Religious Remark Confirmed in Irish Abortion Case

DUBLIN â€" A woman who died after being refused a potentially lifesaving abortion even while she was having a miscarriage was told that her repeated pleas could not be granted because Ireland is a Catholic country, an inquest has confirmed.

In a case that has reignited tensions over Ireland’s strict abortion laws, Ann Maria Burke, the midwife who attended to the pregnant woman, said at the inquest in Galway on Wednesday that the remark “had come out the wrong way” and that she had not meant it to be hurtful.

The pregnant woman, Savita Halappanavar, a dentist born in India, “had mentioned the Hindu faith and that in India a termination would be possible,” Ms. Burke said. “I was trying to be as broad and explanatory as I could. It was nothing to do with medical care at all.”

The state coroner, Dr. Ciaran McLoughlin, testified that public hospitals in Ireland were not bound by any religious dogma.

Dr. Halappanavar’s husband, Praveen, has said the couple were told that the country’s Catholicism was the reason for the refusal to terminate the pregnancy, even though his wife was in severe pain and they had been informed that the fetus had no chance of survival. In Ireland, abortion is legal when there is a fetal heartbeat only if there is “real and substantial risk” to the life of the woman.

Dr. Halappanavar, 31, was 17 weeks pregnant when she sought treatment at University Hospital Galway on Oct. 21, complaining of severe back pain. Dr. Katherine Astbury, a senior obstetrician who had attended to Dr. Halappanavar, said at the inquest that although the fetus’s prognosis was poor, she had refused to conduct a termination until the fetus’s heartbeat had ceased.

“I recall informing Ms. Halappanavar that the legal position did not permit me to terminate the pregnancy in her case at that time,” Dr. Astbury said, referring to a conversation they had on Oct. 23.

She also recalled telling Dr. Halappanavar, who she said was physically well at that point but emotionally distressed, that her only option was to “sit and wait” for as long as the heartbeat persisted.

When Dr. Halappanavar’s condition began to deteriorate rapidly soon after, Dr. Astbury considered performing an abortion regardless of the presence of a fetal heartbeat, she said. On Oct. 24 the heartbeat ceased and the remains of the fetus were surgically removed. But by that time, Dr. Halappanavar had contracted a bacterial blood disease, septicemia. She was admitted to intensive care but never recovered, dying on Oct. 28.

The inquest has also heard testimony that several hospital protocols were not followed, amounting to system failures that contributed to Dr. Halappanavar’s death. Dr. Astbury said she might have intervened sooner had she been made aware of the results of earlier blood tests. Instead, she relied on clinical signs, none of which pointed to sepsis.

Although limited abortion has been legal since a 1992 Supreme Court judgment, successive Irish governments have failed to introduce legislation giving the ruling full effect. Under pressure from the Council of Europe in Strasbourg, France, but in the face of stiff opposition from the anti-abortion lobby, the current government has promised to introduce such legislation by the end of the summer.

The inquest, which began Monday, is expected to last at least another week.