Varadkar abortion report raises troubling questions

It beggars belief that Ireland could have more ‘emergency’ terminations in one year than England and Wales had in ten, writes Greg Daly

It’s difficult not to be troubled by this week’s HSE report that Ireland saw 26 terminations of pregnancy last year under the terms of the Protection of Life during Pregnancy Act.

Three terminations took place, according to Health Minister Leo Varadkar, because a woman was at risk of suicide, nine because lives were in immediate danger from physical illnesses, and 14 because lives were otherwise endangered by physical illnesses. Only one review took place, with the requested termination being rejected.

It is impossible to tell from these figures how many of these ‘terminations’ were in fact abortions, and how many were – as in the controversial case of the asylum seeker known as Ms Y – accelerated deliveries by caesarean section. The report is silent about the health and wellbeing of any babies whose deliveries were accelerated.

The minister claims the law is working as intended, maintaining that the figure of 26 tallies with estimates given to the Oireachtas Joint Committee on Health and Children in January 2013. 

Speaking then, Dr Sam Coulter-Smith said Dublin’s Rotunda Hospital has “approximately five or six cases a year in which interruption of the pregnancy is required to save the mother’s life”, later adding, “I would have thought the national figure is between 20 and 30”.

Unless these ‘interruptions’ were illegal, however, they would not be terminations under the terms of the new law, instead being the kind of regrettable actions Irish law has long permitted where an unborn child might die as an unavoidable consequence of medical actions to save its mother.

Leaving aside those terminations intended to prevent deaths by suicide, the question is whether the 23 terminations that took place to save a mother from death by a physical illness reflect the practical execution of legal abortions in Ireland or merely reflect a change in how medical practice is labelled.

If the former, and allowing that the HSE says nothing about how many terminations were accelerated deliveries, these figures are shockingly high when compared to abortion rates in England and Wales. 

Contrary to popular belief, abortion is illegal in the UK, doctors being exempt from prosecution only when they testify that certain ‘exceptional’ circumstances have been met.

Emergencies

Among these are emergencies where a mother’s life or health is endangered. These ‘Ground F’ and ‘Ground G’ abortions are exceptionally rare: only eight such abortions have taken place in England and Wales over the past 10 years, four happening last year, one in 2013, one in 2012, one in 2011, and one in 2006. 

It beggars belief that Ireland, with a population of 4.6 million, could have required more emergency terminations in one year than England and Wales, with a combined population of 56 million, have needed in 10.

Even non-emergency abortions to save the lives of mothers are far from common there, with – on average – 62 of 186,900 abortions in each of the last five years being ‘Ground A’ abortions because “the continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated”. Not all of these, of course, would pass the ‘X’ test that the mother’s life can only be saved if the pregnancy is terminated. 

With just under 4,000 women with Irish addresses having abortions in the UK over each of the last few years, and with at most 0.03% of each year’s abortions in England and Wales passing the ‘X’ test, a realistic fear would have been that the HSE would have reported one or two abortions last year. 

That it reported 23 ‘terminations’ on physical grounds alone shows the grievously misconceived and poorly executed nature of the 2013 act. 

Even if the Government refuses to repeal the legislation, the minister could take steps to clarify obscurities in the report, establish review mechanisms empowered to challenge decisions that a woman’s life can only be saved by an abortion, and put in place procedures so the legality of terminations can be retroactively examined.

Without such measures, it is difficult to see how the Government can claim to be fulfilling its duty “as far as practicable” to defend and vindicate the rights to life of Ireland’s unborn.