Halappanavar Inquest: Midwife’s remarks rather than clinical mistakes beg legislation and public debate

First of two important stories in the Republic this, comes from the inquest into Savita Halappanavar’s death. Firstly:

Dr Katherine Astbury said she had not seen a notation on the 31-year-old’s charts that would indicate a deterioration in her condition. She also conceded that she had not seen Ms Halappanavar’s blood results, which had changed and could have been indicative of severe sepsis.

The consultant obstetrician told the inquest that had she been aware of these details she would have brought forward plans for a termination to the Wednesday morning.

And secondly:

A SENIOR midwife has apologised after admitting she told an Indian woman suffering a miscarriage that she could not have a termination in Ireland because it was a “Catholic country”.

Ann Maria Burke, a clinical midwife manager at University Hospital Galway, said the comments had preyed on her mind since she made them five days before the death of Savita Halappanavar, and insisted she had never meant them in a “hurtful context”.

It’s hard to know which is worse. Clinically, the system is a serious concern (though not one requiring legislation). For me the Midwife’s words – that Ms Halappanavar could not have a termination in Ireland because it was a “Catholic country” – are almost more serious, in the sense that it reflects a broader certainty that abortions don’t happen in Ireland.

The truth is, they do. That’s more broadly known and understood now after this tragic case. And the core issue is not bound up with pro choice or pro life arguments. Artificial terminations already are and can be legally triggered by proper and ethical concern for the life of the mother.

That a Midwife did not seem to know that shows the extent to which even professionals appear to be ‘dark’ on the precise outlines of what is and is not permissible.

It is this second and seemingly less important from a clinic point of view issue that urges legislation and wider public debate and the more pressing concerns about clinic practice in the Galway Teaching Hospital…

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  • JR

    This is a very tragic case. I don’t think the midwife was really thinking too hard about what she was saying. I certainly would not like to have some of the things I say brought before a tribuneral. Am I the only one who interpreted the midwifes comment as her light heartedly criticizing catholic Ireland? I herd another of the midwifes testimony. She said that she had never seen a woman’s condition deteriorate so quickly. She also said she had been a midwife since 1992. Savita Halappanavar’s case was obviously very rare. Given there are in the region of 30 abortions carried out in Ireland annually the conditions which merit one are also very rare.

  • mollymooly

    I didn’t interpret the “Ireland is a Catholic country” remark as either smug superiority or light-hearted eye-rolling; simply an honest if inappropriate attempt to explain a puzzling situation to a foreigner. You can’t have an abortion because [medical guidelines are very strict because the law is very strict because the Constitution is very strict because there was a referendum because] Ireland is a Catholic country.

  • Neil

    U105 reported her saying it was a Catholic ‘thing’. Minute difference, but contextually it sounds more like it could be said like I’m sorry about our country’s laws but it’s a Catholic thing. As you say she was foreign and may not be au fait with Irish abortion legislation.

  • Barnshee

    Frantic writing up of notes after the event
    http://www.bbc.co.uk/news/world-europe-220847
    Avoid accountability at all cost

  • BarneyT

    I too took the impression that the midwife was expressing a limitation of the system and service rather than a personal religious view, however this demonstrates how context is important.

    Until now I perhaps had a vision of an individual conducting a personal cruisade.

    As mentioned before on this site, we need clarity to remove the scope for interpretation and therefore misunderstanding….and indeed personal opinion and belief. If it didnt get in the way this time, it might in the future.

    The retrospective note taking in my view demonstrates a possible cover up and a willingless to prevert the true course that this incident should take.

    Clearly there and proecdural, system and general communication failings at work here too, which brings into question the management and professionality of the hospital.

  • Coll Ciotach

    Looks increasingly like clinical mistakes rather than Catholic values caused the the death of this unfortunate women which begs the question as to why any legislative change is necessary

  • Mick Fealty

    Neil,

    It’s nothing to with being Catholic. It’s about people, even Irish born Catholic practitioners no knowing, or not being willing to share with patients what the parameters are for when an abortion is permissible under Irish law as it stands.

    CC,

    The answer to that (as I have suggested above) is make it clear to citizens and midwives alike exactly what the law already, is in principle.

  • Absolutely, Mick. If we are to believe what she said, this experienced midwife didn’t know that termination of pregnancy was legal under some situations.

  • Mick Fealty

    Or didn’t let on?

  • To what extent was an abortion denied because the mother was brown, and therefore despised by some Irish people in the hospitals? I have noticed more racism in Dublin than Belfast (don’t know about Galway). Would a conversation with a white Irish mother be more of the nudge,. nudge, wink, wink is there a way around this, rather than a straightforward request and denial?

  • Can we be sure that, if a similar situation arose in N.I. in a smaller hospital, a staff member would never say that termination couldn’t be done because “we are a fundamentalist Christian country.
    The current situation North and South is untenable.