Shortly before Christmas last year, a small rectangular package arrived by courier from England, addressed to Amanda Mellet at her Dublin home. Inside was a box containing the ashes of her baby daughter, Aoife.
Mellet, 38, had been 21 weeks pregnant when she was told that her baby had Edwards syndrome, a rare chromosomal abnormality, and would either not survive the remainder of the pregnancy or would die shortly after birth; the condition was "incompatible with life".
Mellet and her husband, James Burke, had been excited and happy about starting a family and the news was devastating. After much agonising, the couple decided they did not want to continue the pregnancy: "I would face the next 3 1/2 months wondering every day if my baby was still alive or had died inside me," says Mellet, "and knowing that even if she made it to delivery, bringing her into the world was no kindness."
But worse was to come: abortion is illegal in the Republic of Ireland - except in the rarest of circumstances - and the couple would have to travel to England for a termination. Because of the advanced stage of Mellet's pregnancy, this would involve a lethal injection to the foetus in utero, followed by induction and labour to deliver a tiny corpse. What's more, the procedure would cost just under ?2000 ($2500) and the couple would have to find the money for airfares and several days' hotel accommodation.
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Staff at their maternity hospital could not discuss termination, let alone refer them to an English clinic for fear of acting against the law, but advised them to go to the Irish Family Planning Association (IFPA) for counselling and help. Within a few days they were on a plane to Liverpool.
"It felt like everything was adding insult to injury," says Mellet when we meet one sunny afternoon in the elegant upstairs lounge of a Dublin hotel. "Not only did we have to make this horrible decision, we had to speak in euphemisms to hospital staff in Ireland, leave the country like criminals, pay thousands to end a much-wanted pregnancy, and all the while my heart was breaking at having to say goodbye to my darling baby girl."
She says staff at Liverpool Women's Hospital reassured them that they'd made the right decision. "They treated us with dignity and respect and affirmed to me I was a loving mother who wanted the best for her baby," says Mellet. "You have no idea how much I needed that, coming from Ireland where the law of the land made me feel like a monster. They told us they regularly had women over from Ireland who chose not to tell anyone of their decision - not family, not friends, not even their doctors. They go over in complete secrecy, and hold the truth of how the pregnancy ended as a dirty secret in their hearts for fear of judgment."
Irish literature is suffused with the ghosts of dead babies - the "embarrassments", as novelist Sebastian Barry calls them in The Secret Scripture, swept away to sea by Sligo's river, along with the town's rubbish - "the speed and depth of the river a great friend to secrecy". The embarrassments were got rid of, if possible; put out with the garbage or buried under a tree.
It was hard to avoid these shames - as well as the law prohibiting abortion, until well into the 1990s a woman seeking a tubal ligation had to have written permission from her husband. Contraception was banned in the Republic until 1980 and even then available only on prescription from a doctor. In 1985, the law was amended to allow sale of contraceptives, but only by pharmacies to those over 18; as late as 1991, the IFPA and Virgin Megastore were prosecuted for selling condoms over the counter.
The following year heralded a furore over the notorious "X Case", in which a pregnant 14-year-old girl (her identity has never been revealed), who had been raped by the father of a school friend, was taken to England to have an abortion, but was halted almost at the clinic doors with an injunction obtained by Ireland's attorney-general in Dublin. In granting the injunction, the Irish High Court relied on a paragraph in the Irish constitution that gives equal right to life to both mother and foetus. It was his duty, explained the attorney-general years later, to protect the child and make a case for it to be born alive.
"He was in a lonely place," wrote journalist Kathy Sheridan, reviewing the X Case in The Irish Times, "... in a country steeped in moral fudge and rank political cowardice, convulsed by the internment of a pregnant child on the island amid reports of Garda [police] plans to block the airports and watch the ferries, all against a backbeat of global outrage."
Protests, marches and vigils against what was branded a gross violation of human rights had indeed spread around the world; Ireland's law on abortion was "barbarous", said an Australian senator and a French newspaper questioned Ireland's suitability as a member of the European Union (EU). Meanwhile, in Ireland, anti-abortion activists brandished pictures of dead foetuses and prayed for the soul of Miss X's unborn child.
In the event, Miss X's family appealed to the Supreme Court of Ireland, which overturned the decision on the basis of a psychiatrist's report stating that Miss X was in a suicidal state. Abortion was constitutionally permissible, said Chief Justice Thomas Finlay, "... if it is established as a matter of probability that there is real and substantial risk to the life, as distinct from the health, of the mother, which can only be avoided by the termination of her pregnancy".
Miss X was allowed to return to England, where she reportedly suffered a miscarriage. In the aftermath of the case, the Irish people were invited to vote in a referendum on proposed amendments to the constitution. Two principles were accepted: women should have the right to receive information about abortion services - though a ban on the advertising of such services remained - and to "travel" outside the country to seek a termination.
But the proposal to allow abortion where there was risk to the mother's life was roundly rejected by both sides of the debate. The so-called pro-life lobby refused to countenance abortion within Ireland under any circumstances. Those on the left, liberal and pro-choice side were full of objections: the distinction between the life - as opposed to the health - of the mother was spurious; the exclusion of threatened suicide as a ground was unacceptable and the proposal ignored the plight of women like Miss X, whose pregnancy was the result of rape or sexual abuse. The constitution was not the right place in which to tinker with the complex question of access to abortion, they argued; legislation was needed.
Twenty years, several test cases and two more referendums later, nothing has changed, and each year more than 4000 women still find themselves crossing the Irish Sea to England to secure abortions in a strange city, far from home and family. Even those women who might qualify for a termination in an Irish hospital on the grounds of risk to life are unprotected by legislation. Instead, they must rely on case law and may need to apply to the Irish High Court for a ruling - an almost insuperable hurdle for a woman in the throes of a crisis pregnancy who's unable to afford either the cost of advocacy or the time delay of bringing her case to court.
In 2010, Michelle Harte, from Cork, was 39 and undergoing treatment for cancer when she discovered she was pregnant. Both her oncology and obstetric consultants advised against continuing the pregnancy - it would mean months without treatment and her illness would put stress on the developing foetus. A termination was the safest option. But first the ethics committee at Cork University Hospital, where she was being treated, would need to authorise the procedure.
"The doctors felt there wouldn't be a problem," Harte told The Irish Times. "I had cancer, after all, and there was no hope of a cure." But after a delay of two weeks, the ethics committee ruled she was not eligible for an abortion in Ireland as her life was not at immediate risk.
There was further delay as a hospital was found in England - a private abortion clinic would not treat a woman with such complex health problems - and by the time Harte arrived at St Thomas' in London, weak and nauseous, her pregnancy was too advanced for the planned medical abortion. She had a surgical procedure under sedation (she was conscious), as a general anaesthetic was deemed too risky given her condition. Doctors advised a further night in hospital, but she had an early-morning flight booked and could not afford to miss it.
Soon after the ordeal, her condition deteriorated. "Anyone else who was even half as sick as I am shouldn't have to uproot themselves and fly over to England," she told Irish Times journalist Carl O'Brien. "It's not fair and it's not humane." Michelle Harte died in November last year.
Reviewing a similar case in 2010, the European Court of Human Rights, based in Strasbourg, France, found the Irish state had violated the rights of a pregnant woman with cancer who had been forced to go abroad for a termination, and noted the "significant chilling" effect of Irish policy. The Court told Ireland to get its act together and legislate to clarify its position on abortion. Reluctantly, and only after further nudging from Strasbourg, this year the government appointed an expert committee to examine the issues. It was due to report at the end of September, though at the time of going to press, Ireland's minister for health had still not received it.
All sides are apprehensive. The issue threatens both the country's governing coalition - junior partner Labour is committed to abortion law reform - and the unity of the majority Fine Gael party, which includes a far-right flank of backbenchers resolutely opposed to any form of liberalisation. Abortion was murder, said TD [Teachta D?la, member of the house of representatives and equivalent to MP] Michelle Mulherin, addressing parliament in April, and "fornication ... the single most likely cause of unwanted pregnancy".
Abortion is such a political hot potato in Ireland just now, as the government awaits the committee's report, that none of the avowedly anti-abortion Fine Gael TDs I approached for this story would speak to me. Pro-choice TDs were more forthcoming, though resigned to further procrastination: "It's time we got out of the Dark Ages," said TD Anne Ferris, "but abortion legislation will only be introduced in this country when Labour is in government [in its own right]."
Even if the present parliament were to legislate on the recommendation of the committee, it would only be within the very narrow confines of the X Case, where there is a clear risk to the life of the mother. Irish Family Planning Association chief Niall Behan notes that it is unusual for legislation regarding risk to life to ignore the implications for health: "It is like a doctor saying, 'Sorry, you're not sick enough.'?"
That pesky section of the constitution is the stumbling block - Labour Senator Ivana Bacik, a long-time campaigner for abortion law reform, says the government's hands are tied by those few paragraphs that should be deleted, leaving legislators free to frame more humane laws.
I was taken aback to discover that pregnant women in Irish maternity hospitals are not routinely offered a scan at 12 weeks' gestation. Since abortion is illegal, I was told, there is no incentive to test for foetal abnormality. Niall Behan claims that even if a problem is picked up, some hospitals will deliberately not tell the mother until it is too late for her to have a termination anyway. As well, he says, the more advanced the pregnancy, the more risks attach to a termination involving induction of labour.
Paediatric nurse Ruth Bowie, 34, from County Kerry, was fortunate in one way only: because she had some spotting early in her pregnancy, she opted to pay for a private scan at 12 weeks, which revealed that her baby had anencephaly, a fatal neural-tube defect in which major parts of the brain and skull are absent. Bowie says she and her husband had been ready to accept and love a baby regardless of any abnormality, but this was the worst possible news.
"It was a moment when the health system should wrap its arms around you," she says. Instead, like Amanda Mellet, she was told she could either continue with the pregnancy until the baby died - as it would, either before or shortly after birth - or get advice elsewhere about travelling to England for a termination.
"It wasn't the fault of the staff. Their hands are tied," she says. "I cried and cried and was so angry. The anger was not about our baby's diagnosis - I've nursed long enough to realise that bad things happen to people every day - I just felt so angry that we had to travel. I wanted to have the chance to stand up in front of a judge and plead my case to let me be looked after in my own country, but we had to travel to the UK with all our grief, feeling like criminals."
This year Bowie, Mellet and a few other brave and angry women have gone public about their experiences, speaking to the press and lobbying politicians. "Everyone tries to label us pro-abortion," Mellet told me when we met, "but we are campaigning on this issue alone: termination for medical reasons. We have to stick to this, otherwise they'll tear us apart. Abortion is such a taboo here."
I began to understand why she was so adamant. While polls reveal that a majority of Irish citizens would be willing to consider legalisation of abortion in specific circumstances, such as fatal abnormality or where pregnancy is a result of rape or incest, they are evenly divided on a woman's right to choose. The influence of the Catholic Church may have waned in modern Ireland, but its teachings are embedded in the DNA of a nation that finds it difficult to stomach the notion of abortion on demand.
"I honestly don't think the country would accept it," says Joan Lalor, associate professor of nursing and midwifery at Trinity College Dublin. "There is huge discomfort about using termination as a form of birth control." But what about the 15-year-old schoolgirl who finds herself pregnant, or the mother of five who can't face another baby? Lalor nods: "I would like to see better crisis pregnancy services in the community, and better support before and after termination." But she would stop short of legalising abortion for all within Ireland? "Yes, but I won't see it in my lifetime, anyway."
Later that day, I walked over to the other side of the River Liffey to meet midwife Jane Dalrymple, a specialist in foetal medicine at Dublin's Rotunda Hospital. We sit on opposite sofas in the small private room where she talks to couples shocked and bewildered after a diagnosis of foetal abnormality. Many come to her from hospitals around the country that have no provision for such cases and won't even raise the question of termination, she says, instead leaving them to discover options for themselves.
"Some parents need further information to weigh up how disabled or damaged their baby will be," she says. "If they want to continue with the pregnancy, we will mind them and if they don't, then we will advise on where to go for advice. Some won't want us to send letters to their GP or obstetrician because they'd get grief for choosing a termination."
Does she expect legalisation of abortion for fatal abnormality in her lifetime? She blows out her cheeks: "I'd like to think so, but I don't know. There is a great reluctance to acknowledge the problem exists. For example, the EU makes provision for reimbursement of expenses if someone has to travel to another jurisdiction for a medical procedure that isn't available in their home country. We got several of our ladies to apply when they went to England for terminations, and the forms were pushed under the carpet."
I suggest to Dalrymple that Ireland seems culturally "pro-life". She nods: "I've worked in Australia and the UK, where attitudes are different. This country has got a lot more cosmopolitan in the past 10 years, but I don't think social terminations are wanted here and it's not something I want to approve of, either." She shrugs, "If my daughter was pregnant unexpectedly, I might change my mind."
I spoke to several educated, intelligent women during my time in Ireland and most were at least as ambivalent. Both Dalrymple and Joan Lalor warned, too, that the medical profession is unprepared for a change in legislation. "There are no professional guidelines," Lalor explained, "and who wants to be known as the doctor who does abortions? It's not that long ago that health staff were threatened for doing vasectomies."
Though there is majority acceptance of the argument for abortion where there is risk to a woman's life or health and in cases of foetal abnormality, nobody is holding their breath. "It's seen as the thin end of the wedge," one doctor told me, "a door opening to abortion on demand." And a lawyer specialising in medical ethics agreed: "You can't have a little bit of abortion liberalisation, just like you can't be a little bit pregnant," he said. "There will always be arguments for special cases, a hierarchy of need: it really has to be all or nothing."
Niall Behan says there is "fear mongering" that liberalisation would provoke a free-for-all rush to the clinics. "It's not true," he says. "We know women think long and hard about abortion; it's not something they do flippantly." He points out that since Switzerland legalised abortion in 2002, there has been a drop in abortion rates.
Amanda Mellet is still on maternity leave from her job working with victims of domestic violence. "I thought I'd go back earlier," she says, "but I wasn't ready - there are lots of babies and kids in my work and it's stressful." She won't qualify for further leave for another 12 months, but at 38 she's not waiting. "We are trying, trying, trying for another baby," she says with a wan smile.
Meanwhile, she and her husband are keeping up the pressure on legislators. "We've started this campaign and we're not going to stop," she tells me. "Every single week that goes by and the law doesn't change, more people suffer. You accept that terrible things happen, but why make them worse?"
Source: The Age
This article was published nearly a week after the death of Savita Halappanavar but before her case came to light yesterday. While it doesn't really touch on the deaths of mothers who have been denied a life-saving abortion in Ireland, it at least shows that there are people who want it legalised but of course, there is debate as to how far such laws should go.
Source: http://ontd-feminism.livejournal.com/657565.html
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