The anniversary of Savita Halappanavar‘s untimely death recently passed. Halappanavar’s death was a tragic loss of life, and misinformation regarding her case sadly overlooked the mistakes that were made by the physicians responsible for her care. Contrary to what some may believe, pro-lifers do not want women to die, and Ireland’s laws would not have prohibited Halappanavar from receiving the life-saving medical treatment she needed. In fact, a further examination of the case tells a different story than what we may have been told.
What Happened to Halappanavar?
An E.coli bacterial infection entered Halappanavar’s bloodstream via her urinary tract, resulting in septic shock. Tragically for Halappanavar, nobody followed up on a blood test indicating that she had an elevated white blood cell count before Halappanavar’s condition had worsened.
The hospital assumed delivery was imminent due to Halappanavar’s dilated cervix, and miscarriage seemed inevitable. With painkillers masking the obvious signs of infection, intervention was deemed unnecessary, and it was assumed that nature would run its course with no ill-effects to the mother.
The obstetrician treating Halappanavar, Dr. Katherine Astbury, explained during an inquest that she had been prepared to terminate the pregnancy via delivery once septicaemia had been diagnosed. While media reports claimed the presence of a fetal heartbeat prohibited doctors from removing the fetus, Dr. Astbury clarified the purpose for checking the unborn child’s heartbeat had been to ensure that a miscarriage hadn’t already taken place.
Dr. Astbury spoke of two major system failures that led to Halappanavar’s death: her vital signs were not checked every four hours after membrane rupture had occurred, and blood test results indicating an infection were not properly communicated.
Microbiologist Dr. Susan Knowles explained an emergency delivery couldn’t have been performed before chorioamnionitis was suspected. Before this point, medical personnel did not believe that Halappanavar’s life was at risk.
Did Catholic Ethos Interfere With Halappanavar’s Care?
Critics held Ireland’s status as a predominantly Catholic country accountable for Halappanavar’s death, and news reports claimed a strict religious dogma prevented Halappanavar from obtaining a life-saving abortion. A remark from a midwife about Ireland being “a Catholic country” was misinterpreted, and Irish law and Catholicism were blamed for the hospital’s refusal to terminate the pregnancy.
However, Health Minister, James Reilly, said there was “no evidence” that any “Catholic ethos” had interfered with Halappanavar’s medical care. Consultant gynaecologist Dr. John Monaghan also clarified that Irish law does not prohibit doctors from endangering the pregnancy in order to protect the mother’s life. This point was confirmed by Prof. Fionnuala McAuliffe, spokesperson for the Institute of Obstetricians and Gynaecologists, who confirmed doctors know they have the freedom to intervene to save the mother’s life—even if this puts the baby at risk.
Doctors in Ireland adhere to the Guidelines of the Irish Medical Council, and at the time of Halappanavar’s death, doctors were obligated to intervene when there’s a threat to the woman’s life. Citing exceptional circumstances, the guidelines even allowed for “termination of a pregnancy.” While the guidelines asked doctors to save the child’s life if possible, they instructed them to also utilize every effort to save the mother. This is also reflected in the Irish Constitution which protects unborn life, but “with due regard to the equal right to life of the mother.”
Even with the abortion ban in place, by international standards, Ireland has an impressive record when it comes to maternal deaths. Without abortion being legal, maternal mortaility rates in Ireland are 33 times lower than India’s, and 3.5 times lower than the maternal death rates in the United States.
Would Abortion Have Saved Her?
Initial reporting of events alleged that Halappanavar made multiple requests for an abortion but was refused. This was what Praveen Halappanavar claimed. Lawyers for the hospital argued against Mr. Halappanavar’s timing of events, as it was not possible for him to have been present during certain meetings because he was driving his in-laws to the airport at the time. Mr. Halappanavar acknowledged his recollection of events might have been wrong, and Kitty Holland , The Irish Times journalist who broke the story, admitted that the facts surrounding the case may have been “muddled.”
After examining the case, President of the Indian Federation of Obstetric and Gynaecological Societies, Dr. Hema Divakar, determined that, ”In that situation of septicaemia, if the doctors had meddled with the live baby, Savita would have died two days earlier. Even if the law permitted it, it is not as if her life would have been saved because of termination.”
The clamps and forceps required for an abortion procedure may have also risked further infection. The unborn child was not the source of Halappanavar’s bacterial infection, so the use of misoprostol to expedite delivery would not necessarily have guaranteed swifter treatment.
The Royal College of Obstetricians has attributed most of the deaths of pregnant women from sepsis to substandard care and a failure to recognize symptoms. Halappanavar had a mortality rate of 60 percent, requiring an early diagnosis through blood cultures and swift administration of broad spectrum antibiotics. Sepsis is a rare condition, and its diagnosis requires hospital staff to be attentive and knowledgeable of its symptoms.
Halappanavar’s preventable death is incredibly heartbreaking. Regular monitoring of her physical condition may have led to a different outcome, and it’s possible that an under-resourced maternity department had an impact on Halappanavar’s care. If Ireland had sought to truly improve maternal safety, perhaps the focus should’ve been on ensuring hospitals are equipped to care for life-threatening infections—not legalizing abortion.
The views expressed in this article are the opinion of the author and do not necessarily reflect those of Lone Conservative staff.