Obstetricians have ‘full freedom’ to save mother’s life, says doctor

OBSTETRICIANS have “full freedom” under existing law to intervene to save the life of a pregnant woman and the risk of death does not “need to be imminent”, a leading doctor has warned.

Dr Mary Holohan, a consultant obstetrician in the Rotunda Hospital in Dublin, said she was concerned about statements claiming obstetricians are currently curtailed in their ability to care for pregnant women who are seriously ill.

She said that such statements were causing “unnecessary fears”.

Her comments, in a letter to today’s Irish Independent, contrast with previous warnings by a number of other obstetricians who said existing legislation was too restrictive.

Some have insisted the law is forcing them to wait until a pregnant woman is near impending death before termination.

They argue that repeal of the Eighth Amendment to widen the abortion law is necessary to bring in legislation, permitting them legal flexibility to exercise their own clinical judgment without fear of criminal sanction.

However, Dr Holohan states: “I am concerned that recent statements are causing unnecessary fears for women.

“They suggest that obstetricians are curtailed in their ability to care for pregnant patients who are seriously ill and are causing unnecessary fears.”

She said: “Ireland’s law fully provides for the small number of cases relating to necessary obstetric interventions. Where it arises, the duty to intervene to save the woman’s life is clear. Under the present law we have full freedom and support for the requirements of ethical and safe practice.

“The threat to the woman’s life does not need to be imminent.

“We have the scope of practice needed to guarantee best international standards of care to women in pregnancy. Indeed, Ireland has an excellent record by any measure of performance, with very low numbers of women who tragically die in pregnancy.”

Favours

She did not elaborate further, and did not give her view on whether she favours repeal of the Eighth Amendment.

Dr Holohan was appointed to the expert group which advised the Department of Health on the Protection of Life During Pregnancy Act 2013.

This legislated for the X case – allowing for abortion where there is a serious risk to the life, as opposed to the health, of the mother. It includes risk of suicide.

Dr Holohan was also the medical director of the Sexual Assault Treatment Unit in the Rotunda for many years and is currently Director of Examinations and chairperson of the Examinations Committee of the Royal College of Physicians of Ireland.

Meanwhile, a body representing obstetricians states that the risk of death from a medical abortion, where a pregnant woman is prescribed pills under a doctor’s supervision, is rare and as low as two in every 100,000. The risk of infection is estimated to be two in 1,000 and a haemorrhage at one in 1,000.

The guidance has been issued by the Institute of Obstetricians and Gynaecologists in advance of the referendum on repealing the Eighth Amendment.

The Institute, which supports the removal of the Eighth Amendment, said the risk of undiagnosed ectopic pregnancy – where pregnancy develops outside the womb – was estimated to be one in 7,000.

The Government proposes unrestricted medical abortion for up to 12 weeks of pregnancy, if the referendum is passed.