By Dr Irene Gafson, Obstetric and gynaecology registrar, London11:17AM BST 22 Apr 2013
Last week the verdict of an inquest into the death of Savita Halappanavar, who sadly died in a Galway Hospital last October, was announced. She was 17 weeks pregnant and died from E Coli septicaemia. The jury unanimously decided that the verdict was 'medical misadventure'.
At the time of her death, there was significant media coverage surrounding the Irish abortion laws. There are suggestions that there was a delay in successfully combating her sepsis by augmenting the delivery because of concerns regarding presence of the fetal heartbeat and laws concerning abortion in Ireland.
As an obstetrician, it is hard to pass comment on this specific case without thorough inspection of her case notes and I am certain that this has been a truly devastating experience for the obstetric, midwifery and nursing teams involved.
What has truly saddened and shocked me is that there is the suggestion that there were delays in terminating her pregnancy because of the ongoing presence of the fetal heartbeat.
My first and foremost duty and responsibility lies with the care of the mother in any given situation. It would be a real tragedy if this cornerstone principle of obstetrics was overlooked because of the Irish laws regarding abortion. As doctors in general, two of the four key ethical principles that should guide our management in any situation are non-maleficence (do no harm) and beneficence (do good).
Pregnant women can deteriorate very quickly when they are fighting a severe infection and it is essential to act swiftly and safely. In a situation like this where the mother’s life is always considered the priority, a termination can be a lifesaving intervention when a woman is facing overwhelming sepsis (blood infection). If the infection is believed to originate from an intra-uterine cause, the only real option is to terminate the pregnancy and remove the focus of infection. Simply treating with antibiotics is not enough. Doing so is still classified as an abortion and legally requires the appropriate paperwork, but in these situations, most families understand the necessity of this.