On the morning of October 21, 2012 Savita Halappanavar, a 31-year-old dentist, in her first pregnancy attended the University Hospital Galway with a backache and lower abdominal pain at 17 weeks of her pregnancy. Later that day she was admitted to the hospital for management of inevitable miscarriage. Her membranes spontaneously ruptured on October 22. As the fetal heartbeat was present, the consultant continued to observe her condition and delayed terminating the pregnancy. The patient’s condition rapidly deteriorated and she went into septic shock followed by multi-organ failure, and died on Sunday, October 28, 2012.
The investigation into Ms Halappanavar’s death, which I chaired, found an over-emphasis on the need not to intervene until the fetal heart stopped together with an under-emphasis on the need to monitor and manage the risk of infection and sepsis in the patient. In other words, the reason for the delay in terminating the pregnancy despite threat of severe illness and possible death – and the hopeless situation of the fetus – was the presence of the fetal heartbeat.
We considered the interpretation of the law related to lawful termination in Ireland to have been a material contributory factor in this regard. It was clear that the legal issue delayed the doctors from intervening to terminate, as any doctor in another country would have advised.
I was pleased to be invited to address the Joint Oireachtas Committee on the 8th Amendment and clarify that if a termination had been carried out when Savita and her husband requested, she would not have had sepsis and she would be alive today.
Best medical practice is to terminate the pregnancy if an infection is found to be present. From a purely medical point of view, infection represents a major risk to the health of the woman and her health could be jeopardised by delay in treatment. If Savita had survived, the delay in intervention could have resulted in serious health issues, including pelvic inflammatory disease, tubal blockage and subfertility.
Infections can escalate rapidly, particularly in pregnancy: one moment, there can be no threat to life, but the patient can take a bad turn within an hour. Medical decisions should be made based on medical need to save lives and promote health. Requiring doctors to wait until a risk to the health of a pregnant woman has unequivocally deteriorated to a point where her life is at risk is clinically unworkable. It is poor patient care and ethically wrong. It is a violation of the right of the pregnant woman to the highest attainable standard of health.
Five-and-a-half years after Savita Halappanavar’s death, people in Ireland have the opportunity to change the harmful law that cost her life. By repealing the 8th Amendment, you have an opportunity to uphold women’s basic human rights. There is an urgent need to do so and to begin to provide all possible care to preserve women’s health and protect their lives in pregnancy.