Abortion in Ireland: illusion of reform
The expectation that the public outcry over the death of Savita Halappanavar would lead to a liberalisation of Ireland’s abortion laws has been dealt a blow by the outcome of her inquest and by the details of legislation and guidelines brought forward by the government.
The inquest into the death at University College Hospital Galway was hailed as exemplary. But as an exercise in uncovering the full reasons for her death, as opposed to absolving the state of responsibility, it was feeble. Even allowing for the narrow scope of an inquest there were significant issues that went unexamined and unexplored. The declaration by Praveen Halappanavar that he hadn’t “got answers yet why Savita died” is a more accurate assessment than the stream of praise that poured from media pundits and politicians.
At most the inquest established a cause of death and presented a narrative of the events leading up to her death. We now know that Savita was found to be miscarrying when admitted to UCHG; that her membranes ruptured leaving her open to infection; that she pleaded for a termination but was told it was prohibited unless there was a threat to her life; that infection was not identified at an early stage; and that when sepsis was diagnosed there were further delays which meant it was too late to take action that would have prevented her death. The inquest also established that if the foetus had been removed at an earlier point in her treatment then Savita would have likely survived.
Despite the litany of failings and the jury voting unanimously for a verdict of death by “medical misadventure” the coroner still concluded that there should be no implication that those failings caused her death. The hospital as an institution was effectively absolved; the perverse law that prohibits a termination at the point it would be most effective in preserving the life of the woman was absolved. The religious doctrine that informs both the law and the treatment of women in medical institutions was completely ignored. This is despite confirmation of the “Ireland a Catholic country” comment being made (a fact the hospital had denied). Indeed, the midwife who made the comment was quite open about her motivation, explaining to the inquest that: "It was the law of the land and there were two referendums where the Catholic Church was pressing the buttons." The response of the coroner was to dismiss any suggestion that Irish hospitals are influenced by religious dogma and to admonish her for generating unfavourable worldwide media coverage.
Yet the details of the inquest showed all too clearly that medieval Catholic dogma was at the heart of the case. The medical staff knew that the foetus could not have survived. Many Irish doctors have acted in these circumstances in the interests of their patient. The bigoted beliefs of medical staff forced Savita to continue the pregnancy while they waited for the foetal heartbeat to cease.
The fact is that Ireland is not the modern European state it likes to portray itself as. Despite the formal separation of church and state the Catholic Church has, and continues to have, influence over public institutions and politics. It has been an ideological and practical bulwark of the Irish ruling class for many years and there is no indication that the Church or the state wants that to end. Indeed, the decline of religious sentiment and the various scandals to have hit both the Catholic Church and the state, means they have to cling together ever more closely.
This is why the prospect of a liberalisation of abortion laws is very unlikely. It has been twenty years since the Supreme Court ruling on the X Case; there have also been rulings from the European Courts over the years; but none of these limited amendments has ever been legislated for. The contents of the promised Protection of Maternal Life Bill indicate that it will maintain the highly restrictive status quo on abortion.
The possibility of incremental reform on the abortion issue, which has been promoted by some left groups, is an illusion. There is great indignation, but insofar as there is a movement, it is a mobilisation of the Catholic right to ensure that there is no change in the setup. The lack of any sizable mobilisation of socialists or feminists means that the issue is trapped in the narrow confine of the Dail with the outcome more reactionary legislation – focusing on the need to prevent an “escape clause” around the risk of suicide and committees of doctors to interrogate pregnant women. The legislation is fantasy. No sensible women will present herself to these interrogations when the boat to Britain is available. The reactionary nature of the legislation is underlined by the retention of barbaric sentences for those seeking abortions or purchasing abortifacients online.
The confessional nature of the state, the lock of the Catholic Church on medical institutions, the conservatism of the medical and legal professions, the weakness of the working class, the small size of the feminist and socialist movements, as well as the grip of reformism within these milieus, make real reform impossible. Rather than relying on court rulings or reacting to periodic public outcries at the cruel consequences of denying women access to abortion we need to build a movement that has as its clear objective the achievement of full reproductive rights for women.
In the context of Ireland this really would be revolutionary.