Oireachtas committee urged ‘not to make’ foetal abnormalities list

The Oireachtas committee debating the Eighth Amendment to the Constitution, which gives effect to the State's abortion ban, will be strongly advised not to "make a list" of foetal abnormalities that might be permitted grounds for termination.

Dr Peter Thompson, a consultant in foetal medicine at Birmingham Women and Children's Hospital, will appear before the committee on Wednesday.

In his opening statement, Dr Thompson will note that one of the issues faced by the committee is “the decision regarding which, if any, foetal abnormalities will be compliant with the new legislation for termination of pregnancy”.

“With regard to this I would urge you not to make a list, as with the ever changing progress in medicine, conditions would need to be added and removed from the list on a regular basis,” his opening statement says.

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He will “strongly advise” the committee against “being prescriptive and using the term lethal abnormality”.

Counselling women whose pregnancy is complicated by a foetus with a severe abnormality is not a binary state of affairs but rather a complex discussion that requires a description of risk and probability

“The problem is there is no agreed definition as to what lethal actually means, is it that all foetuses with that condition die before birth, that they die either before birth or in the neonatal period despite supportive therapy, a baby that usually dies in one of these two periods of time or is it that it has been noted that there is an association between the condition and death.”

Malformations

Dr Thompson will outline research with the most common conditions which have been said in medical literature to be lethal foetal malformations, along with survival rates for these conditions.

He will note that, since the 2012 research was published, survival until 13 months has been reported in a case of a condition known as renal agenesis, where one or both kidneys do not develop.

“Therefore counselling women whose pregnancy is complicated by a foetus with a severe abnormality is not a binary state of affairs but rather a complex discussion that requires a description of risk and probability,” Dr Thompson will state.

There were 250 cases in England and Wales last year where a pregnancy was terminated on either the ground that the continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated, or that the termination was necessary to prevent a "grave permanent injury" to the physical or mental wellbeing of the woman.

Termination of pregnancy in England and Wales is presented as one of the options available to women if their foetus is at substantial risk of significant disability

Of these terminations, just 33 were performed after 20 weeks gestation.

Travel for termination

Dr Thompson will tell the committee that more than 3,000 women a year travel from the Republic of Ireland to England or Wales for a termination of pregnancy and that last year, 141 of these had a termination of pregnancy under clause E of the Abortion Act.

This is where there is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously disabled. Termination of pregnancy in England and Wales is presented as one of the options available to women if their foetus is at substantial risk of significant disability.

Dr Thompson will note that Parliament there “has not defined either substantial or significant but have purposefully left it to the medical profession to make these decisions in good faith”.

The committee will also hear from officials from the Department of Children and Youth Affairs and from the Department of Education and Skills, in relation to the ancillary recommendations of the Citizens' Assembly on issues related to sex and relationships education.

It began hearings in September and is expected to publish its report next month.