Ireland has avoided confronting its repressive laws by exporting its abortions. That must stop

Savita Halappanavar should still be alive. Her death should be the galvanising moment for Ireland to reform its abortion laws, says Sarah Ditum.

Savita Halappanavar should still be alive. Her husband should not be a widower. When she was admitted to hospital on 21 October suffering a miscarriage, and it was found that there was no chance of the baby surviving, the staff of University Hospital Galway should have acted at once to protect her life by performing an abortion. Instead, her husband says that her requests for a termination were refused on the grounds that a foetal heartbeat was present. “The consultant said it was the law, that this is a Catholic country,” Praveen Halappanavar told the Irish Times.

With appropriate medical care, Savita could perhaps have been in her home again within a few days, where she and her husband could have begun the painful process of recovery from the loss of the child they wanted. Instead, the hospital apparently refused to remove the remains of the foetus until it was dead – which took an agonising five and a half days. By then, she had contracted the infection that would kill her. On 28 October, a week after her original presentation at hospital, Savita died of septicemia and E.coli.

Even under Ireland’s remarkably harsh abortion law, this should not have happened. Abortion is not available to preserve the physical or mental health of the woman; rape or incest are not valid reasons under Irish law; you would not be entitled to an abortion on the grounds of foetal abnormality, or for economic or social reasons. The one circumstance in which abortion is permitted is when the life of the mother is at risk. The two investigations into Savita’s death should establish why the law was not followed in her case, and perhaps whether there was some element of racism in claiming a religious motive for denying treatment to an Indian woman of Hindu faith.

But the truth is that, even if Savita’s death was avoidable under Irish law, Irish law has fostered the environment in which doctors made the decisions that led to her death. Over many decades, the Irish government has defied public opinion in favour of some liberalisation, and enforced an ultra-conservative constitution that places the foetus’ life on an equal footing with the woman’s. In doing so, the government has hypocritically benefitted from Ireland’s geographical closeness to England. Ireland has avoided confronting its repressive laws by exporting its abortions.

That Irish women are able to obtain abortions is some mercy; that they must do this at the cost of travel to another country (with the attendant expense, disruption and risk to aftercare) is inhumane. The organisation Termination for Medical Reasons campaigns to improve access to abortion for women carrying a baby with no prospect of survival outside the womb. On its website, you can read the agonising stories of women forced to make an overseas journey at a time when, with the grief and trauma of losing their child, they should have had the support of family and community most of all.

What Savita’s case shows, though, is that the harm caused by Ireland’s so called pro-life laws cannot always be packed on an aeroplane and sent out of the way. When the constitution holds that a foetus has the same rights as the woman it is inside, women will die. There are others who will suffer too: those forced to undergo the same anguished wait for a foetus to expire before they can receive treatment are also victims, even if they have the marginal good fortune not to contract a fatal infection on the way.

The international horror at Savita’s death should be a galvanising moment in Irish politics. For too long, Irish women have been the victims of cruel politics and heartless zealots: it is time to listen to the campaigners who speak for the simple truth that women’s lives matter.

Photo: Getty

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear