After the Supreme Court’s historic decision to overturn Roe v. Wade, some doctors are highlighting the 2012 death of a pregnant woman in Ireland and warning that the identical thing could occur on a big scale in the US.
Dr. Savita Halappanavar, a 31-year-old Indian-born dentist, died in 2012 in Galway, on Ireland’s west coast, after she was denied an abortion by doctors who cited the country’s strict laws, despite there being no probability of her baby’s survival, in accordance with Ireland’s official report on the case.
Her death shook the foundations of the traditionally conservative and predominantly Roman Catholic country, and catalyzed its pro-abortion rights movement. In a 2018 referendum, Irish people voted by a two-thirds majority to legalize the procedure.
The avoidable death of Halappanavar, who was 17 weeks pregnant, proved that doctors — not politicians, police and judges — should help determine one of the best plan of action in similar cases, in accordance with Dr. Sabaratnam Arulkumaran, the expert who in 2013 wrote the official report on the case.
“That is why Biden said that the problem ought to be between the patient and the doctor, moderately than with the law,” he told NBC News by phone, referring to President Joe Biden’s speech reacting to Roe v. Wade’s reversal June 24.
In Halappanavar’s case, doctors opted against an abortion since the fetus had a heart rate and anyone carrying out a termination could theoretically have been prosecuted at a later date.
“Since the fetal heart rate was present on a regular basis, the obstetrician didn’t do a termination. If someone decided that she had done it illegally, she would have gone to jail,” he said, referring to the doctor attending on Halappanavar.
Arulkumaran, a professor emeritus of obstetrics and gynecology at St. George’s University of London, added that moms’ lives are at stake in the US.
“I feel maternal mortality will go up,” he said. “I feel those that are going to be affected are those from lower socioeconomic groups, adolescents, those that do not have facilities to go for termination.”
Back pain first sent Halappanavar to Galway University Hospital on Oct. 21, 2012. She was sent home but returned just hours later after she “felt something coming down” and said she had “pushed a leg back in.” A midwife confirmed no fetal parts might be seen, in accordance with the official report. Later that day, she described the pain as “unbearable,” in accordance with the official report.
She was admitted and on Oct. 23, a physician told her a miscarriage was “inevitable” as a consequence of the rupturing of the membranes that protect the fetus within the womb, despite the incontrovertible fact that her baby was a standard size and was registering a heart beat. The medical team had decided to “monitor the fetal heart in case an accelerated delivery is perhaps possible once the fetal heart stopped,” the official report said.In Halappanavar’s case, an accelerated delivery would likely have meant a medically induced miscarriage.
When, on Oct. 23, Halappanavar and her husband, Praveen, asked about medically inducing the miscarriage as an alternative of delaying the inevitable, a physician told them: “Under Irish law, if there is no evidence of risk to the lifetime of the mother, our hands are tied as long as there is a fetal heart[beat],” the official report said.
The report added that when their waters have broken, pregnant women are at very high risk of infection, which in some cases will be fatal.
On Oct. 28 at 1:09 a.m., having caught an infection and gone into septic shock, Halappanavar was pronounced dead.
“It was a life-threatening condition but they took the view of not doing anything due to the legal framework,” Arulkumaran said within the interview.
Praveen Halappanavar, who didn’t reply to a request for comment, told The Guardian newspaper in 2013 that the inquest into his wife’s death “vindicated” his version of events. He told the inquest that a physician told him an abortion couldn’t be performed because “this can be a Catholic country.
After the report was released University Hospital Galway apologized to Halappanavar’s family in an announcement which said it “was clear” that “there have been failures within the standards of care provided.”
“We will reassure all concerned that now we have already implemented changes to avoid the repeat of such an event,” it added.
Threat to a mother’s life
While some American states have enacted “trigger laws” banning abortion — some offering exceptions reminiscent of within the case of rape or incest, and all currently allow abortion if the mother’s life is seriously in danger — many experts query how easy it’ll be to get such an exception. As well as, asking doctors to interpret complex laws in the course of a medical emergency can result in dangerous decisions, they said.
Irish law in 2012 allowed abortion to forestall a “potential major hazard or threat to the mother’s life.” However the Halappanavar report said a physician decided the purpose at which an abortion was “allowable in Irish law” had not been reached.
This is just not a theoretical scenario within the U.S., said Dr. Jen Gunter, an OB-GYN based in California and the writer of “The Vagina Bible.”
“I’ve personally been in a situation where as a consequence of the state law, abortion was illegal at our medical center and we had a patient who needed one,” she said in an interview, declining to share any further details of the case apart from the incontrovertible fact that it was in Kansas, where abortion is legal as much as 22 weeks with some restrictions.
“It wasn’t a pregnancy complication, her organs were failing due to the extra burden of pregnancy as a consequence of her underlying condition,” she added.
The attorneys on the medical center in Kansas told Gunter she couldn’t perform the abortion unless the lady was in “imminent danger.”
“I used to be like, ‘What does that mean?’ And their interpretation was that she was going to die in the following three minutes,” she said. Gunter said the hospital attorneys arrange a call with the state politician involved within the laws, who told her, “Do what you’re thinking that is best, doctor.”
“So I assumed, ‘Then why do now we have this law?'” she said.
An ectopic pregnancy — through which a fertilized egg implants and grows outside the uterus, often in a fallopian tube, and might endanger the lifetime of the mother — could cause added confusion and untenable delays in treatment under the brand new laws, she said.
Watch more from NBC News: More confusion on state abortion laws spreading following Roe v. Wade reversal
Gunter is unsparing in her prediction for what tighter abortion laws could mean within the U.S.
She said women could die despite higher antibiotics to treat septic abortions.
“Halappanavar? That will not ever change things within the States when that happens here, and it’ll occur.”
Lawmaker Ivana Bacik, leader of the Irish Labour Party and a long-standing advocate of abortion rights, led a protest against the Supreme Court decision outside the American Embassy in Dublin on Monday “in solidarity for American women and girls.”
“Our experience here is that banning and criminalizing abortion puts women’s lives at risk. It’s totally clear that is the appalling reality now for American women,” she said.
“In the event you remove the correct to abortion from women and girls, you endanger lives. The fact is that there might be life-threatening conditions in pregnancy that can threaten lives and health.”
Bacik said Halappanavar’s story was instrumental in turning public opinion toward a “yes” vote in 2018. As was the case of a brain-dead woman in Ireland whose life support machine was only turned off greater than three weeks after she was declared clinically dead in 2014 following a protracted legal battle because she was 18 weeks pregnant.
Of their submission to Ireland’s ongoing government review of abortion laws, a gaggle of 20 women’s rights and heath care charities commissioned polling in March showing 67% of individuals across the island supported free access to abortion — mirroring the support for the “yes” vote in 2018.
Still, opponents to abortion rights in Ireland proceed to fight. On Saturday, a Right to Life rally will happen in Dublin, where organizers are calling on sympathizers “to be a voice for the 6,500 babies being killed by abortion every 12 months.”
Carol Nolan, an independent lawmaker representing the constituency of Laois–Offaly within the Irish midlands, opposed the law change in 2018 and argues that Halappanavar’s death has been “deliberately and continually” misrepresented by women’s rights campaigners.
“The aspects that overwhelmingly contributed to Savita’s death were then, medical negligence and the mismanagement of maternal sepsis,” she said via email, adding that she believed the law prior to 2018 — often called the Eighth Amendment — was not a barrier to Halappanavar receiving proportionate and effective care.
“Following the removal of the constitutional amendment, now we have seen an explosion within the numbers of abortions and the appliance of relentless political and nongovernmental pressure to further widen the parameters of the post-2018 law,” Nolan said.
Watch more from NBC: How overturning Roe v. Wade affects access to medication abortion
There have been 32 abortions in Ireland in 2018 and over 6,000 in each of the next two years, in accordance with the most recent figures available from the country’s government.
“This was entirely predictable,” Nolan added. “Nevertheless, it has only served to vindicate my very own view that the Eighth Amendment acted as a beacon of proportionality and sound law grounded in an authentic vision of human rights.”
The sometimes deadly intersection of law and medicine in the talk preoccupied those that support abortion rights, too.
Bacik, the Dublin lawmaker, cited the case of Andrea Prudente, an American woman who was denied an abortion after heavy bleeding in Malta on June 12. She was airlifted to Spain where she received treatment and the fetus was removed.
Multiple cases of girls dying after being denied abortions have emerged from Poland, which has a near-total abortion ban. Last 12 months, a 30-year-old woman known only as Izabela, who was 22 weeks pregnant, died of septic shock, her family said. Scans had shown multiple problems with the fetus but doctors refused to terminate while there was a fetal heartbeat, Reuters reported.
After fetal death, doctors could then legally operate. But Izabela’s heart stopped on the strategy to the operating theater to have a cesarean section.
At subsequent mass protests in Poland, flags were raised bearing the slogan: “Her heart was beating too.