What the Death of Savita Halappanavar and Canada’s Attitude to Abortion Have to Teach Us

Savita Halappanavar’s life ended because medics put the life of her unborn child - who they knew would die anyway - before hers, and because those medics were prevented by law from performing a procedure that would have saved her.

Nov 16, 2012 at 2:09pm | Leave a comment

This week I’ve been thinking a lot about the tragic death of Savita Halappanavar, the 31 year old dentist who passed away in a Galway hospital last month, after being refused an abortion that could have saved her life. By the time this goes live, I’m sure the controversy will have reached Frankenstorm proportions.

Halappanavar was admitted to hospital miscarrying at 17 weeks. However, abortion is illegal in Ireland, and because the foetal heartbeat was still beating, medics refused to perform the medical abortion she needed and begged for. She miscarried days later, but not before she’d contracted the septicemia that would go on to kill her.

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Anti-choice campaigners may rabbit on about the provision under law that states that abortion can be provided when there’s a direct threat to a woman’s life, or claim that the medics looking after Halappanavar should have induced labour in order to save her life.

The reality, as we’ve now seen, is that abortions are just not performed. And as for their suggestion that medics should have induced the birth of her unborn, but dying foetus? It would have been both cruel and totally unnecessary when the foetal heartbeat could have been stopped as the first step of the abortion Halappanavar repeatedly asked for.

The fact is, her baby, sadly, was not going to survive no matter what course of action her doctors took. So why not opt for the one that would have saved her?

Last week, I was contacted by Joyce Arthur, who is the Executive Director of the Abortion Rights Coalition of Canada (ARCC). Arthur emailed members of the British media wanting to talk about Nadine Dorries’ recent attempts to reduce the time limits on abortions in Britain.

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Nadine in the jungle: yet another misguided decision from Ms Dorries.

She explained that abortion had been fully decriminalised in Canada in 1988 because it was felt that the application of either civil or criminal laws to medicine was inappropriate.

Abortions are seen as a matter for women and their doctors, not law-makers and politicians, and the overall impact has been positive - abortion rates had fallen. Arthur also felt that Dorries, and her strategies, were ‘misguided.’

Happy to talk to anyone who describes Nadine Dorries as ‘misguided,’ I contacted her for an interview.

Who are the Abortion Rights Coalition of Canada, and what do you do?

The Abortion Rights Coalition of Canada is a national advocacy group for abortion rights so we do lobbying and education. We act on various issues, working with MPs, to protect the abortion rights that we have and also try and improve access to abortion in different ways.

What abortion services are freely available in Canada? Are they available on the Canadian National Health Service for free?

We do have universal healthcare [an equivalent to the NHS] so it is fully covered. In 1969, abortion was decriminalised to allow women to go before a therapeutic approval committee of three doctors to get approval before an abortion.

Abortions were available at some hospitals but it turned out that the committees were very arbitrary in how they made decisions so that law was completely struck down by our Supreme Court in 1988.

After that, access improved. Before 1988 abortions were funded [by the health service] and that continued. We had a fight over the next ten years of getting private abortion clinics, which had previously been illegal, funded.

In your email to me you said, “Parliamentary debate led by MP Nadine Dorries on reducing the time limit for abortion is misguided since criminal or civil law is inappropriate in medicine.”

Can you explain to us how the laws surrounding abortion in Canada works?

We don't actually have any laws. Basically, abortion care is delivered just like any other healthcare. We don’t use civil or criminal law in healthcare normally. Healthcare is delivered by the medical profession and they have their internal policies, they have a code of ethics for doctors around informed consent, all the normal stuff like that.

Really what it comes down to is a decision between a woman and her doctor, and the doctor has discretion over what’s appropriate for each patient and what their own limits are, and so on and so forth. They decide whether they want to perform abortions, to what gestational length and all that kind of thing.

The Canadian Medical Association passed a policy around the time of the Morgenthaler decision in 1988. Briefly, the policy is on induced abortion. It says:

“Abortion on request is recommended up to twenty weeks, and after that under exceptional circumstances.”

It doesn’t really go into [what these “exceptional circumstances” might be]. It just leaves it up to the Doctor’s discretion.

In practice what happens is that very, very few Doctors in Canada perform abortions after twenty weeks. It’s obviously a more complex procedure – it’s more skilled, so not many doctors are trained in it to begin with, meaning it’s only available at a few centres.

In almost all cases, what usually happens, especially later on in pregnancy, an abortion is sought because of lethal foetal abnormalities, where the foetus can’t survive the birth. Other cases most often involve serious health or life endangerment problems for women.

And sometimes a late abortion might be performed in especially socially compelling circumstances, which would be at the discretion of a doctor. For example, if a very young girl was in denial about her pregnancy, or a sexual assault or a domestic abuse survivor sought an abortion. In situations like that though it’s on a case-by-case basis according to the Doctor.

How has the full decriminalisation of abortion affected women in Canada?
The overall effect was that abortion was kind of incorporated into a regular part of healthcare, and even though we also had stand-alone clinics doing abortions, hospitals still were doing the bulk of abortions at the beginning.

They still do almost half so I think having that hospital-based service is important for integrating abortion care into regular healthcare instead of having it so isolated the way it is in the United States, for example.

I think it’s also shown that it's working - we've gone for 25 years without law and nothing bad has happened – women are not presenting for 9 month abortions so they can fit into their prom dress, and so on.

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Back to Ireland. Performing or procuring an abortion in Ireland is a criminal act, with persons found guilty of either risking life imprisonment.

Savita Halappanavar’s life ended because medics put the life of her unborn child - who they knew would die anyway - before the life of the woman in front them. Because those medics were prevented by law from performing a procedure that would have saved her, and because the politicians who have the power to legislate so that no woman ever has to go through this again have refused to.

On Wednesday, hundreds of people gathered in protest outside the Dail (Dublin’s equivalent to the House of Commons), to express outrage at this tragedy and, once again, demand the government decriminalize abortion in this country.

Surely this time, now that Ireland and its abortion laws are under international scrutiny, something has got to give.

I’m tweeting angrily about Savita, Dorries and the state of reproductive rights in Ireland @AlisandeF

To make donations to ARCC or show your support, check out their website, or follow them on Twitter @abortionrights

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