News Abortion

Inquest Confirms Savita Halappanavar’s Life Was Subordinated to Non-Viable Fetus

Jodi Jacobson

This is the inevitable outcome of abortion bans. Women die.

Last year, Rewire reported on the tragic and wholly preventable death of Savita Halappanavar at Galway University Hospital. Halappanavar, a dentist who was pregnant with her first child, was admitted to the hospital with severe back pain. She was in the midst of miscarrying a non-viable fetus in a much-wanted pregnancy.

Over the course of three days, Halappanavar experienced an incomplete miscarriage that resulted in a life-threatening infection and unbearable pain. Halappanavar and her husband begged doctors to terminate the pregnancy. The doctors refused because, as she was told by the hospital’s midwife manager, Anna Maria Burke, “Ireland is a Catholic country.”

And in that Catholic country, where a woman’s life is secondary to a non-viable fetus, the woman died.

Now, a report by the Health Service Executive has concluded, according to the Irish Times, that there was “an overemphasis by hospital staff on the welfare of Ms Halappanavar’s unviable foetus and an underemphasis on her deteriorating health.”

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As reported by the Times, the report says, “The investigating team considers there was an apparent overemphasis on the need not to intervene until the foetal heart stopped, together with an underemphasis on the need to focus an appropriate attention on monitoring for and managing the risk of infection and sepsis in the mother.”

The final draft of the report did not mention the widely quoted comment by Burke about Ireland being a “Catholic country” where doctors would not end a miscarriage, but Burke admitted to saying this during testimony.

Reading reports of testimony provided during the inquest left me feeling the panicked helplessness I can only imagine that Praveen Halappanavar felt as his wife lay dying from a preventable and treatable condition that was treated as subordinate to a pregnancy that could not succeed. Reading the details of their ordeal is difficult even for a complete outsider.

According to both the timeline of Halappanavar’s “care” and reports by clinicians who evaluated the records, it is clear that infection had already set in when Savita was admitted to the hospital, but tests revealing elevated white blood counts were “not immediately relayed” to her doctors.

According to experts interviewed by the Times, the key issues arising from the report revealed that “on admission to the Galway University Hospital on Sunday, October 21st, Ms Halappanavar’s white blood-cell count was elevated, which indicated her body was fighting an infection.”

It finds her vital signs were inadequately monitored; that she was seriously ill by the evening of Tuesday 23rd, but that this was not acted on; that her team saw her on the morning of Wednesday 24th and she had further deteriorated, and still this was not acted on adequately; that further blood samples were not taken until later that day and that the High Dependency Unit did not get involved until the Wednesday evening, after the foetal heartbeat had stopped.

In a subsequent article, the Times reports that Dr. Susan Knowles, a consultant microbiologist at the National Maternity Hospital who testified at the inquest, “was also critical of poor documentation at a critical time in Ms Halappanavar’s care on Wednesday, October 24th last.”

Moreover, the report notes that “the possibility of performing an abortion was discussed by the medical team on the Wednesday. Mr Halappanavar was unaware this had been discussed. The couple’s request for a termination on the Tuesday is acknowledged in the report, but not in Ms Halappanavar’s medical notes.”

So doctors and nurses knew they had a non-viable fetus, they knew they had a woman at high risk of death, and they must have known that time was of the essence.

And yet they did not act.

This is the inevitable outcome of abortion bans. Women die.

Commentary Abortion

Pregnant Women Are Mere Vessels Under Irish Law

Lisa Hallgarten

Until the Irish government repeals the Eighth Amendment and replaces the new unworkable law with policies that facilitate rather than obstruct access to abortion, women will continue to be seen simply as means to an end.

“I am not a vessel” has become a popular mantra for Irish reproductive rights advocates after Sir Nigel Rodley, chair of the UN Human Rights Committee, chastised Irish law for treating women who are raped and subsequently denied abortion and forced to carry a pregnancy to term as “a vessel and nothing more.” But in a country where an embryo has the same constitutional rights as a woman, we know that women are considered mere vessels, and never has this been more vividly demonstrated than in last week’s revelations about the forced pregnancy, forced hydration, and coerced cesarean section of a survivor of rape who was seeking asylum in Ireland.

Following the enormous public outcry after the preventable death of Savita Halappanavar, who was denied a life-saving abortion, the Irish government was put under huge pressure to address the lack of clarity in the law about when and why an abortion could be legally provided. However, the day they changed the name of the draft legislation from the “Protection of Maternal Life Act” to the “Protection of Life in Pregnancy Act,” I predicted that nothing would change. It was clear that the Eighth Amendment—which “acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother”—would prevail.

Even if you could believe, in principle, that a fetus or even a zygote should have the same value and the same legal protections as a woman, it is clear that in practice the rights of a woman and her fetus will sometimes be in competition—when a woman’s life is threatened by the continuation of her pregnancy, as it was for Halappanavar; when urgent and vital medical treatment for the woman carries risks for the embryo; or when the pregnancy is causing suicidal intent. In these situations, the state or the medical profession has no choice but to come down on one side or the other. We have to ask why, time after time in Ireland, the fetus’ rights have trumped those of the woman?

Facts are still emerging in the most recent case reported in Ireland. It seems that a woman, pregnant as a result of rape, sought an abortion at eight weeks of pregnancy. She was denied an abortion, despite meeting the legal criteria (two psychiatrists confirmed that she was suicidal and therefore theoretically eligible under the new act). Perhaps because of her immigration status, she was unable to do what so many Irish women do, which is to beg and borrow to fly to England or the Netherlands for a privately funded abortion. Lied to and obstructed, when she finally realized she would not be permitted an abortion she went on hunger strike, refusing food and water. Doctors were awarded a court order to forcibly hydrate her. Subsequently they sought a court order to force her to have a live delivery by cesarean section against her will. Finally—clearly under duress—she agreed to the procedure. The whole process was aimed at delivering a baby—albeit so prematurely that the baby bears the risk of living with serious developmental and physical disabilities.

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I once debated with an anti-choice campaigner who declared that one day society will have the technology to keep a “baby” alive outside of a woman’s womb after a couple of months. No woman, he asserted, would begrudge continuing the unwanted pregnancy for just a few weeks until their fetus could safely complete its gestational development in a machine and then be adopted by a deserving childless couple—could they? Of course we know they could. Moreover, 15 years later no such technology exists. In fact, neonatologists think that at 24 weeks, regardless of technological advances, we have pretty much reached the limits of viability determined by the physiological development of a fetus and can only hope to improve outcomes for babies born at or after that point.

However, for fundamentalist anti-choice campaigners these facts present no obstacle—after all, we have women to carry children to term, whether they like it or not, even when doing so threatens their health and lives. On Monday, August 18, on BBC Radio Ulster, anti-choice guest David Quinn lamented that the woman at the center of last week’s controversy had her cesarean section at 24 weeks and was not forced to continue the pregnancy until she could deliver a healthy, fully developed baby at 40 weeks: “A truly ‘pro-life’ culture would have looked after the mother until longer into her pregnancy, so as to ensure that the baby was going to be a healthy baby when delivered.”

This is the logic of the anti-choice movement and the Irish legal and medical profession that saw this young woman only as a walking incubator, rather than a human being of flesh, blood, and feelings. International law, policy, and convention and common sense tell us that women are not simply wombs to be commandeered in the service of childbearing. Until the Irish government repeals the Eighth Amendment and replaces the new unworkable law with policies that facilitate rather than obstruct access to abortion, women will continue to be seen simply as means to an end: vessels.

Commentary Religion

The Bishops Do Not Speak for All Catholics

Magdalena Lopez

I do not believe that people—especially Catholics—in either the Philippines or Ireland want our elected officials to bend a knee to the will of the bishops when it comes to reproductive health.

Last week, members of the Irish parliament, the Dáil, and pro-choice organizations invited me to speak at a meeting in Dublin. The meeting came as parliament was in the midst of debates over a small change to the law, one that would allow women whose lives are at risk as a result of pregnancy to access an abortion without having to travel overseas.

The parliamentarians and activists all seek progressive change in the country’s abortion laws—many wanting much more than is currently on offer. As we talked, I was struck about the similarities that Ireland shared with the country I was born in, the Philippines.

I am proud of my country for many reasons, but mainly for its people. Like the Irish, Filipinos are warm and hospitable people with world-class talents, and many of us work overseas to remit money back to our loved ones.

One thing I am certainly not proud of is the fact that one-third of the county’s 95 million people live in dire poverty.

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A lack of resources forces many to make choices they should not have to make. This is especially the case in relation to health care, where life and death situations occur far too often.

For 15 years, I fought for a bill that would give my compatriots a choice when it came to family planning.

For 15 years, I watched it languish in parliamentary limbo because of vehement opposition from a determined Catholic hierarchy.

Last December that opposition finally was defeated, and a reproductive health bill was passed.

The parliament stood up for the rights of the people in the Philippines and passed a bill that allows women to, in good faith, make the reproductive health decisions that meet their needs and not those of the hierarchy.

I do not believe that people—especially Catholics—in either the Philippines or Ireland want our elected officials to bend a knee to the will of the bishops.

I’m not suggesting that, in a democratic society, any voice should be silenced, whether or not I agree with it. But it is the job of politicians to carefully examine every lobby group, whether it is a union, a business, or a bishop, before accepting its assertions.

There are a few questions politicians should ask themselves before they accept the bishops’ counsel.

First, does this group speak for the people? A poll showed that 75 percent of people in Ireland—a substantial majority—back wider access to abortion.

Second, is what the group saying correct? On abortion, the evidence shows that increased access to safe and legal reproductive health care services helps women. Clarity in the law would most likely have saved Savita Halappanavar’s life. The bishops’ assertion about the impact of abortion in general and this law in particular are wildly off-target.

Thirdly, how would the changes this group is proposing affect a secular, democratic society?

Every country’s leaders should govern in a manner that allows people to make the best decision for themselves and for their families. The bishops do not believe this.

However, it is worth remembering that the church’s own laws do not require Catholic politicians to legislate according to church teachings.

In addition, Dignitatis Humanae, Vatican II’s Declaration on Religious Freedom, promotes a broad definition of religious freedom, stating that it is “imperative that the right of all citizens and religious communities to religious freedom should be recognized and made effective in practice.”

Imposing the hierarchy’s interpretation of the church’s teaching on abortion onto all Irish people would appear to be the antithesis of supporting such an expansive vision of religious freedom.

Individual lawmakers and individual citizens may not agree with the law and may not choose abortion for themselves, regardless of the circumstances they are in. But personal beliefs should not be used to deny the right to others to make those decisions, in good faith and in good conscience.

Irish legislators now face a similar decision to their colleagues in the Philippines: They will either bow to the hierarchy or permit Irish women, Catholic or otherwise, to make their own reproductive health decisions.

As we mark the 50th anniversary of the death of United States’ only Catholic president, John F. Kennedy, we would do well to recall one of his many fine speeches:

I do not speak for my church on public matters, and the church does not speak for me. Whatever issue may come before me as President if I should be elected—on birth control, divorce, censorship, gambling, or any other subject—I will make my decision in accordance with these views, in accordance with what my conscience tells me to be in the national interest, and without regard to outside religious pressure or dictates. And no power or threat of punishment could cause me to decide otherwise.

The conversations I had with the activists in Ireland were honest, forthright, and touching. They want to see real change in their homeland’s anti-abortion laws. I trust that Irish politicians will take their views and President Kennedy’s words into account and do what is right for Irish women, their families, and the nation.