Abortions are carried out by obstetricians in the State to save the life of the mother, according to the Master of the Rotunda hospital, Dr Peter McKenna.
The circumstances in which this occurs have been outlined to officials in the Department of Health, as part of the discussions on the forthcoming Green Paper on abortion, Dr McKenna has told The Irish Times.
The Department has confirmed that its officials has discussed progress on the Green Paper with the Masters of the three Dublin maternity hospitals. More than 3,000 submissions have been received by the Interdepartmental Working Group on Abortion, and the Green Paper is expected to be ready by the end of the summer.
Anti-abortion campaigners argue that no medical circumstances exist in which the mother's life is threatened by pregnancy and could be saved by abortion. They are seeking an amendment to the Constitution to undo the Supreme Court judgment in the X case, allowing abortion in cases when the mother's life is in danger. In that case the court held it was endangered by her threat of suicide.
"As a practising obstetrician for 20 years I have come across such cases, and they have been dealt with," said Dr McKenna. "They are a real, though infrequent, problem."
He described one such case from his own experience, where a foetus of about 17 or 18 weeks had to be aborted to save the mother's life.
"It was a molar pregnancy, in which there is a tumour on the afterbirth. There is rarely a co-existing foetus, but in this case there was a normal pre-existing foetus.
"The treatment is to empty the uterus. You don't know whether the tumour is malignant or not until you remove it. One of the effects of a molar pregnancy is pre-eclampsia [dangerously high blood pressure, potentially leading to heart attack or stroke], and we don't normally wait for it to develop.
"Because of the pre-existing foetus we waited for things to happen, until about 17 or 18 weeks. Then the mother developed severe and uncontrollable high blood pressure, which did produce heart failure. Under those circumstances you have no option but to remove the molar pregnancy with the inevitable result of removing the normal pregnancy."
Two other cases where he had to end a pregnancy to save the life of the mother were where she had cervical cancer in the early stages of pregnancy, and a hysterectomy was necessary.
According to the Pro-Life Campaign this is not abortion, it is a medical procedure which has the unavoidable and unintended side-effect of killing the baby. No one questioned this either before or after the passing of the constitutional amendment, according to Dr Berry Kiely of the PLC.
Dr McKenna does not agree. "We were all told before the last referendum by eminent people that they had never seen cancer of the cervix and it was not an issue. Then when it did arise we were all granted absolution. "The near impossibility of reconciling rights in the cases I have cited was shown by the fact that judges could not avoid making a bad decision over a difficult case in the X case, which involved a lot of bad decisions at every stage."
He does not accept that the decision he has made would never be questioned. "All it needs is one individual in the hospital to pick up the phone and report it to the gardai and I don't think the gardai would be in a position to refuse investigating it."