When is an abortion not an abortion?


COMMENT:Savita and Praveen Halappanavar walked unknowingly into Ireland’s grey zone of hidden realities, unspoken truths and word games

On Monday, Tánaiste Eamon Gilmore greeted Ireland’s election to the United Nations Human Rights Council as a “major endorsement” of the country, a sign that its battered reputation had been restored in the eyes of the world. “This is a great day for Ireland and for the values which are dear to us,” he added.

Within two days, Ireland’s values were yet again being held up around the world, not as a beacon of human rights but as a shameful departure from civilised norms. The slow, agonising and perhaps unnecessary death of Savita Halappanavar seemed to many people in distant continents to signify a country in which ideology takes precedence over women’s lives.

The two events were actually related, albeit in the most ironic way.

When it looked at Ireland in 2007, the UN Committee on Human Rights criticised Ireland’s failure to clarify its abortion laws, reiterating “its concern regarding the highly restrictive circumstances under which women can lawfully have an abortion in the State” and regretting “that the progress in this regard is slow”.

In its draft report on the progress made since then, the Government states that abortion is actually legal in Ireland but adds that no statistics are maintained in relation to the “number of abortions taking place in Ireland each year”.

The Economic and Social Research Institute has pointed out that some information is available in statistical form, under the heading of “Pregnancy with abortive outcome”.

However, the bizarre official position is: abortions happen in Ireland, but we don’t count them. If Savita Halappanavar had indeed had the abortion she asked for, it would not even have appeared as a number on an official spreadsheet.

This position was also argued by the previous government before the European Court of Human Rights in the case of A, B and C versus Ireland. The government told the court there was nothing at all murky about Ireland’s abortion laws: “The procedure for obtaining a lawful abortion in Ireland was clear. The decision was made, like any other major medical matter, by a patient in consultation with her doctor.”

But when the court requested basic details, the government was unable to supply them. Asked by the court how many of these “lawful abortions” take place in Ireland every year, the government, as the court put it, “revealed a lack of knowledge on the part of the State as to, inter alia, who carries out lawful abortions in Ireland and where”.

This is the Irish solution to an Irish problem. Under the X case ruling, it is, as the government’s lawyers pleaded, “lawful to terminate a pregnancy in Ireland if it is established as a matter of probability that there is a real and substantial risk to the life, as distinct from the health, of the mother, which can only be avoided by a termination of the pregnancy”. But this lawful activity is the subject of wilful ignorance. No one in the State officially knows who is carrying out abortions, how many they are performing and which hospitals will or will not perform them. The State’s considered position appears to be: “Ah well, go ahead, but don’t tell us about it.”

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.

Symbolism is everything. Ireland has abortion rates that are typical of western Europe (albeit that the vast majority of Irish terminations are performed in Britain). Women are entitled to information on abortion services and to travel for terminations. The State itself acknowledges openly that “lawful abortions” are carried out here. Abortion, in other words, is a fact of life in Ireland, just as it is in comparable countries. What remains utterly distinctive about Ireland is its refusal to acknowledge that fact. The symbolism must not be contaminated by the reality. The women whose messy realities contradict the desired image must remain invisible.

There have been many times in Irish history when some people have believed that symbols are worth dying for. But now Ireland has to decide whether they’re worth forcing someone else – a vibrant young woman desperate to live – to die for.

The misfortune of Savita and Praveen Halappanavar was to walk unknowingly into Ireland’s grey zone of hidden realities, unspoken truths and linguistic evasions. Had they grown up here, they might have been more alert to the way we do things here, our charming insistence on wrapping even matters of life and death in convoluted equivocations and rich ambiguities. But even then they could scarcely have imagined that one society’s self-regarding games could have such barbaric consequences.

Background: Death of Savita Halappanavar

On October 21st Savita Halappanavar, who was 31, went to University Hospital Galway with back pain. She was 17 weeks pregnant and miscarrying.

Her husband, 34-year-old Praveen Halappanavar, said that after learning she was miscarrying she asked several times if the pregnancy could be terminated, but as the foetal heartbeat was still present she was refused and told, “This is a Catholic country.”

After three days of pain the heartbeat stopped and the foetus was removed. Halappanavar died of septicaemia on October 28th.


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