The discussion and debate around Savita’s inquest this week has been criticised for the level to which it has been hijacked and politicised by the two sides of the debate – the “pro-life” and the “pro-choice”. (Terms, incidentally, I detest.) Indeed, the crassness and closed-mindedness of some of the commentary has been nothing short of disrespectful in its militant determination to push its own agendas. Many of the pro-life side blatantly and robotically ignoring the fact that Savita was refused a medical termination was a key factor in the outcome. Many in the pro-choice camp ignoring the fact that in turn, medical negligence has clearly also played a large role. The complexity of the inquest means that both the abortion issue and the standard of the medical care received by Savita are relevant, and to deny either amounts to a deliberate obfuscation of the story in order to pursue a personal agenda. Which in itself is disingenuous and counter-productive, even disrespectful. This is not to mention the glee with which certain elements are attacking Catholics en masse, in what amounts to another form of thinly disguised bigotry. Not that certain members of the church can claim any degree of critical thinking in the debate, such is their adherence to tired Catholic dogma at the expense of the more Christian values of compassion and care.
However, we do need to have this discussion. And happily, we are hearing a little more from those who occupy the middle ground. Listening to and watching coverage of the debate on abortion in the Irish media over the past 20-odd years, you could be forgiven for thinking that there is no middle ground. That everyone is either pro-life or pro-abortion. I have even heard arguments rubbishing the use of the term “pro-choice”, suggesting that those who use it are simply, “pro-abortion”, and why dress it up? This does a great disservice to the large proportion of people who may or may not personally agree with abortion, but fervently hope that they are never faced with that decision, and would not seek to deny others the choice of making it. I think of all the discourse I have read around abortion since November, Johnny Fallon summed up my own feelings best in this piece published in the Irish Independent. The issue is far from clear-cut, and despite what political commentators insist, I would hazard a guess that most reasonable, compassionate Irish people feel like this and above all, hope it is a decision they are never faced with.
What irks me most, I think within this debate, is that, within the pro-life lobby – apart from the frankly ludicrous women-queuing-up-to-have-abortions scenario they appear to envisage – there is little recognition of the fact that even if abortion were readily available in Ireland, it is a path that many women, even those facing an unplanned or unviable pregnancy would not choose. Even among those who advocate for choice, it’s a safe to suggest that for some, it would not be a choice they would make personally. Equally, what irritates me about certain elements of the pro-choice campaign is the inherent assumption that all pro-lifers are driven by a religious agenda.
Meanwhile, what scares me the most reading Savita’s story, is that as a woman of childbearing age, under current Irish law, I can present to a hospital, in physical and emotional pain, be told that my baby is going to die, and be forced, against all my wishes and instincts, to comply with a standard procedure – natural delivery – that prolongs that pain. Under Irish law, in this situation, I don’t have a say in my treatment. Whatever your views on abortion, forcing a pregnant woman who is miscarrying to carry through with a natural delivery (and placing her at a higher risk of infection) when there are medical options available to hasten the procedure is, in my mind, wrong. The thought of it terrifies me – Praveen and Savita are described as “begging” for a termination. How needlessly traumatic. I’m not medical expert, but I can see no moral or ethical reason why she should not have had the choice of a medical termination in that situation. And I see no reason either why a middle-aged midwife should feel she has to apologise for explaining the cultural basis of our laws to a distressed woman why it is that her wishes had to be ignored.
Incidentally, neither do I, as a citizen of a supposed democracy, should I feel I should have to consider before attending a doctor whether their own personal beliefs will prevent me from accessing all the information I need to decide what course of action is best for me. While it’s natural that doctors hold personal beliefs, based on their own ethical and moral code, at the very least they should be obliged to provide information and contacts on all options, including abortion, should a woman seek them.
Using Savita’s death to call for “Action on X” makes me feel uncomfortable, however. In fact, I have serious reservations about leglisating for X in its current form, but that’s a discussion for another time. My understanding and belief is that even had it been already enshrined in legislation, it would have done little to prevent Savita’s death, as it was not believed her life was in danger when the termination was requested. Had Savita been granted a termination when she sought one, however, and not been left vulnerable to infection for so long, it is likely and arguable that the sepsis which killed her would never have set in. (It is also likely, that had it been a surgical termination, she would have monitored more closely). That she did not, and was not is a direct consequence of our abortion laws. And who is to say that Savita is the first, or will be the last?
Ultimately, I am in favour of full choice for women when it comes to abortion. Yes, abortion “on demand” (what a dreadful, dreadful term) should be available, if a woman decides it is the option she wants to pursue. I believe that any woman who honestly thinks an abortion is the best option for her should receive the necessary physical – and more importantly, psychological care, firstly to make that decision and secondly, to deal with the implications if she does. While I may hold my own beliefs, I cannot in good conscience say why they should prevent others from making a decision that involves their own body, based on their own instincts, conscience and beliefs. I would greatly welcome a referendum on full abortion; however I cannot imagine that happening in Ireland even within my lifetime.
I’ve been accused, perhaps justifiably, of passing the buck on this before. How I can advocate giving people the choice to “kill an unborn child”? Do my beliefs extend to giving women the option of third trimester abortions? Where I would draw the line and at what stage does an “embryo” or “fetus” become a “life”? Again, I have my own beliefs, but I still maintain it’s not for me to say. In the absence of proof, I’m not the one who should draw those lines definitively for others. All I can ever do is try, in as much as is possible, to control my own situation, and live by my own conscience and moral code when it comes to such matters, and importantly, allow others the freedom to do the same. And certainly where others are not in a situation to control their situations (e.g in the case of a pregnancy as a result of rape, or where a pregnant woman has been told her fetus is incompatible with life) who on earth am I to deny them the means of dealing with it in the way they feel is right?
The bottom line is that with abortion, no-one can ever claim to be really right.
Whatever your opinions on abortion, or indeed on religion or healthcare in Ireland, it is important and respectful to remember that at the heart of the evidence we are hearing this week lies a tragic story of a beautiful, healthy young woman, two bereaved parents living half a world away and a heartbroken husband who has lost his wife needlessly. With her, he lost the promise of a family, and whilst dealing with his own grief he has had to fight to have his story heard and believed. In doing so, he has done this country a huge service by making us confront an issue we have conveniently ignored for far too long. That should not be forgotten.
Photo: D.B. Patil (www.thehindu.com)
This is a thoughtful, considered, and beautifully written piece that does you great credit, though I cannot join in your conclusions.
I think it has been missed in this debate thus far that almost nobody believes that Savita's delivery should have been speeded up – whether one chooses to call that an abortion or an inducement of delivery is a matter of almost supreme irrelevance – and that to have done so would have been legal.
She needed, from a medical standpoint, that baby out, or so all medical evidence suggests, and this did not happen, though the law, medical ethics, and even catholic teachings permitted it. If this happened because of ideology it is unforgivable, and if because of medical misdiagnoses it is unbelievably tragic. The woman had a life and a family, and I hope in time she'll be remembered for that and not just the manner of her parting.
On the issue itself, I share your views in every way but one – I cannot see how I can believe, as I do, that abortion takes a life, and then say that I am okay with it if other people are. Does this require me to “impose my views” on others? It does, but it is not just any view. I can't get to a position where I will ever be able to say that a person taking a human life is permissable simply because they define it as something less than human. I wouldn't be on the planet had I not once existed as a 3 day old foetus or a 3 month old foetus or a 3 minute old newborn.
Life is a journey from nothing, to something, and back again to nothing. Interrupting that journey at any other stage is considered murder. I have never, and never will, be able to believe that for nine months of that journey, it is something else.
But thanks for writing about it. It's a pleasure to see civility brought to what has often, and probably inevitably, been the most uncivil of debates.
In the second paragraph above I said “almost nobody believes”. This should obviously have read “almost nobody denies”. The need for, justification for, and legality of expedited delivery/termination is not in dispute. It should have happened. The debate is about whether this was due to misdiagnosis or ideological malfeasance.
“almost nobody denies” – actually the doctor who testified at the coroners inquest did exactly that. She believed that the law prevented a termination / inducement until the 24th IIRC.
Dr Susan Knowles: Were 'subtle' indicators of sepsis before Weds Oct 24 but none to call for termination of pregnancy. [Fergal Bowers tweet]
So it may be that Dr Astbury reflects the consensus among Irish medics: you can only terminate when the risk is really very great.
The blog ignores the fact that routine termination is not the normal treatment in cases of inevitable miscarriage. The risks of surgery and unnecessary instrumentation have to be considered, as well as the possible complications of surgery. If a woman is stable and is showing no signs of infection, it's very common to let the miscarriage proceed without intervention. The key issue was that Savita did have an infection which wasn't detected. The failures in her care were unbelievable and this is what “pro-life” and “pro-choice” women should be focusing on.
My heart goes out to Savita, Praveen and her family. I hope standards of care will be improved so this can't happen again.
Or intervene in any way that would interfere with natural delivery? I doubt, given what we've heard both in this inquest and in the recent Oireachtas hearings, that the law needs to be clarified, even for medics.
Thanks for your comment. I don't think my post ignores that at all. While I understand that allowing miscarriage to proceed naturally is frequently the case, and indeed, often what the woman wants; I repeat that I fail to see why, when she requested intervention, that the implications of such action were not even considered – it was just not on the cards.
I wholeheartedly agree that there were massive failures in Savita's care. That cannot be disputed. And we are certainly in agreement on our sorrow that this ever happened in the first place.
I appreciate your kind comments, and while I respectfully disagree with your beliefs (particularly the use of the M-word), I can absolutely understand why you hold them. Thanks you too for reading and contributing.
I think you are right about the middle ground – I think that because people assume that everyone must be “pro-choice” or “pro-life”, this prevents open discussion as it's such an emotive topic. I am certain that there are huge numbers of people for whom the idea of abortion is personally very upsetting but who believe that women should have a choice about their own bodies
Hi Office Mum, thanks for reading. I think you've hit the nail on the head there (in far fewer words than I did!).
No one is ever right sums it up perfectly, as in Roe v. Wade which has been fought since 1973, and I have no doubt if the termination of a pregnancy where to become illegal again in the U.S. that would be fought for another 40 years. I have every empathy for the family of Savita, absolutely heartbreaking to hear what she went thru, perhaps her life could have been spared if an emergency C-Section been performed at the first signs of complications, oh wait silly me her vitals, blood work etc were not correctly monitored. A whole system failure as in many hse run hospitals, some of which should have a sign posted outside ‘Abandon hope all ye who enter’.
I believe you are incorrect stating no one can claim to be really right.
I believe too that even doctors are neglectful, all too often.
Savita paid the ultimate price for this.
That doctor is in denial.
And it seems the medical profession actively promotes arrogance over truth.