When is an abortion not an abortion?

The purpose of this extraordinary position is about the only thing that is clear in this whole area. It is to keep abortions, even those that are lawfully performed in the very restrictive circumstances allowed by the Constitution, under the carpet. Women have a constitutional right to terminate a life-threatening pregnancy.

But the exercise of that right is deliberately “unknown”. It is meant to be a secret. For the women who find themselves in this difficult position, the message is none too subtle: this is not something we talk about. Shame clings to a procedure that logically should produce pride: the saving of a life.

Why? Because there is very strong pressure on politicians from anti-abortion groups to uphold the fiction that abortion is never necessary to save the life of a mother. These groups adopt two (actually rather inconsistent) positions: (a) abortion is never in fact necessary to save a woman’s life; and (b) even if it is, it’s not abortion.

This insistence hinges on a linguistic manoeuvre: there can be no such thing as an abortion to save a mother – simply because we choose to define such a procedure as not being an abortion. As one of the leading anti-abortion figures in Irish medicine, Prof Eamon O’Dwyer, puts it, “There is a fundamental difference between abortion and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child.” In other words, abortions we approve of must not be called abortions.

These word games may seem abstract and harmless. Does it matter that a doctor who performs a life-saving termination of pregnancy salves his conscience by telling himself that it is not an abortion? Unfortunately it does. The combination of the State’s refusal to record abortions and the ideological insistence that some abortions are not abortions confines the subject to a grey zone. We do not yet know the full circumstances of Halappanavar’s death, but it seems likely that, if septicaemia was the primary culprit, uncertainty, hesitation and fear were secondary causes.

There is, in all of this, not so much a lack of clarity as a refusal of clarity. An acknowledgment of the basic truth that abortion is sometimes necessary to save a woman’s life would make it necessary to be honest and define the how, where, when and why of lawful abortion in Ireland. That in turn would mean giving up on the idea that Ireland is, as Halappanavar’s husband, Praveen, recalled being told, “a Catholic country” – an almost unique place in which the evil of abortion has been kept at bay.