The death of Savita Halappanavar is a devastating tragedy for her husband, family and friends.
Nobody can read or watch coverage of her case without being moved. Nobody can think of her case and not feel for Praveen Halappanavar – a man now grieving both his wife and the baby daughter they expected together.
Savita Halappanavar was 17 weeks pregnant when she attended UCHG with back pain. She was initially examined and told that she could go home as everything was fine. She went home but later decided to return to UCHG, as she continued to feel unwell. On her second presentation she was given an internal examination. She was found to be dilated and miscarrying. She was admitted into hospital. We don’t know the circumstances of her medical treatment over the next few days – and won’t until the findings of the inquiries into her death are made public. When she started antibiotics is not clear, which may prove to be a crucial factor in the outcome of her case. Some media coverage has reported that Savita was brought to theatre for an evacuation of the womb (D&C). Other coverage has reported that she delivered her daughter vaginally following spontaneous miscarriage.
Simply put, we don’t know the full facts of her case. What was the cause of her back pain? When was the ESBL E. coli infection detected? Did Savita have a pre-existing infection when she presented to UCHG? When were antibiotics started? Was the correct antibiotic for ESBL E. coli used as soon as the infection was detected? Did it become apparent to the team caring for her that delivery was necessary? If this judgement was made, when was it made? Was delivery delayed, as is alleged? If so, why? Were the team caring for her following the Medical Council’s guidelines in this area? If not, is the Medical Council taking disciplinary actions against them? Did the team do everything they could for Savita Halappanavar, but her infection was such that she died despite the best efforts of the team?
We don’t know the answers to any of those questions.
What we do know is that the Medical Council instructs doctors to provide any and all necessary medical treatments to women during pregnancy, even if these treatments may, sadly, result in the death of the unborn child.
We also know that expediting delivery in the case of miscarriage does not constitute abortion, medically or legally.
Miscarriage has never made up part of the abortion debate in Ireland – and it ought not. Miscarriage is a very sad, and common event. Approximately 14,000 women experience miscarriage in Ireland each year – half of them attend hospital for treatment. Obstetricians treat women experiencing miscarriage as a regular part of their medical practice. It would never cross a doctor's mind that treating women in these situations constitutes abortion.
It is dishonest for pro-choice campaigners to claim that legalised abortion would have prevented the death of Savita Halappanavar. In Britain, where abortion is widely available, sepsis is the leading cause of maternal death. Dr. David Walsh, an obstetrician/gynaecologist, said on the Vincent Browne programme that the Confidential Inquiry to Maternal Death found that a woman dies every month from sepsis in the UK. Legalised abortion is not the panacea to sepsis that pro-choice activists would have you believe.
Director General of the HSE, Tony O’Brien worked for years as the head of the IFPA, one of the most vocal groups in pro-choice campaigning in Ireland. He makes no secret of the fact that he is pro-choice regarding abortion. I found it interesting, then, when he stated on the News At One on the 22nd November 2012 that the case of Savita Halappanavar should not be discussed in the context of the abortion debate.
Seán O’Rourke: What’s your response to the observation… the statement from Galway Pro Choice today, where they say Savita’s family have received no personal apology or expression of condolence from any government or HSE official?
Tony O’Brien: A letter of condolence was issued on the 31st of October by Galway University Hospital together with contact information so that Praveen could make contact with regard to anything he would need, which included, and was followed up by, contact from the solicitor with regard to the release of files which we’ve already discussed. I think it’s regrettable – and you know in my past career I have had some involvement with this debate – it’s regrettable that this clinical review is being contextualised by people who have quite separate political agendas. This should not be seen as part of that context. This is what it is. It is an objective, internationally validated clinical review to find out what happened and how we can provide the best interests of our patients be protected into the future.
The Minister for Health, Dr. James Reilly, has stressed the importance of awaiting the findings of the inquiries “so that we get to the truth of what happened”.
Speaking in the Dáil, he said there was no evidence to suggest a Catholic ethos at the hospital prevented Savita Halappanavar’s life from being saved: "People have raised questions about a Catholic ethos that is preventing people or inhibiting people from carrying out proper medical treatment as defined by the Medical Council. I have no evidence of that, but I am not going to preclude what a coroner's court will find, and I want to await that independent investigation."
The minister also read into the Dáil record the Medical Council’s guidelines for medical doctors. The guidelines state that, in some cases, “therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby.”
As a general comment, based on his experience as a GP, the minister said that it was often the case that where a miscarriage was inevitable, “the view of the medical expert is that to allow that to occur naturally is the safest option. There will come a point, and a time, where that is not the safest option and where intervention must take place.”
When Kitty Holland ‘broke’ the story in the Irish Times on 14th November 2012, the headline read “Woman ‘denied a termination’ dies in hospital”. In her article in The Observer on the 17th November 2012, Kitty Holland acknowledges: “Whether the fact that Savita had been refused a termination was a factor in her death has yet to be established.” To me, this seems like a critical point – yet it is tucked away in the 8th paragraph of her article. Why did Kitty Holland run with the headline on the 14thof November when, by her own admission, whether the alleged refusal of termination was a factor in her death has not been established?
How Savita Halappanavar died has yet to be established. Abortion advocates are dishonestly but skilfully claiming that X case legislation is necessary in the wake of her death. The law and the Medical Council guidelines are very clear that women should receive all medical treatments they require during pregnancy. X abortion legislation does not safeguard or strengthen these guidelines. The X case legalises abortion without a time-limit and would lead to a regime of wide-spread abortion in this country. There is no evidence that abortion saves women’s lives. The UK, with widespread abortion, has a maternal mortality rate that is twice ours. Twice as many maternal deaths occur in the UK – some of those women dying from abortion complications. The US, which also has widespread abortion, has a maternal mortality rate three times higher than Ireland’s. It has been proved that excellence in maternal care saves women’s lives. Ireland has an excellent record in this regard. We are consistently in the top 5 world leaders for maternal health, sometimes even #1.
Excellent maternal care – not abortion – saves women’s lives.
