Sir, – In response to Fintan O’Toole’s piece on abortion, Lucy McDonald (September 6th) is concerned that he does not consider the feelings of those who have suffered an ectopic pregnancy. Shortly after the referendum on abortion in 1983, I suffered an ectopic pregnancy. We were dismayed to lose a much-wanted pregnancy, but as well, I was terrified that I might lose my life, or that, if I was saved, I would lose my only remaining fallopian tube, therefore losing all chance of having a baby.
My fear of losing all chance of pregnancy arose from the very “fact” Lucy McDonald raises, the idea that what I needed was not an abortion but something else. Much of the debate during that referendum campaign had more to do with theology than medicine. It put forward the idea that by removing an ectopic pregnancy from a woman’s fallopian tube you are really only repairing a faulty organ and the removal of the pregnancy is a mere unintended action. Let’s be clear, the procedure that saved me from haemorrhaging to death was an abortion, and I am grateful for it. Theology did not get in the way; my fallopian tube was saved and later repaired.
To have a genuine conversation about this, we need to define our terms.
Abortion is not a nasty word, it is just medical terminology. Spontaneous abortions, often called miscarriages, are a very common natural occurrence, often for good, but sad, reasons. The procedure that saved me and many other women was an abortion of a tubal pregnancy – the abortion of a pregnancy that could not be successful. Discussing abortion with clarity is the problem Fintan O’Toole was writing about. – Yours, etc,
Sir, – In his article “State feigns ignorance on abortions in its hospitals”, (Opinion Analysis, September 4th), Fintan O’Toole stated that, “Our (in this case inaptly named) HIPE system has been programmed to obscure information and make it unusable”.
This statement is incorrect, as are a number of other statements made by Mr O’Toole including, “it [the State] uses its information technology systems to make it impossible for anyone to tell how many abortions are due to the most common cause – ectopic pregnancies . . . Someone has gone to the trouble of making sure that abortions, miscarriages and other procedures are jumbled up together”.
The Economic and Social Research Institute (ESRI) manages the Hospital Inpatient Enquiry (HIPE), which collects administrative, demographic and clinical data on all discharges from all acute public hospitals. Data must be coded to enable computerisation and analysis.
For the clinical data (diagnoses and procedures) collected on HIPE, the system of coding used is ICD-10-AM, which is an international standard based on the World Health Organisation’s International Classification of Diseases. This system is used for coding diagnoses and procedures in many countries.
The diagnostic codes that are available for coding conditions arising under the heading of "Pregnancy with abortive outcome" include the following: ectopic pregnancy, hydatidiform mole, other abnormal products of conception, spontaneous abortion, medical abortion, other abortion, unspecified abortion, failed attempted abortion, complications following abortion and ectopic and molar pregnancy. For each diagnosis recorded, there are a range of procedures that might be undertaken and the procedures associated with each diagnosis are also reported. More detailed information is available on www.HIPE.ie– Yours, etc,