Medical realities of saving mothers

Sir — Mary Stewart (Letters, Sunday Independent, October 29), referring to the tragic death of Savita Halappanavar, says that we have read of no evidence from the many gynaecologists who value the Eighth Amendment. She states that Dr Peter Boylan’s claim that Savita’s death was due to the amendment was not queried in the media.

As a retired obstetrician/ gynaecologist who worked in Ireland for 22 years as a consultant, I feel that I am qualified to take up her challenge.

Have I ever felt, in a lifethreatening situation when it was necessary to act to save the mother’s life by ending the life of the baby, that the amendment was inhibiting me from acting? The answer is no.

Thus once I scanned a patient in early pregnancy and detected a bleeding pregnancy in a fallopian tube. There was still a heartbeat, but was I supposed to wait until it stopped beating? Obviously not and an immediate operation was done by me to remove the eight-week-old baby.

I, and most obstetricians in my time, will have been faced with the enormous head of a markedly hydrocephalic baby. The brain will have been fatally damaged and a caesarian section pointless and dangerous. As the cervix of the uterus opens up in labour, it is easy to perforate the head and let off many litres of fluid, though this will be fatal for the baby.

To do nothing would mean a uterine rupture. I have done this procedure several times and never thought of the amendment. After all, the designers of the amendment were not thinking of asking doctors to preserve the baby’s life when this would be impossible.

One must remember in similar cases that if the mother is liable to die, then so will the baby she is carrying who therefore cannot be saved.

The case of poor Savita should not be used in the push for abortion in Ireland.

I do not know why her request for the pregnancy to be ended was not acted upon, but it might not have been that easy and perhaps with the baby alive there must have seemed to be a minimal risk of any infection; indeed this would normally have been the case with the early resumption of progress in emptying the uterus naturally.

Had the pregnancy been terminated early, the infection would still have been present, needing to be detected and dealt with. Alistair McFarlane, Cambellstown, Letterkenny