnancy. Sad and devastated to be losing a child in the fist place and then she is given hope that could kill her by "doctors" id like to see their degrees

Going back a bit on the thread, LRD, I think you are right, I think that is partly what bothered me - this is being reported as that Savita was refused an abortion, whereas she was actually refused the medically recommended, life-saving treatment for a miscarriage which was not complete. This was a wanted baby, she was already miscarrying, she didn't want an abortion, she wanted an induction, which, from everything I have read, should have been performed as a matter of course, no question.

The Guardian headlined the story 'woman refused abortion after miscarraige', which is really medically a nonsense - until relatively recently, the word abortion was used to denote either induced or spontaneous pregnancy loss. The problem is that the rhetoric of abortion is so emotionally loaded that it clouds the issue.

I have been through so many different thoughts on this since reading all the posts here and thinking it over, I am not sure I can say anything worthwhile any more. One of the things I was wondering was whether, if medical professionals induced labour at 32 weeks say, in exactly the same circumstances and the baby died during labour, this would still be seen as abortion? I doubt it. The difference here is that a 17 week old foetus would not be viable outside the womb, but the risks to the mother are the same. Except it was not viable inside the womb as she was miscarrying anyway. So inducing labour would not have been not feticide. Another thought, how do we know that the foetus did not die of the same septic infection they did not treat?? I mean, that's one sure way to kill a foetus, isn't it? Not to treat the mother and then she gets infected and dies. How is it going to survive that? Whatever way you look at it, it's medical incompetence, and I don't think they should be allowed to dress it up in any kind of ethical or moral debate.

I also want to know why in, three days, no-one thought to seek guidance from either the Irish College of Obstetricians or a court, if they were that worried.

It is heart-breaking that no-one in this hospital thought to do more, to question, to stand up and say this is wrong.

I think it is part of the anti-abortion brigade's rhetoric creeping in, isn't it? Everything must be about 'abortion' rather than all the varied things than happen. Like those poor women in the US and in parts of Latin America, where you are at risk of being accused of having had an abortion if you miscarry.

I agree with you they should have sought guidance. But it also should never have come to the point where someone has to think 'how much danger is this woman's life in ... is it worth the risk'.

Something that always strikes me, with this and with (for example) foetuses that have conditions incompatible with life, is, is it fair to put them through the pain? We know foetuses feel some pain. If the foetus is never going to live, is it fair to make it go through pain just so we can say it died outside the woman's body, not inside? Obviously it should be a very personal choice, but I think forcing a woman not to have an induction isn't necessarily even being humane to the foetus.

I realize this shades into arguments about euthanasia and becomes complicated (if you are anti-abortion), but it still seems relevant.

Btw, grimma, that quotation is spot on.

A retired senior obstretician from Galway has said that these doctors should have known they could intervene. Can't link to the article from here but it's as I thought.
Debate on the Late Late show last night and one Pro-lifer saying again that there's no situation when a termination will save the life of the mother. Where do they find these people???

I would guess that they did know they could intervene. The Supreme Court decision from 20 years ago did say that the mother and the foetus both have rights, and in the absence of any clear law from the Dail since then(!!) it at least establishes something. But there's the issue of what the doctors' colleagues would say afterwards. If someone who wasn't involved says "You didn't need to do that--the woman wasn't absolutely dying and just waiting a day or two would have resolved the situation" what could the answer have been? I think in an Irish context (and Galway may not be the most advanced place in Ireland) the doctors would feel pressured never to remove a live foetus except as a last resort when the need is totally clear. But if the issue goes into attitudes that extend beyond the legal area, I bet nobody will want to talk about it.

As for the person who said "This is a Catholic country", they are probably trembling in fear in case their identity is revealed.

The need was totally clear. She was dilated and leaking amniotic fluid. The risk of infection is well known.

They were spineless and ignorant, poorly trained and badly educated doctors, and imo, they were 'trained' from a philosophical/cultural pov to see women as 'less than' men, expendable, vessels, one is as good an another, etc.

Agree with mathanxiety - plus, how hard was it to seek a second opinion from higher levels of decision making in the time they spent doing nothing?

No matter whether they induced or not, or whether there was a heartbeat, the foetus could not have survived if the mother got an infection, or if she died. Why didn't they start her on antibiotics sooner?

Plus, Savita was having contractions and leaking. It wasn't just a case of either a leak or contractions. The way to deal with this situation was to administer ABs and induce/D&C. Not wait and see if the sac could magically repair itself and labour stop.

The "risk" was indeed well known. But a risk is only a chance. If they'd gone ahead, they'd have been "killing a foetus" for a certainty. Or maybe they'd have called it "killing a baby". We may be horrified by the way they think in Ireland, but it's possible to understand it, and it's more than just incompetence.

As for "a second opinion from higher levels of decision making", who's to say that they didn't do exactly that. And it was "carry on". I think this was established policy and there wouldn't have been any disagreements. Or those who disagreed knew that they had to shut up about it.

Yes, that is genuine incompetence--if they were determined to leave the poor woman in that vulnerable state, why didn't they pump her full of antibiotics right away? That's inexplicable.

The foetus would have died if she had died, so why not administer prophylactic ABs? The foetus would have been killed or seriously impacted by maternal infection. Plus, a foetus whose mother is in labour, and whose amniotic sac is ruptured is not going to live either inside or outside the womb. Stopping the heartbeat 24 hours sooner than it would have stopped anyway is not killing it.

The fact that they contemplated killing the mother by taking a chance on her risk of infection indicates a misplaced priority, a terrible medical decision. They took a chance on the health and life of a mother who could have been saved in order to avoid actively terminating the foetus's existence.

TT, there is no "way they think in Ireland" There are 4.5 million of us and we don't all think as one unit. Most people I know are as horrified by this as you.

Sorry Chipmonkey. It would be better to say "the way people in authority think in Ireland". And even then, there's probably plenty of disagreement, but with a huge amount of pressure on people to follow tradition, or religion, or whatever it is. As I said, can't we imagine the doctors who would have done immediate surgery on Savita Halappanavar facing colleagues who'd have claimed they'd acted unethically?

If this is going to come out into the open and be debated, that's one possible good result. But I'd hope to hear about any pressure medical people feel to avoid anything that looks like "abortion".

The Irish Feminist Network and the Belfast feminist networks have both held candle light vigils as has the Queen's university feminist society. everyone here is deeply saddened by the loss of life and are doing everything we can to bring about change. There is a law which was created 10 years ago but never ratified maybe now we will see it get passed.

Just to add to what's already been said, can I put a big "citation needed" on that statement by Ruth Cullen.

Is there anyway of finding out if Ireland's maternity services really are world class?

Is it worth writing to Enda Kelly even if you are not an Irish national?*

*Technically I could be, but I've never got around to sorting out the paperwork.

It's Enda Kenny.
I think you could try contacting him. No harm in reminding him how badly our laws are regarded internationally.
But successive governments have been afraid of losing the conservative right-wing vote. Fianna Fail and Fine Gael are both pretty middle-of-the-road and have already lost any left-wing support they had.

Cullen is correct that the maternal mortality ratio in the Republic of Ireland is very good. Latest figures are 6 women die per 100,000 live births. The Guardian printed a table a few years ago.

Doesn't make what happened to Savita in any way OK.

A point made on the Late Late show was that the low infant mortality rate has nothing to do with the lack of provision for termination. Italy has a lower infant mortality rate and they do allow termination.

Sorry maternal mortality rate.

the maternal mortality ratio in the Republic of Ireland is very good
That makes this case all the worse - the medical skills are available.

Grimma, I think that if the obs who delivered my last three babies had been in charge of Savita, she would probably still be alive. I really don't think he would have carried on in that nonsensical way, letting her die in pain.

That is just Irish smugness coming out. It comforts people to think this is unusual, this doesn't happen every day, most women have a good chance of coming out alive from a hospital for pregnancy related treatment. It sometimes comes across as 'we treat our women well'. Meaning 'women have no right to complain'.

It is one thing to send women home alive, but it is another entirely to send them home after experiencing the joys of the average Irish maternity ward and the not so fabulous post natal nursing care, dirty bathrooms, etc., during the busy baby season.

TeiTetua -- I would hope that more medical professionals would be taught that there is a difference between abortion and terminating a doomed pregnancy. More or better education perhaps? More ongoing professional accreditation requirements after qualifying? Or maybe they could be taught ethics in light of the fact that under the constitution the mother has an equal right to life, and sort out a code of best practices with that right in mind.