When the young woman lay in agony in the hospital late last month, there should have been nothing standing between her and an emergency medical intervention. But instead, what stood between Savita Halappanavar, a 31 year-old, Indian-born dentist, and the Irish doctor treating her, was a dangerously wide grey area that has long hovered over Ireland’s constitution. As she suffered through complications stemming from a miscarriage, she begged for an abortion. It was denied, reportedly because the fetal heartbeat was still present. Her husband later recalled that Savita was told by a medical consultant that an abortion would be impossible because Ireland “is a Catholic Country.”
That exchange, seared in her aggrieved family’s mind, lay bare the medieval nature of one of the Western hemisphere’s harshest abortion bans. Savita, a Hindu born in India, argued that she was “neither Irish nor Catholic.” None of that mattered, because Ireland’s anti-abortion law, as it was interpreted by her medical provider, trumped questions of both bodily sovereignty and cultural difference.
Savita’s case was one of countless pregnancies across Ireland in which a woman’s fate may come down to a subjective medical assessment colored by “conscience.” To qualify under Ireland’s near-total abortion ban, Savita’s life was apparently deemed not sufficiently endangered—until the two heartbeats ended after days of crippling pain, leaving both the fetus and the mother dead, the latter of septicaemia.
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Savita’s death has set off a wave of protests—not just among pro-choice activists in Ireland but also Ireland’s Indian immigrant community and in her home country. Two official investigations into the medical decisions leading up to Savita’s death are pending. Even the Indian government has gotten involved, with a meeting between the Indian ambassador to Ireland and the Irish foreign minister.
Yet Savita’s tragedy isn’t about her Indian identity per se; it points to the barriers facing all women in Ireland. The unwritten religious subtext of the policy—“cruelty disguised as piety,” in the words of one columnist—effectively places the bodies of both Catholic and non-Catholic women, citizens and migrants alike, under a sweeping, vague rule at odds with rights enshrined in international law.
The main legal guidance for the abortion ban is the case of X, involving a 14 year-old rape victim who was blocked from traveling to England for an abortion. The court set the medical threshold for abortion as “real and substantial risk to the life, as distinct from the health, of the mother.” The lack of concrete legislation on the standard has left the the one narrow avenue for legal abortion mostly in the hands of doctors. For a woman ineligible for a medically necessary abortion, virtually the only safe option is to travel to the United Kingdom or another country to terminate her pregnancy.
In light of the various legal challenges women have brought against the restrictions, the UN Human Rights Committee and the Council of Europe Human Rights Commissioner have criticized the government’s failure to comply with international human rights standards and clarify the ban through legislation. Savita’s death seems poised to intensify public pressure on Irish lawmakers.
Mairead Enright, a legal scholar at the University of Kent, said the political stagnation over the past twenty years shows that “certain kinds of public religious interests are being given a privilege which does not match the level of support or membership that they have in the actual population.”
How many women have, in the last 20 years, been denied not only basic reproductive choice, but even access to medically necessary abortion, because of a draconian legal rationale or the biased opinion of a doctor? Savita was an educated professional. Less-privileged women may have even fewer options when it comes to negotiating medical care, and virtually none if they can’t afford to travel abroad to circumvent the ban.
Savita’s case also reveals how immigrant status can underscore the policy’s social parochialism.
Commentator Gerald Howlin wrote in the Irish Examiner, “The cultural colonialism and condescension that characterised our attitudes to people of other races from the developing world has been witheringly turned back on us.”
But the cost is ultimately borne by anyone with womb. The socioeconomic divisions that strafe the prospects of a woman’s reproductive future are deepened by the restrictions established in the case of X.
According to the Irish Family Planning Association, the costs of terminating pregnancy overseas often total 1000 euros, the process of obtaining a visa adds additional burdens:
Women and girls who experience most difficulty are those who are already marginalised and disadvantaged, those with little or no income, women with care responsibilities, women with disabilities, women with mental illness, women experiencing violence, young women and women of uncertain residency status.
An immigrant woman seeking asylum may be further hindered by the hardships of wading through the asylum bureaucracy, forced to scrape by on meager state subsidies and without decent access to reproductive health care.
“Restricting this right for most people, restricting it for a right to travel–that has always raised issues of class and race and poverty,” said Enright.
The reproductive justice question resonates beyond Ireland; in the United States, immigrant women, women of color, and other marginalized groups see their reproductive health and choice constrained by both legal barriers and poverty, as well as linguistic and cultural divides. Undocumented women especially are either barred or sharply deterred from seeking family planning services.
Perhaps the one positive aspect to Savita’s tragedy is that it has further entwined Ireland’s reproductive rights movement with an international struggle for reproductive choice and health. The plight of the Halappanavars indirectly highlights the narrowness of a “Catholic” law in an increasingly borderless world. The question now is whether the global valence of a woman’s death can inspire a national reckoning.