Laws forcing Irish doctors to ‘work in vacuum’ inquest told

The former master of the National Maternity Hospital claimed doctors coming from abroad have “great problems” understanding the legislation, which left Savita Halappanavar’s clinical team waiting for her severe sepsis to get worse and reach a mortality rate of up to 40 per cent before acting.

“They cannot understand the law, but we have to work within the law,” Peter Boylan told the Indian dentist’s inquest.

The leading doctor revealed that Mrs Halappanavar would probably be alive today if doctors had been allowed to acquiesce to her pleas to terminate the baby as she miscarried.

The words from one of Ireland’s most senior obstetricians rang out in the silence of the coroner’s court and threw Ireland’s controversial abortion laws back in the spotlight.

“The legal position that obstetricians act under is guided by the Medical Council guidelines which state very clearly abortion is illegal in Ireland except where a real or substantive risk to the life, as distinct to the health, of the mother,” Dr Boylan added. “There are no guidelines as to how severe that risk should be or how great the risk that the woman must be.

“So obstetricians in Ireland are working to a certain extent in a vacuum.

“Unless a mother looks like she is going to die and unless she has a termination of pregnancy you are on very sticky ground.”

The Irish Government has pledged to publish new abortion laws in July, which will include the threat of suicide and a combination of legislation and regulations for doctors to abide by in cases where there may be uncertainty.

As it stands in current medical practice, doctors must treat an expectant mother and her unborn baby as equals.

Dr Boylan said women in Ireland have “no input” into their care, unlike other countries where a termination would be offered during a non-viable pregnancy.

He confirmed Mrs Halappanavar’s consultant, Dr Katherine Astbury, was prevented from even considering her patient’s requests on the Monday and Tuesday when she detected the heartbeat of the baby daughter Prasa.

By the time severe sepsis was diagnosed on the Wednesday, it was “too late to save her life”.

The evidence by the former master lends credence to Dr Astbury, who told the inquest she could not induce delivery the day before Mrs Halappanavar became critically ill as she was restricted by the law.

She has denied claims she refused an abortion because “Ireland is a Catholic country”.

“In this country it is not legal to terminate a pregnancy in grounds of poor prognosis of the foetus,” she said she told her patient. But she admitted there were failures in her care and that she would have acted sooner had known of concerns by a junior colleague.

The case continues.