THIS WEEK IN the Dáil, a private members’ Bill to give effect to the 20-year-old Supreme Court decision in the “X” case was introduced by Clare Daly of the Socialist party on behalf of herself, Joan Collins of People Before Profit and the Independent TD Mick Wallace.
The Medical Treatment (Termination of Pregnancy in Case of Risk to Life of Pregnant Woman) legislation would allow for abortion where there is a real and substantial risk to the life of the mother.
Meanwhile, a 14-member expert group is studying the options on how to implement last year’s European Court of Human Rights ruling that the State had violated the rights of a woman who has cancer and said she was forced to travel abroad to obtain an abortion. It is due to report to the Government in June.
How relevant are these cases to the thousands of Irish women who travel abroad for abortions every year? What do we know even now of their motives, experiences and outcomes? Today we report on two very different cases. Because of the stigma surrounding the subject, they have retained their anonymity. They shared their stories with The Irish Timesbecause they believe there is something to be learned from their experiences.
We are also inviting other people to share their experiences with us by contacting us as detailed below.
RACHEL AND TIM
“She was less than a pound. They gave us photographs . . .Then they cremated her body?”
RACHEL AND TIM are married and in their mid-30s but look 10 years younger, huddled together on a sofa, exuding vulnerability, grief and bewilderment.
Only three months ago, they were wildly excited expectant parents, in busy, fulfilling jobs, saving what they could. She was 21 weeks pregnant when they turned up for her second scan at a Dublin maternity hospital on a Friday afternoon in mid-November. They happily expected to learn whether they were having a boy or a girl.
But as the sonographer focused on the screen, it was obvious that something was wrong. She couldn’t see all four chambers of the baby’s heart, only three. She could say no more than that. They would have to wait until Monday to see a consultant.
After a tormented weekend, they returned for the consultant to perform another scan. Three possible conditions were mentioned, of which two are almost invariably fatal to the baby. A chromosome test was required, but as they were public patients they would have to wait two or three weeks for conclusive results. For €250 upfront, they could have the answer by Thursday. They paid.
On Thursday, a midwife confirmed by phone that Aoife, as she was later named, had Edwards syndrome, an abnormality caused by the presence of three, as opposed to two, copies of chromosome 18. Most cases with the condition die in the womb. Some live for a short time after birth, and a tiny percentage live to adulthood with severe mental retardation. But the condition is usually considered fatal.
“That meant our baby would probably not survive outside the womb . . . And there were so many other problems. Fluid was developing in her body,” Tim says with a heavy sigh.
On the Monday, at their only meeting with a consultant throughout their ordeal, Tim had asked for guidance. “I asked her, ‘Do we have an abortion?’ It’s not something anyone would want to go through, but I had to ask. We had no idea. What do other people do in this situation?”
No one used the word “abortion”, Rachel noted. “Nobody would just call it what it was. The consultant used the word ‘terminate’. She said, ‘Some people in your position would choose to terminate.’ Tim asked her, ‘Is that something we can do here?’ She said, very formally, ‘Not in this jurisdiction.’ Apart from that, the language always used was, ‘If you choose to travel.’ And I was just thinking, It’s not a bloody holiday.”
They were now in week 22, aware that the cut-off limit for such abortions in Britain is 24 weeks. The reality of their situation was dawning on them.
“Aoife was showing and moving and kicking, and you’re wondering, is she going to live today?” says Tim. Rachel swallows hard. “I was working full-time and I was thinking, How can I get up every day and go to work, and [my] belly is getting bigger, and people are asking, ‘Is it a boy or a girl?’ And what [am I] going to say: actually, my baby is going to die?
“You have all this knowledge, and it’s like a time bomb. I don’t know how I could have carried on to full term. What kind of options are those? At that point it’s a baby. There was no good choice.”
The hospital midwife referred them to the Irish Family Planning Association (IFPA). “That was the first time anybody clearly explained the options, the costs and where you could go,” says Rachel.
“That’s how we ended up with Liverpool Women’s Hospital. To transfer my medical reports, the [Irish] hospital had to fax them to the IFPA, who had to fax them to Liverpool because the hospital couldn’t do it directly,” she says, her voice breaking.
“And that makes you feel like you’re doing something wrong. I felt, I love my baby,” she says despairingly, “and this makes you feel like you’re being judged. Shouldn’t the hospital be doing this? I mean, they’re the medical experts, yet I’m having to rely on this charity to send my medical records over to an English hospital.”
They drained their savings for the flight, hotel and hospital costs – more than €2,360 in total – and flew out on a Monday night. The following afternoon, they went to the hospital for the first part of the process: an injection to stop the baby’s heart.
“You’re going through this procedure, which takes four to five days. You’re leaving the hospital and wandering around a place you don’t know. Or you’re sitting in this tiny hotel room, with no family there, no support. “The internet wasn’t working. We felt so isolated,” says Rachel.
On Thursday, they returned to the hospital at about 11am; she was allocated a private room and given the first round of medication to induce labour. The codeine administered for the pain made her severely ill, so the next round had to be deferred. In the end, the baby wasn’t delivered until Friday night. Afterwards, Tim slept on the sofa bed in Rachel’s room.
Next morning, they saw Aoife. “They had cleaned her up and dressed her up . . . She was very small, 420g, a little less than a pound. They gave us photographs and footprints and handprints . . . Then they cremated her body,” says Tim, haltingly. Her ashes were sent home two weeks later.
After packing their little mementos that Saturday morning, they left for their flight. For Rachel, this went beyond psychological distress. “I remember there was a really long line for security. I was bleeding. I could feel the blood coming out of me, and I really thought I was going to faint but I thought, If I faint, they won’t let me on the plane and I won’t be able to go home. I just wanted to go home and get in my bed and pretend it all hadn’t happened. But we just had to get on that stupid plane, and they’re selling scratch cards and people are on their way to a hen party, and I was just sitting there, and our world had just ended.”
They have only positive things to say about the Liverpool hospital staff. “They were amazing . . . They deal with women whose babies aren’t going to survive. And they’re used to Irish people as well.”
The staff asked the couple whether they wanted their records to be sent to the Irish hospital. Puzzled, Rachel said yes, of course. “They said, ‘We always ask the Irish women, because they don’t want their GP or the hospital to know.’ And then, of course, you don’t get any follow-up care. You’ve delivered a baby and come back and pretend that nothing happened. What do you tell people if the hospital or GP don’t know? Where did the baby go?”
The wall of official secrecy, the euphemistic language, the process by which one hospital passed highly confidential medical reports to a nonmedical charity for transmission to a foreign hospital, the intensely lonely, isolating journey to a strange city, have magnified the effects of the tragedy.
Rachel and Tim agreed to this interview because they believe their situation is far more common than is believed. A midwife told them that in this one Irish hospital, “at least once a week”, there is a diagnosis that a baby will not survive. Tom checks his watch: “Around this time, the scans are being done and someone is going through this right now.”
“One of the midwives said they see it all the time and it breaks her heart to see all those women going over to England . . . In a lot of hospitals in Ireland, she told us, they wouldn’t even tell you that [abortion] is an option,” says Rachel.
The Irish hospital arranged for sessions with a bereavement social worker, which they are finding very helpful. When the IFPA asked an Irish support group if couples in situations such as this could join, however, the request was declined. “I think they felt it would be too contentious an issue in the group if someone seeking support had terminated the pregnancy.”
They take comfort from a UK group called Antenatal Results Choices which has an online forum for people in their situation. A small corner on an Irish parenting website has also “helped immeasurably”.
They are haunted by the thought of those women who haven’t the resources or the knowledge to make a choice. “I know well that for some women, continuation would have been the most comforting course,” says Rachel. “But I also know that I actually would have gone crazy. If I’d felt there was any benefit for the baby by continuing, I would have done that.”
She treasures the memory of the midwife in Liverpool who told them that they had nothing to be ashamed of, that they were doing the right thing for their baby, simply because no other medic had done so.
“I feel like we made the most humane choice for a much-loved baby. I don’t feel we’ve done anything wrong, but we’ve been put in a situation where we feel we have.”
“It’s your life and somebody else’s life. Every situation is different; everyone needs time to reflect”
LUCY IS IN her 30s now, in a stable relationship and “totally ready” for a baby. But in her 20s she didn’t have much luck in her relationships or in her timing. She was about 27 when her suspicions of pregnancy were confirmed by a home-testing kit. She reckoned she was about four or five weeks pregnant, assuming her new boyfriend was the father. He had made it abundantly clear that he did not want a child.
It was only as she was having an ultrasound in an English abortion clinic a couple of weeks later that the “bomb” dropped. “You’re quite far gone – it’s 11 weeks,” said the nurse. By that measure, the father was a previous partner, a man she had known for a long time, who hadn’t reciprocated her desire for a more serious relationship.
“It was shocking to be lying there and to realise that everything in my head was wrong . . . I went out – I think I even went to the phone box to call him. I have this vision of doing that, but you can’t trust memories.”
He had not taken their relationship seriously and had never answered her calls to his workplace before, so he was hardly going to now, she reasoned. “I wondered afterwards, maybe he’d have picked it up [when he saw] the English number. But all I thought at the time was that it would have been a dreadful thing to do to him, to tell him that at work.”
So she went back to the waiting room. “It’s an extraordinary situation, unlike any other doctor’s surgery, where people look at each other and they chat a little. There’s just none of that. There’s no talking, no eye contact. People are just trying really hard to hold it together. And you’re aware that there are people in there who don’t want to be. So you don’t want to be assuming anything about anybody.”
She was offered an anaesthetic, with the warning that it would leave her drowsy. “I said no, because I was on my own in a strange city and had to find my way back to the train for a two-hour journey, so I didn’t want to compromise my wits.”
The procedure itself went on for “a surprisingly long time” – probably about 10 to 15 minutes. “I just remember being on this kind of dentist’s chair or table, and the bright lights, and oh God, I just wanted my mother so much. I cried a lot during it. They put some kind of a tube in, and it sucks everything out. Your womb goes into these contractions, probably like having a baby. It’s really agonising. I remember looking up at that ceiling and just desperately wanting my mother.”
In the recovery room, she vaguely remembers being given a choice of angle for the chair. “Some women were in real pain. You were told you could stay for up to three hours, but as they started late with me I had only about 40 minutes. Then I walked all the way back to the train station. “Miserable. And I bled like hell. They gave me the option of putting in a coil, and I think that made me bleed a lot more. I bled for a month afterwards.”
But, she wants to make clear, her misery is not the point. “The point I want to make is that if I had been at home in Ireland, having this procedure legally, and had this new reality presented to me with the ultrasound – a very different reality, as I discovered, to what I had thought – I would almost certainly have cancelled that day. I would have gone home. I would have been able to call the father in question, been able to talk and make a decision.”
But she was in the north of England, with less than a week to the legal cut-off point for women in her situation. If you live in England, she says, “the normal thing is that you go for a preliminary talk and then, for a couple of days, you are expected to go away and think about it. So you are given all the information they can give you, and you have time to mull it over.”
For women travelling from Ireland, the appointment is made in advance and the abortion is carried out the day they arrive at the clinic.
“There must be people who would actually have changed their mind, either to postpone or to cancel. But the fact is, when you’ve got time off work, paid the money to get there, made all the arrangements and travelled that distance, I can’t imagine there are very many who would change their minds.
“Yes, I could have cancelled the whole thing, I could have flown home the next morning and started again from scratch, with less than a week to do it in. That just didn’t seem like a viable option. I believed that was what [the father] would have wanted anyway.” And when she told him afterwards, he “seemed to be fine” about it. “But who knows? You never really know. When I told him afterwards, it was a fait accompli.”
She says the woman is the only person capable of making the decision. “You are responsible. It’s your life and somebody else’s life. I don’t think there is anything black and white. Every situation is different and everyone needs the time to reflect on their own situation. It’s not something anyone else can tell you.
“I am pro-choice, yes. That does not in any sense make me particularly pro-abortion. Lives can be ruined going down either path, and that’s why it’s the person on the path who has to make the decision. I suspect that fewer people would go through it if we could become a little bit more open about it.”
So if she had a say in any new legislation, what would she look for?
“I would legislate for reflection, for really thinking it through. I don’t think it should be easy. It’s not right that it should be easy. You’re dealing with two lives, there’s no question about that. It’s the potential of life up to 12 weeks. In my ideal world, I wouldn’t want someone to go in there without the due and sober reflection that it deserves.
“Everybody is entitled to make their own choice, but when you put somebody under the pressure of sending them off to another country and not feel able to talk about it at home, because it’s such a stigma – well, by the time they arrive at the clinic, the thing is half done. You’re there, you’re ready, you’re booked in and all the people around are doing the same thing.
“Once I had the decision made, I wasn’t going thinking about it an awful lot. You’re just upsetting yourself and tying yourself up in knots. So you’re just making your decision and pushing it to the back of your mind until you’re there. And then the reality of it is presented to you – as it was in my case, which was that I was much further on than I thought, and was pregnant by a completely different guy who I’d known for a long time.”
Kathy Sheridan is inviting people who have experienced abortion to share their stories in The Irish Times. Confidentiality will be respected at every stage, and stories will be published only after an interview.
If you are willing to share your experience,contact Kathy at firstname.lastname@example.org