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Chairman says health of mother and not just life needs protection

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Chairman says health of mother and not just life needs protection .

The legal situation should be addressed “urgently” to ensure that not only the life but the health of the mother can be protected in pregnancy, the chairman of the review team said.

Prof Sabaratnam Arulkumaran was asked whether, to ensure another woman did not die in circumstances similar to those in which Savita Halappanavar had died, the law should permit termination of pregnancy where there was a threat to the health and not just to the life of the mother.

He replied: “Yes.”

More women could die in Irish hospitals in a manner similar to Savita Halappanavar unless legal clarity is provided for doctors on when they can intervene to terminate a pregnancy, the HSE report into her death has warned.Savita Halappanavar report: Tragic. Devastating.
Savita Halappanavar (left of photo) with children at Galway’s St Patrick’s day parade.The girl with the diamond smile
Dr Katherine Astbury advised Savita Halappanavar and her husband that a termination might have to be considered after a diagnosis of sepsis was confirmed. Photograph: Eric LukeTermination was denied at first because clinicians believed their ‘hands were tied’
Sabaratnam Arulkatumaran (left), Chairperson, and Dr Philip Crowler, National Director for Quality and Patient Safety, at the publication of the HSE clinical review report into the death of Savita Halappanavar on Thursday. Photograph: Eric LukeSerious gaps remain in what we know about operations in the hospital
“Failing to devise and follow a plan of care for this patient” is a fairly damning indictment of the healthcare professionals who looked after Ms Halappanavar. Photograph: Eric LukeMedical view: Focus on basics of care likely to help save lives

The Irish Times takes no responsibility for the content or availability of other websites.

“There are certain conditions a pregnant mother might have which can suddenly escalate – for example in this particular situation from an infection that is very localised but which spreads to the whole body and is sepsis.

“With severe sepsis the mortality rate is about 40 per cent, and if she goes into septic shock the mortality rate can be as much as 60 per cent. This can be in a very short period of time which means that [if] intervening is at a later stage it is difficult to bring the patient back to normality and to control.

Medical community
“So what we are saying is the medical community have to discuss with the legal profession if you really want to say the chances of making sure someone survives; this needs discussion.

“We don’t want another death happening because there is some ambiguity about how they interpret the law.”

He also said there were situations where a mother’s health only was threatened but which could escalate rapidly into a situation where her health would be permanently damaged.

“If you have infection, by the time it comes to sepsis and severe sepsis the fallopian tubes might be injured, she can become sub-fertile, she might have [later] an ectopic pregnancy. Life-long she might have pelvic inflammatory disease. I mean, how much are you prepared to take before considering termination of pregnancy?

“At what point is this going to give permanent injury to the woman, or what point might it escalate to death.”

He said too much responsibility was on individual doctors to interpret when it was legal to intervene, leading some to wait until the foetal heart stopped to be sure they were acting within the law.

“Even until the last minute they are waiting for the foetal heart to disappear before the termination would be considered. Some might have done it much earlier … so it seems to be a little bit individual, even within Ireland. So we must have some definitive meanings as to when you think this should be done.”

His patient
If Savita had been his patient in the UK she would have been offered a termination on Sunday, October 21st, the day she went into hospital. “If it was my case I would have terminated the pregnancy,” he said.

We need to get the 8th amendment repealed to safe guard women’s health.

Activism and Agitation

Statement from Galway ProChoice: Savita inquest proves urgent need for legislative change.

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Back in October I linked to the Statement from Galways Prochoice as the news about Savita broke and a statement explaining how they had been approached initially by Savita#s friends now they have a follow up.

For Immediate Release:

Savita inquest proves urgent need for legislative change.

The media reports from Savita’s inquest this week have shocked and saddened many across the country. Hearing the different accounts of how and why Savita died brings home more than ever the urgent need for legal clarity and compassion in cases where a pregnant woman’s health is at risk.

The strength and bravery of Praveen Halapannavar throughout the investigative process have been remarkable. Despite aggressive cross-examination, Praveen’s account of Savita’s final days has been largely vindicated. Savita was denied a termination when she requested one, and this was at least partly because of the legal ban on abortion in Ireland. System failures have been acknowledged, and a midwife in the inquest was brave to admit the truth: that Savita was indeed told that ‘Ireland is a Catholic country’ in an attempt to explain this decision to withhold treatment.

It has been clearly revealed this week that Ireland’s ban on abortion was a leading factor in Savita not receiving the care that she required. Dr. Astbury, the consultant managing Savita’s case, confirmed that termination of pregnancy would have been the intended treatment for Savita’s condition. However, she was forced to deal with a ‘balance of probabilities’ – delaying treatment against her patient’s wishes as Savita got progressively more unwell. It was only after consulting with other senior colleagues after Savita’s health rapidly declined did she feel in a position to provide a termination. However by then it was too late and Savita was moved to ICU with severe sepsis.

This case highlights that a ‘real and substantial risk to the life’ of a woman can develop within a matter of hours. In cases such as these, how can doctors efficiently interpret this law and what constitutes a substantial risk? 40%? 60%? How long must doctors really be expected to wait and consult before providing life saving terminations? The law here in Ireland simply does not protect doctors, or the women living here.

The inquest this week has also revealed some of the system failures at UCHG in Savita’s care. Medical staff failed to follow up the results of a blood test taken on her admission to the hospital, and her vital signs were not monitored closely enough. It was also revealed that there was a delay in sending the blood cultures to the lab for testing and one test for lactate was refused as it was in the wrong bottle. This refusal was not communicated to the ward. Nonetheless, the ban on abortion in Ireland was a crucial cause for delay in what has been revealed this week would have actually been the intended treatment for her condition.

Legislative change is urgently needed to prevent more unnecessary deaths.

Rachel Donnelly of Galway Pro Choice said:

“Dr. Katherine Astbury, Savita’s obstetrician, made clear at the inquest this week that she felt constrained by Irish law from acting to protect Savita’s health. This situation can no longer continue. We must have X Case legislation by the summer, and then we must have a referendum to remove Article 40.3.3 from the Irish Constitution as soon as possible.”

Orlaith Reidy of Galway Pro Choice stated:

“Savita’s case proves beyond any doubt that the lives and the health of women in Ireland are being endangered by the constitutional ban on abortion. This is not about scapegoating individual medical personnel. No doctor should feel that for legal reasons they have to wait until their patient is at death’s door before administering treatment. We need a referendum now to remove the 8th Amendment from our constitution and ensure that no woman ever again has to go through what Savita did.”

For more information please contact Galway Pro Choice:

Tel.: 087 706 0715

Email: prochoicegalway@gmail.com

Activism and Agitation

Magdalene Laundries by Joni Mitchell

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Joni Mitchell put a song about the atrocities committed by the Magdalene Laundries on her 1994 album Turbulent Indigo

Magdalene Laundries
Joni Mitchell

I was an unmarried girl
I’d just turned twenty-seven
When they sent me to the sisters
For the way men looked at me
Branded as a jezebel
I knew I was not bound for Heaven
I’d be cast in shame
Into the Magdalene laundries

Most girls come here pregnant
Some by their own fathers
Bridget got that belly
By her parish priest
We’re trying to get things white as snow
All of us woe-begotten-daughters
In the steaming stains
Of the Magdalene laundries

Prostitutes and destitutes
And temptresses like me–
Fallen women–
Sentenced into dreamless drudgery …
Why do they call this heartless place
Our Lady of Charity?
Oh charity!

These bloodless brides of Jesus
If they had just once glimpsed their groom
Then they’d know, and they’d drop the stones
Concealed behind their rosaries
They wilt the grass they walk upon
They leech the light out of a room
They’d like to drive us down the drain
At the Magdalene laundries

Peg O’Connell died today
She was a cheeky girl
A flirt
They just stuffed her in a hole!
Surely to God you’d think at least some bells should ring!
One day I’m going to die here too
And they’ll plant me in the dirt
Like some lame bulb
That never blooms come any spring
Not any spring
No, not any spring
Not any spring

Activism and Agitation

The X Case: 21 years ago, 2 referendums, 1 supreme court ruling still no Law.

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Last year the Journal.ie did a timeline of the events surrounding the X Case you can find it here: http://www.thejournal.ie/twenty-years-on-a-timeline-of-the-x-case-347359-Feb2012/

Today is the 4th of February 2013, here is what happened 21 years ago:

4 February 1992: The victim and her parents decide to travel to the UK to undergo an abortion. The family informed the Gardaí of their decision and asked whether the foetus could be tested after it was aborted to provide proof of the paternity of the accused in the rape case.

The Gardaí then asked the Director of Public Prosecutions whether such evidence would be admissible in court. The DPP liaised with the Attorney General Harry Whelehan.

The parents of the 14 year old child, were talking her to the UK for the good of her health and life and were trying to make sure the man who had raped her would not go unpunished.

That was 21 years ago and we have had 2 referendums and 1 Supreme court ruling and X Case has not been legislated for and there is still no law.

The current government have legislating for X in their program for government but again we are seeing more delay tactics.

Cabinet update on abortion law delayed | Irish Examiner.

Dr Reilly has said he hopes the measures will become law by July.

Activism and Agitation

Abortion Training for Irish Doctors.

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A little while ago I wrote about Irish Abortion Providers and what type they may be and how “even with all the Drs we train in this country none of them are trained to carry the procedures needed.”

There has thankfully been some movement on this.

http://www.irishexaminer.com/ireland/doctors-offered-uk-abortion-training-219561.html

Doctors offered UK abortion training

Tuesday, January 15, 2013

Two Irish medical students have applied for a course offering training in abortion care at a London clinic.

The one-week externships, at the largest London clinic of the British Pregnancy Advisory Services in Richmond, will allow students witness how abortion procedures are carried out.

According to Medical Students For Choice, which supports the BPAS programme, it gives students the opportunity to learn about aspects of women’s healthcare that are not part of routine medical training courses in Ireland.

“At the moment in Ireland, there is a lot of stuff they don’t go over [in medical education] such as how to do it [abortions] and the circumstances in which an abortion can be performed,” said MSFC member Amelia Reid. “A lot of medical students are scared about finding themselves in a situation where they need to know what to do to save a life.”

———————————————————————————————-

A BPAS spokeswoman said the only criteria for taking part in the course was that the medical student had completed one year of medical school, had a basic medical knowledge, an understanding of confidentiality and ethics, and was able to explain in writing why they wanted to take part. She said they were not looking for students “at an advanced point in their studies”, although such students would not be excluded.

The spokeswoman said students would get a “complete overview” of the patient’s experience at the clinic, from pre-abortion counselling to choices for contraception afterwards.

She said BPAS opened the course to applicants in Irish medical schools after last year’s course — the first British course run by BPAS — attracted considerable attention from Ireland. As part of the course, students will also work with Antenatal Choices and Results, a charity that supports parents whose unborn baby is diagnosed with foetal anomaly.

Richard Lyus, who will mentor students on the BPAS scheme, said they were looking ahead “to a time when the law enables doctors in Ireland to provide abortion care to all women who need it”.

“We hope these placements will give Ireland’s next generation of doctors important insight into the needs of women in this situation, which they can make use of in the course of their careers,” said Dr Lyus.

Ms Reid said MSFC has a presence in all of the medical schools in Ireland, with the exception of University College Cork.

She said approximately 250 students in Ireland joined MSFC’s database since it set up here two years ago and that it hoped to provide financial assistance to Irish students accepted on the BPAS course. The educational aspect of the course is provided free of charge, courtesy of BPAS.

If you want to know more about Medical Students For Choice you can find them here:
http://www.msfc.ie/

And if you want to know more about Doctors For Choice you can find them here:
https://www.facebook.com/pages/Doctors-For-Choice-Ireland/522714117761585
https://twitter.com/Doctors4Choice

Activism and Agitation

Irish abortion providers…

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I was reading this, this morning and those 3 words jumped out at me. I am pretty certain I have never seen those 3 words in that configuration before. Here is where they came from and the context.

http://m.guardian.co.uk/commentisfree/2012/dec/20/on-abortion-we-need-spirit-of-67

When, this week, you read a headline saying, Ireland to legalise abortion; or see a statement from the Catholic church saying “Irish abortion reform is a ‘licence to kill innocent babies'”, you should treat it with great scepticism. For a start, nobody has suggested changing the law, nobody’s legalising anything, and innocent babies have more to fear, as ever, from the Catholic church, than from any Irish abortion providers.

Nobody has suggested, even out of respect for the recently killed Savita Halappanavar, the slightest modification in the law, so that an abortion might be permitted in a case where the mother would probably die without it, and the foetus would probably die regardless. There are no new ideas, and no concessions to anybody – all that’s been mooted is the codification of a supreme court ruling, so that the abortion provision they do have is no longer just precedent, it’s actually enshrined in law.

The rest of the the piece written by https://twitter.com/zoesqwilliams explains the legal and historical back drop to the legal situation on abortion. If you like the writers of Jezebel need to brush up on the facts, please do take the time to read the rest of it.

So this morning with my coffee I find myself wondering what Irish abortion providers would look like, ok so say with a wave of a magic wand we have legislation, even the most conservative legislation along the lines with which the majority of people agree. That is abortion to protect the life and health of women including cases of rape/incest and terminations for fatal fetal complication. What happens next?

Well medical policies and procedures would have to be introduced along with guidelines and best practices and insurance policies amended as well, which is a massive amount of paper work.

Currently even with all the Drs we train in this country none of them are trained to carry the procedures needed.
This point gets made time and time again by Drs for choice and Medical Students for Choice. So even when such legislation is passed there will be a long waiting time before a woman would get the timely treatment she needed and most likely will end up with the HSE paying for her to travel and have the procedure in the UK. Like they had to do in the case of Miss D.

So would we see private clinics being set up as Irish abortion providers?

This may cause a whole new get of issues. Part of the Ruling by the EU court of Human Rights in the ABC cases was that MS C right to privacy was breached and with Ireland being such a small place I would worry that such places would be heavily picketed as the anti choice lobbists have been known to picket family planning clinics here and take pictures of people going into them. It will still be that those who can afford to go privately will have more choice and privacy and may still choose to leave the country.

Irish abortion providers, I would prefer if they were just part of the general OB/GYM services in this country, but even these services suffer from the policies and practices which have them as an add on service and not part of holistic health care for women.

Even when we have less restriction on abortion in this country there will be still so much work to be done on ensuring women and transmen have the health care they need.

Activism and Agitation

‘Pro-life’ change had little impact

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'Pro-life' change had little impact.

“‘Pro-life’ change had little impact
In this section »

PAUL CULLEN Health Correspondent

UK route: At least 143,000 women have travelled from Ireland to have abortions in the UK since the Constitution was amended in 1983 to recognise the right to life of the unborn.

The British authorities maintain a comprehensive set of figures on abortion, which includes a classification by country of residence. In a typical year, women who give their address as the Republic of Ireland account for two-thirds of non-resident women having an abortion.

The figures show that the 1983 “pro-life” amendment had no visible impact on the rising trend of Irish women travelling to Britain for an abortion.

Their numbers had begun increasing significantly in the 1970s and this trend continued through almost three succeeding decades.

The figure for Irish abortions in England and Wales peaked in 2001 at 6,625 before beginning a slow but steady decline right up to 2011, when 4,149 abortions were carried out on Irish-resident women.

The Irish Times has compiled the figures from data provided by the British department of health and office of statistics, and from archived articles of this newspaper.

Figures could not be obtained for four years in the 1980s and 1990s, but an average was used to calculate the overall estimate.

The British figures are subject to a number of caveats. They do not include Irish women who travelled for an abortion but gave a UK address. They could include women of other nationalities who gave an Irish address. They do not include abortions carried out on Irish women in Scotland, which does not compile statistics for non-residents.

In addition, more Irish women have begun travelling to other European countries for an abortion, though their number is likely to be small compared to the UK figures.

Of the abortions carried out on Irish-resident women last year, 37 involved girls aged under 16, and 111 related to 16-17-year-olds. Some 1,404 related to women in their 20s and 1,801 to women in their 30s. Some 257 were performed on women in their 40s.

Studies show that Irish women who travel to the UK tend to have abortions later in their pregnancies than British women availing of local services.

In 1970, just 261 Irish women were reported to have travelled to Britain for an abortion, but the following year this more than doubled to 577. By 1973, the number had reached 1,200 and, by the end of the decade, 3,000.

We’ve been exporting abortion for far too long.

Activism and Agitation

“Why I Voted No” and honest answer from a TD.

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http://www.broadsheet.ie/2012/11/29/why-i-voted-no/

Sean Kenny, Labour TD for Dublin North East.

Lisa Powell writes;

I re-e-mailed my TDs re: legislation this morning, this was one response:

Hello Lisa,

You might be aware that Labour TDs including myself, did not support Clare Daly’s billon the X case last night. As your TD, I want to explain why I voted No.

In order to succeed in getting legislation for the X case, I, as a legislator, have to work with the reality of the political games that are being played in order to get X case legislation passed into law.

Fine Gael, Labour’s coalition partners would not support Clare Daly’s bill. I believe that Labour Ministers suggested to them that they should support it. But they did not wish to do so – they want to wait to debate the Expert Group Report which has been published recently. This is because Fine Gael and Labour agreed on the Expert Group process a year ago.

Fine Gael now want to see that through. It is clear on reading the Expert Group
report that the Expert Group believes legislation for the X case and regulations for doctors, is the way forward on this matter.

Fine Gael are a very conservative political party. They do not really want legislation. Labour will have to force them to support legislation.

It is very, very difficult getting them to move on this – but it is working previously, for example, Enda Kenny has said he will not be rushed. But earlier this week he said he would move swiftly.

The really conservative Fine Gael TDs and Ministers are now speaking out in the media about their opposition. They are doing that because they know that Labour is influencing Fine Gael and that they will have to support legislation. They are trying to re-assure their anti-choice voters.

All of that going on in Fine Gael is down to Labour Party TDs and Ministers pushing Fine Gael on this.

As part of that, if Labour, their coalition partner, were to antagonise Fine Gael by supporting Clare Daly’s Bill and breaking with the Expert Group route, Fine Gael will not trust Labour and then there never will be any legislation because Fine Gael will not support it.

I also would like you to consider the way in which Dáil seats are divided up in this Dáil. Each seat in the Dáil is worth one vote.

Labour have 37 seats in the Dáil.
Fine Gael have 74 seats in the Dáil.

Fianna Fáil have 19 seats.
Sinn Féin have 14 seats.
Independents have 20 seats.
ULA have 4 seats.
The Ceann Comhairle has one vote – this vote is cast only in the event
of a tie.
If Fine Gael seats (ie, votes) are left out of the equation, there are not enough TDs who will support legislating for the X case. A number of the FF and Independent TDs are very pro-life – some will vote against legislating and others will simply not show up to vote at all.

Just 27 votes supported Clare Daly’s Bill last night. Even if all the Labour TDs had supported it, it still would have failed to pass.

In other words, for X case legislation to be passed without question in the Dáil, Fine Gael AND Labour are needed to support X case legislation when it comes down to a vote on in the Dáil because they have the most seats, and therefore, the most votes.

Fine Gael control Dáil Éirean and Labour supporting legislation alone will not get that legislation voted through.

Fine Gael are required.Over the next couple of weeks, there will be a debate on the Expert Group report. After that, the Government will decide what steps to take. I
am confident that there will be legislation on the X case and that it will happen within the next two or three months.

Yours sincerely,

Sean Kenny TD

Activism and Agitation

Playing Party Politics with women’s lives.

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28th November is the full moon and there will be a lunar eclipse, it will also be one month from when Savita Halappanavar died in hospital in Galway.

That same day a bill to legislate for the X Case is tabled to be debated and discussed. Claire Daly as part of the ULA is bringing the bill forward and it will do what is needed.

Unfortunately despite it being a good bill and legally sound it is most likely it will be voted down by the government parties.

Who will not want to legislate someone else’s bill, who want to drawn out the process and will stall and then grudgingly create their own bill months later.

The Labour party does want to legislate as soon as possible but they are tied in coalition with the very conservative Fine Gael and even if there was a free vote in the Dáil the bill can not pass with out Fine Gael votes to support it.

So they are playing party politics with women’s lives.

Activism and Agitation

Do we need to appeal the 8th amendment?

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The reason we are in this mess is 29 years ago when there was pressure to legalise contraception (yes you heard me legalise contraception which happened in 1984) there was a fear as Irish law is case law and precedents that a high court could make a ruling and allow for access to abortion, an Irish Roe V Wade. So we ended up with a bad amendment which even back then legal minds point out could in face result in what it was touted not do to. By constitutional Lawyer Mary Robinson and even in the Dáil by Alan Shatter who is now our Minster for Justice.

So do we need to appeal the 8 amendment and do a better job?
When it was passed Mary Robinson stated that it could lead to putting the lives of women at risk as she was on the side which opposed the amendment.

Constitutional lawyers William Binchy (Pro-Life Amendment Campaign) and Mary Robinson (Anti-Amendment Campaign) debate the legal implications of the result of the referendum on the Eighth Amendment of the Constitution on a Today Tonight Referendum Results special, 8 September 1983.

She pointed out that the term ‘unborn’ was not a legal term and that there would be test cases against the amendment as it was ambiguous. She was right, and women have been paying the price for the last 29 years and it’s time we repealed the 8th amendment.