Fatal foetal cases still being forced abroad for abortions, Dáil told

There are "worrying signs" that women with fatal foetal pregnancy diagnoses are still being forced abroad for abortions, Solidarity TD Ruth Coppinger has claimed.

She alleged that “conservative Catholic control of hospitals and a very narrow law with criminalisation are having a chilling effect and forcing such women to travel abroad”.

But Taoiseach Leo Varadkar stressed the difference between fatal and severe abnormalities and said the Oireachtas had debated and agreed that disability would not be grounds for the termination of a pregnancy but that fatal abnormalities would be.

He said there were now 274 GPs nationally who had signed up to provide terminations in early pregnancy and about 10 hospitals providing the service, which had to “develop and evolve”.

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During leaders’ questions in the Dáil, Ms Coppinger highlighted the case of a woman who had a scan at Portiuncula Hospital in Galway and was told by an obstetrician that there was a possible case of Edwards Syndrome, that there was only a 15 per cent chance of delivery and that the baby might live for an hour or so.

“However the doctor then said that for whatever reason that nothing could be done as she was over 12 weeks,” and she was handed the name of three hospitals in England.

Ms Coppinger added that the woman said a staff member had treated her like a “leper” after this point. She said women were encountering problems with hospitals particularly in rural areas.

The Dublin West TD said the woman told her “I would lose my head if I had to continue this pregnancy but Ireland will do nothing for me”.

Ms Coppinger asked the Taoiseach why in Ireland is a “distinction made between fatal and severe abnormalities that is not made in other countries”.

And she said nurses were asking who decided what got onto a list of fatal foetal abnormalities and why it varied from hospital to hospital.

Individual cases

Stressing that the Oireachtas decided to make the distinction that fatal abnormalities would be grounds for abortion but disability would not, Mr Varadkar said it would be inappropriate for him to comment on individual cases when he did not know the facts.

He told Ms Coppinger that she had previously raised an individual case, the facts of which turned out to be different from those she laid out on the floor of the House.

The Solidarity TD said it was not helpful for the Taoiseach to conflate fatal foetal abnormality with disability “when you know these conditions are very complex and interact with one another”.

There was a need to review the law sooner than the three year review set out in legislation. She claimed politicians “chickened out” on the citizens’ assembly recommendation that severe foetal abnormalities be included as well.

But the Taoiseach insisted that “we did not check out. We decided as a House,” that they would not allow disability to be grounds for termination after 12 weeks.

Mr Varadkar said that the service “may not be up to scratch for some women and patients now but we will see to it that it improves and evolves as it is developed”.

Guidelines

Edwards syndrome (Trisomy 18) is included in a non-exhaustive list of fatal foetal anomalies contained in the Institute of Obstetricians’ draft guidelines on terminations carried out for this reason.

Since this year, abortions can be carried out without restriction as to reason up to 12 weeks, but thereafter they are available only under a small number of specific categories.

The law on providing terminations in the case of fatal foetal anomalies is set out in Section 11 of the Health (Regulation of Termination of Pregnancy) Act 2018, passed by the Oireachtas last December.

This section, dealing with a “condition likely to lead to death of foetus”, states that a termination may be carried out where two medical practitioners, having examined a pregnant woman, “are of the reasonable opinion formed in good faith” that the foetus is affected by a condition that is likely to lead to its death either before, or within 28 days of, birth.

One of the two certifying medical practitioners has to be an obstetrician while the other is to have “a relevant speciality”.

Where a pregnant woman is refused a termination under any of the provisions of the Act, she has a right to seek a review of the doctors’ decision by the Health Service Executive.

The Institute’s guidelines say fatal foetal anomalies include diagnoses that are highly likely to lead to death in utero or within 28 days of birth “although for some of these diagnoses, survival beyond 28 days has been reported”.

“For these conditions, the diagnosis and prognosis are unequivocal.”

The guidelines state the list of fatal foetal anomalies “may include but are not limited” to 14 named conditions, including Trisomy 18.

Edwards/Trisomy 18 is a rare genetic condition caused by cells having an extra copy of chromosome 18.

Most babies with the syndrome will die before or shortly after being born. However, some with less severe types, such as mosaic or partial Trisomy 18, survive beyond a year and, very rarely, into early adulthood. They are likely to have severe physical and mental disabilities.