Call for lifesaving legislation to be introduced after UHG death

The late Savita Halappanavar

The late Savita Halappanavar

If legislation is not immediately introduced to allow women to terminate a pregnancy when necessary to save their lives more women will die, Galway Pro-Choice group warned this week.

Representatives from the organisation were speaking out following the death of a 31-year-old dentist who was 17 weeks pregnant at University Hospital Galway on October 28.

Two investigations are taking place into the death of Savita Halappanavar. She trained as a dentist in India and lived with her husband, Praveen Halappanavar, an engineer at Boston Scientific, in Roscam. She had had come to Ireland four years ago and worked in Westport, Co Mayo.

She presented at the hospital with back pain on October 21, was found to be miscarrying and died of blood poisoning a week later.

Her husband is reported as saying that she requested a medical termination on several occasions over a three-day period. She had been told she was miscarrying and had spent one day in severe pain. He is quoted as saying that this was refused because there was still a foetal heartbeat and he was told it was the law, this was a Catholic country.

Reports indicate that she spent a further two and a half days in “agony” until the foetal heartbeat stopped. The dead foetus was removed and Ms Halappanavar was taken to UHG’s high dependency unit and then the intensive care unit. She died there of septicaemia on October 28. The results of a post mortem revealed she died of septicaemia “documented ante-mortem” and E.coli ESBL.

Galway Pro-Choice group says under the X Case ruling, women in Ireland are legally entitled to a termination when it is necessary to save their lives.

“However, legislation has never been passed to reflect this. It is the failure of successive governments to do so that led to Savita Halappanavar’s death,” it claimed.

“She was first admitted to the hospital on October 21 complaining of severe back pain. It became clear that her waters had broken, and she was having a miscarriage (spontaneous abortion ). She was told that the foetus had no chance of survival and it would all be over within a few hours.

“However, her condition did not take its expected course and the foetus remained inside her body.

Although it was evident that it could not survive, a foetal heartbeat was detected. For this reason her repeated requests to remove the foetus were denied.

“By Tuesday it was clear that her condition was deteriorating. She had developed a fever and collapsed when attempting to walk. The cervix had now been fully open for nearly 72 hours, creating a danger of infection comparable to an untreated open head wound. She developed septicaemia.

“Despite this, the foetus was not removed until after the foetal heartbeat had stopped. Immediately after the procedure she was taken to the high dependency unit. Her condition never improved. She died at 1.09am on Sunday the 28th of October.”

Galway Pro Choice group claims if the foetus had been removed when it became clear that it could not survive, Ms Halappanavar’s cervix would have been closed and her chance of infection would have been dramatically reduced.

“Leaving a woman’s cervix open constitutes a clear risk to her life. What is unclear is how doctors are expected to act in this situation.”

Spokesperson Rachel Donnelly says this was an obstetric emergency which should have been dealt with in a “routine manner.”

“Yet Irish doctors are restrained from making obvious medical decisions by a fear of potentially severe consequences. As the European Court of Human Rights ruled, as long as the 1861 Act remains in place, alongside a complete political unwillingness to touch the issue, pregnant women will continue to be unsafe in this country.”

Galway Pro-Choice member Sarah McCarthy, says her organisation believes that Ireland must legislate for freely available abortion for all women.

“Deaths like Savita’s are the most severe consequence of the criminalisation of abortion, yet it has countless adverse effects. We must reflect long and hard on the implications of her tragic and untimely passing and we must act to ensure that such a tragedy never happens again.”

Councillor Catherine Connolly, a member of the HSE West’s regional health forum, says the death of Ms Halappanavar in UHG - a “hospital that has been repeatedly portrayed as a centre of excellence is truly shocking”. She is calling for an independent investigation into her death.

“That a woman should die in such circumstances however in the 21st century should also elicit a sense of outrage and anger on the part of all who care and who believe that this should not have happened and should never happen again.

“Furthermore the reported comments by staff to the woman herself and/or to her husband are most distressing, unprofessional and unacceptable.”

There are a number of very serious issues which must be examined, she says. “Who made the decision that the hospital’s ‘hand were tied’ and based on what? What protocol and procedures were in place in the hospital to deal with a situation of this nature? What code of practice/guidelines, etc, were in place from the medical bodies, representing both doctors and nurses, in relation to handling a situation of this nature? What meetings/case conferences took place in relation to this very serious medical situation and if not why not?

“These issues and many more raised by the death of Ms Halappanavar require at the very least an independent investigation - internal investigations by the HSE and the hospital are simply not appropriate.

“Separately of course the Government must act as a matter of urgency and enact the necessary legislation to give effect to the Supreme Court Judgment of 20 years ago.”

Derek Nolan, the Labour Party deputy for Galway West and a member of the Public Accounts Committee says the death of Ms Halappanavar at UHG recently is “tragic and heartbreaking”.

“I am very concerned at reports I have read on the circumstances of her death and of the nature of engagement with consultants. I am aware that a number of investigations are taking place.

“These reports must be completed as thoroughly and quickly as possible. We need answers on what happened.

“My thoughts and sympathies are with her husband Praveen, her family and friends.”

Meanwhile, Senator Ronan Mullen, who is from Ahascragh, says the Savita Halappanavar case is “a deep tragedy that should not be used as a wedge by abortion campaigners”.

“In fairness to the medical staff involved we should await the outcome of the investigations that have been established. According to medical council guidelines, widely accepted medical practice and Irish law, a woman in Ms Halappanavar’s situation is entitled to the medical treatment she needs. This is true regardless of the existence of a foetal heartbeat or whether her unborn child might die or already have died. A primary issue in this case may have been the diagnosis and management of infection. But there would be no good legal or ethical reason why an induced delivery could not have taken place, once the medical situation called for that.”

He points out it is regrettable that some people are seeking to use this tragedy as an argument for legislating for the Supreme Court decision in the X case.

“There is no legal impediment to offering all necessary medical treatment to pregnant women. Notwithstanding this tragedy, Ireland still ranks as one of the safest countries in the world for pregnant women. On the other hand, legislation for the X case decision would, among other things, introduce abortion on a mental health ground that is unjustifiable on any reputable medical basis.”

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