How one woman's death pushed the Irish on abortion

London: Five years ago Savita Halappanavar, a 31-year-old pregnant woman, died of blood poisoning in the middle of the night in a hospital in Galway, after staff had refused to consider terminating her pregnancy until she was almost beyond saving.

That young dentist’s death galvanised the country’s pro-choice forces into action and, if the polls are accurate, on Friday Ireland will vote to end its abortion ban in a historic referendum.

Volunteers from Reproductive rights, against Oppression, Sexism & Austerity (ROSA) dressed as characters from ‘The Handmaid’s Tale’, demonstrate in Dublin calling for a ‘Yes’ vote.

According to an investigation by the Health Service Executive, Ireland’s public health provider, the patient and her husband had enquired about the possibility of having a termination, but it was “not offered or considered possible by the clinical team” until she was so sick with infection that she would be in intensive care less than a day later.

This was “due to [doctors’] assessment of the legal context in which their clinical professional judgment was to be exercised”: in other words the Eighth Amendment to the Irish constitution, inserted in 1983, which insists on the right to life of the unborn, equal to the right to life of the mother.

The HSE recommended the Parliament revisit the abortion law “including any necessary constitutional change” necessary to save mothers’ lives.

Professor Sabaratnam Arulkumaran, who chaired the inquiry into Savita’s death, told Irish radio on Wednesday the Eighth Amendment played a major role in her passing.

“By the time they decided to do the termination she was in septic shock, and what held them behind was the fear that they might be prosecuted for performing an illegal abortion,” he said. “The doctors’ hands are tied.”

The doctors were still checking the fetus’ heart beat when they should have been saving the mother’s life, he said.

“I’m very happy that because of that case and other cases … it has come to a referendum so the people of Ireland can see what is just.”

She didn’t get the medical treatment she needed because of the Eighth amendment.

But some experts – including obstetrician Dr Trevor Hayes, a member of Doctors For Life which supports retaining the Eighth Amendment – say it is wrong to blame the Eighth for Savita’s death.

A pro-life supporter canvasses for a No vote on the streets of Dublin, Ireland.

An official inquiry found 13 “missed opportunities” that could have saved her life, and a “general lack of provision of basic, fundamental care”. A failure to diagnose sepsis, not the abortion law, was to blame, Hayes said.

He said all necessary treatments to save the lives of mothers were already permitted under the amendment.

Of course, pro-choice campaigners argue abortion should be available much more widely than when a mother's life is at stake.

The Eighth Amendment was added in a conservative groundswell of resistance against the liberalisation of abortion laws elsewhere in the world in the 1970s and early '80s, amid concerns that Ireland was inching towards legalising or at least permitting abortion in wider and wider sets of circumstances.

On a turnout of 54 per cent, the amendment was passed by a 67-32 majority.

Pro and anti-abortion posters reflect voters’ differences of opinion in Dublin.

Under the law a woman can only get an abortion in Ireland if remaining pregnant could kill her – and this clause is strictly interpreted. Rape, incest or serious birth defects in the fetus are not enough under the law.

It is estimated that around 10 Irish women a day travel to the UK to have abortions, though one of the main UK hospitals offering the service to Irish women in cases of fetal abnormality, in Liverpool, recently scaled back access because staffing problems meant it had to concentrate on British patients.

An estimated three to five Irish women take illegal abortion pills at home each day – the number is rising with increasing availability on the internet – but using them is punishable by 14 years in prison, though no-one has yet been prosecuted.

Minister for Health Simon Harris has said he looked at changing the sentence, but it could not be done because the Eighth was an impediment to change.

A woman protests against a demonstration by pro-abortion campaigners.

Gemma Hussey, a former Irish government minister, said anyone who thought Friday’s referendum was a foregone conclusion had forgotten the lessons of 1983.

“All of us who have been through the political maelstrom know there are very few foregone conclusions,” she said. “There have been so many attempts to undo the damage that was done in 1983.

“But we have never succeeded.”

She recalled receiving anonymous letters in red ink “with references to ‘we know where you live’ and ‘we know your children’”.

By all reports, this debate has been more civil.

But polls show support for repealing the abortion ban has now plunged below 50 per cent, from more than 60 per cent in January.

A recent Irish Times poll showed 44 per cent support for repeal and 32 per cent wanting to keep the ban. A quarter of the electorate were undecided or unlikely to vote.

One of the reasons cited for the changing view has been the government’s pledge to introduce legislation allowing abortion for any reason up to 12 weeks, and beyond that in cases of rape, incest, fatal defect or where the physical or mental health of the mother is at risk.

The pro-life campaign says Ireland would, suddenly, have one of the world’s most liberal abortion laws (a debatable claim), calling it “abortion on demand”. Its posters say “One in five babies in England are aborted. Don’t bring this to Ireland”.

Some who had been persuaded the abortion ban was too strict find the alternative, now made clear, to be too permissive.

The “no” side also argues that Ireland is one of the safest places in the world to have a child, and that changing the law could put that at risk.

Surveys show a growing number of Irish might not vote at all.

The change is noticeable among socially liberal men who, anti-abortion campaigners say, have been lost by the repeal side.

“They have essentially been telling male voters and older voters consistently … that the only people to whom this referendum is relevant are women of child-bearing age,” John McGuirk, a spokesman for the anti-abortion campaign Save the 8th told Politico. “And the problem is that lot of those voters have taken them to heart and said, ‘Okay, you don’t want us involved.’”

The polls also show a big urban-rural divide, with the conservatives in the countryside.

And the Catholic Church has learnt from its failure in the 2015 gay marriage referendum. The church is losing its old influence on Irish culture and politics, damaged by clerical sexual abuse scandals. Archbishop Eamon Martin of Armagh told the Catholic news website Crux  that the church had looked for lay figures to lead the pro-life campaign.

“We are fully involved, but our technique is to encourage our lay faithful to be the voices, because they are the people – particularly women, who have very strong feelings on this particular matter,” said Martin.

There are powerful voices on both sides.

“I hope the people of Ireland remember my daughter Savita on the day of the referendum,” her father Andanappa Yalagi told The Guardian this week.

“I think about her every day. She didn’t get the medical treatment she needed because of the Eighth amendment. They must change the law.”

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