Second Opinion: What now for repealing the Eighth Amendment?

Whither now for repealing the Eighth Amendment? Remember that one? In 1983 it made the life of a foetus equal to that of a woman or girl. Will politicians have the appetite to repeal it? Two recent polls show that most people living in Ireland today want a chance to vote again.

An Irish Times poll found that 64 per cent were in favour of repealing the amendment. An Amnesty International poll showed that almost three-quarters believe there should be another referendum. The vast majority of respondents (87 per cent) want access to abortion expanded. Eighty per cent want abortion legalised when a woman's health, as distinct from her life, is at risk, and in the case of rape and incest.

Both polls showed very little difference between male and female responses. In the Irish Times poll, 60 per cent of men and 67 per cent of women were in favour of repeal and the Amnesty poll found "gender did not play a significant role in people's opinion".

Why has there been such a dramatic shift in public attitudes? The referendum was held at a time when most people thought those in powerful positions could be trusted to tell the truth. In 1983 people believed the false medical rhetoric that “Ireland is the safest place in the world to give birth”.

The Lourdes Hospital Enquiry of 2006 into unnecessary hysterectomies showed that medical experts cannot always be trusted, that the hospital's maternity unit had "a strong unvalidated belief in its excellence", and "it is a story set in a time of unquestioning submission to authority, whether religious or civil".

‘Hardship was embraced’

In 2013 we heard about the practice of symphysiotomy in maternity units, a barbaric procedure involving the slicing open of women’s pelvises. The report noted that many maternity units “had a culture in which hardship [during labour] was actively embraced” and midwives showed “a cheerful disregard to complaints” [from the women] and did not want to “bother” obstetricians with the women’s pain.

Since 1983 the government has been criticised many times by human rights committees because of its treatment of women in childbirth and, in particular, its stance on abortion.

Even today, nobody really knows what goes on in Ireland’s 19 maternity units. Following several highly critical reports the units must produce monthly Maternity Patient Safety Statements comprising 17 metrics, including rates of inductions and instrumental deliveries. This is a very welcome development. The December 2015 reports are now available.

Unbelievably, hospitals seem to have calculated the metrics differently so that statistics cannot be compared or contrasted. For example, figures are given separately for first-time mothers and multiparous (at least one previous birth) women. Several maternity units used cumulative percentages instead of weighted averages for “total women”. Other units seem to have used unweighted averages. The rate of induction in one hospital was 30 per cent for first-time mothers and 28 per cent for multiparous women. The rate for total women was calculated as 11 per cent which cannot be correct. Who put these statistics together? Are the errors due to carelessness or worse?

Many HSE employees do not like spending time doing what they, wrongly, see as box-ticking. If we cannot trust maternity unity to produce accurate statistics can we really trust them to defend and vindicate women’s “equal right to life”?

Luckily there are international statistics. In 2015 Ireland was ranked 22 in the world for maternal and infant health. So it is a fairly safe place to give birth but not as safe as either Norway (in 1st place) or Denmark (ranked 4th), both of which permit abortion in all circumstances, including on request.

The polls show that attitudes to abortion have fundamentally changed since 1983 when 67 per cent voted in favour of the Eight Amendment and only 33 per cent voted against. Since then almost all countries, including those that ignore women’s rights such as Saudi Arabia, have liberalised their abortion laws. According to Abortion Policies and Reproductive Health around the World 2014, from the United Nations Department of Economic and Social Affairs, Saudi Arabia, Pakistan, Eritrea, and many other states now permit abortion to preserve women’s lives as well as their physical and mental health.

In Europe almost all countries allow abortion in most circumstances. Syria, Iran, Afghanistan and Yemen are like Ireland and permit abortion only to save a woman's life. What great company to be associated with. It is time to repeal the Eighth Amendment. drjackyjones@gmail.com

Dr Jacky Jones is a former HSE regional manager of health promotion and a member of the Healthy Ireland Council.