Abortion debate: Eighth creates ‘inequalities’ in foetal abnormalities care

The Eighth Amendment creates inequalities in care for pregnant women dealing with fatal foetal abnormalities depending on how they choose to respond to the diagnosis, a specialist in foetal medicine has said.

Dr Nóirín Russell, a consultant obstetrician and gynaecologist at Cork University Maternity Hospital, said about 36 of the 8,000 women who attend the hospital every year are told that their baby has an abnormality of such severity that survival after birth is unlikely.

"There are two options for women and their partners when they are told that their baby is not going to survive," said Dr Russell.

“There is perinatal palliative care where they continue with the pregnancy until full term. The second option is termination of pregnancy and that option is availed of by women who, for a whole variety of reasons, just cannot continue until full term and choose to end their pregnancy early.”

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Regardless of when their baby is delivered, she said people taking either route know that they will be preparing for a birth and a funeral at the same time.

Palliative care

Dr Russell said some seven out of every 10 women diagnosed with a fatal foetal abnormality when attending the hospital opt for the perinatal palliative care route. Three out of 10 opt for a termination which, because of the Eighth Amendment, requires them to travel abroad, she said.

“The contrast between the two care pathways for me, as their doctor, is massive because when my patient chooses perinatal palliative care, I will look after them throughout the pregnancy and delivery and when they bring their other children and family members in to meet their baby in the post-natal period.

“They will get the full array of care and multidisciplinary support whereas for the 10 to 12 patients each year who choose to terminate, I really feel like I am not their doctor anymore - my support becomes whittled down to a text message saying ‘Thinking of you today’ - that’s it.”

She added: “I’m not there looking after them if they have a complication, if they have a post-partum haemorrhage and similarly I’m not there to admire their baby after birth because that termination is an early induced labour and those babies are still delivered as babies, perfect in their imperfection.”

Medical notes

According to Dr Russell, there is a significant inequality in the level of care that she can provide to expectant mothers who opt to travel for a termination. She said she cannot refer them to a clinic or hospital or forward their medical notes to whoever will be treating them.

“I’m a firm believer and advocate for perinatal palliative care but I’m also a firm believer and advocate for termination if that is what is right for the couple but the care that they get from me, as one of their doctors, is lesser because I am not there- there is a just huge inequality,” she said.

“It upsets me when I hear cases of fatal foetal abnormality being referred to as the ‘hard cases’ as if it was somehow their fault. For me, it is exactly these cases and these women’s right to be cared for by their own doctors in their own country that makes voting Yes the compassionate thing to do.

“As a doctor, I am asking to be allowed to care for all women with fatal foetal abnormalities, to allow them to choose the path which is right for them and the important word here is ‘choice’ because no-one can know what they would choose until a fatal foetal abnormality becomes their lived reality.”