A few years ago, I met a young man who had recently lost his wife in childbirth. He described in heartbreaking detail an agonising, drawn-out death in the maternity ward: his wife vomiting, shivering with a fever, her blood pressure dropping like a stone. He showed me a dog-eared certificate on which, in the space for “cause of death”, was written just one chilling word: sepsis.
The man lived in a shantytown in Sierra Leone, a country which has one of the highest rates of maternal mortality on Earth. Hospitals there routinely have to let patients die of preventable infection for lack of drugs, equipment or because the family can’t pay.
For a young pregnant woman to die of septicaemia leading to multiple organ failure in similar agony, crying out for help that never came, in a busy teaching hospital in a country that is supposedly one of the safest places in Europe to have a baby seems incomprehensible. The circumstances of Savita Halappanavar’s death in Galway University Hospital last month are now the subject of several official inquiries.
In Ireland, perhaps even more than elsewhere, the reaction to her husband’s moving testimony has been one of profound shock. Even in rural areas, like the one where I write this, most people, including practising Catholics, believe Savita’s life ought to have taken precedence over the life of her unborn child.
Was this previously healthy young dentist barbarically left in labour for three days, her 17-week-old foetus dying inside her, but refused a termination because, as her husband alleges, doctors said “This is a Catholic country”? Or was there a cock-up, a failure to spot the signs of blood poisoning – a common risk during miscarriage. Was it both? Until we know, we cannot say for sure that she would be living now if she had been given the abortion she requested.
But Irish people don’t need any more information to demand an end to a scandalous failure by the Irish state to protect its women. Regardless of the judgements made in Galway, we know that doctors in Ireland have been left in an impossible state of legal confusion for at least 20 years. This morass is directly a result of attempts by pro-life groups (some of them US-funded) and their backers in the Catholic church to make abortion in Ireland constitutionally impossible.
Abortion had already been outlawed for 120 years when, in the early 1980s, campaigners began agitating for, and secured, a “pro-life amendment” to the constitution that made the life of the unborn child “equal” to the life of the mother. Ten years later came the case of “X”, a teenage girl pregnant after rape, barred from leaving the country for an abortion. A Supreme Court ruling in that case allowed abortion in Ireland where the life of the mother is at risk, including from suicide.
But 20 years on, and six governments later, there is still no legislation to enact this technical entitlement. To be clear, we’re not talking about abortion rights that women in most of the developed world take for granted. We’re talking merely about legislation that would allow medical termination in extremely limited cases.
The result of the cowardice of Irish politicians who have not kept pace with public opinion, or indeed pressure from the European human rights court, is that a doctor has to establish that there is a “real and substantial risk to the life” of the mother before doing anything that might interrupt the pregnancy. Note the wording: the risk is not to the “health” of the mother, but the “life” of the mother. In other words, the mother must be on death’s door or the doctor risks breaking the law.
What an appalling choice for a medical team in a crisis if it's not yet clear how ill the mother may be: do you stand back and do nothing as long as there is a foetal heartbeat, as is alleged happened to Savita, or do too much and risk a criminal prosecution? No wonder 12 women every day still travel to the UK from Ireland for abortions.
The stereotypes of Ireland as still a theocracy ruled by mullah-like priests in soutanes are lazy and outdated. The Prime Minister has openly denounced the Vatican for covering up child sex abuse. It is hard to imagine that works of fiction by living writers like Edna O’Brien were ever banned because they contained a few mild references to sex. We have also travelled light years from a time when a young mother in my home town, a family friend, advised to risk no further pregnancies after a series of miscarriages, died in childbirth because her husband, a GP, could not countenance flouting the church’s teaching on contraception. But Savita’s case shows there is still a long way to go and I fear that the same dishonest debate pushed by the Christian right in America during the presidential election campaign will rear its ugly head very soon.
Two things have changed. Cold comfort to her grieving husband, but in death, Savita has given the debate a human face. And a new generation of young women has suddenly woken up to the legacy of the vicious battles over abortion rights that those of us who came of age in the 1980s were powerless to combat. This time, the pro-life extremists must be seen off by enlisting the compassionate majority. A good place to start would be to spread the slogan somebody had on a placard outside the Dail on Wednesday night: “Savita had a heartbeat too”.