As I understand it, whatever about the third world, the incidence of septicemia in or subsequent to miscarriage is very low in Ireland, which is partly why our maternal and child mortality rates are so low. It may also be why the medical team felt the "real and substantial risk to the life of the mother" standard wasn't met - until she actually did develop septicemia by which time (AFAIK, but I don't have a precise timeline) the foetus was already dead, but also by which time an abortion/womb evacuation/hysterectomy or other surgical procedure might only have increased the risks to her life.

The real issue here is that the current Constitutional standard in Ireland ("real and substantial risk to the life of the mother") is too high, and ANY risk to the life or health of the mother should have been taken into account - in which case an immediate abortion on admission would have been a no brainer, as the foetus had no chance of survival in any case.

It would require a Constitutional Amendment, by popular referendum, to change that standard. I don't sense any appetite, amongst the political parties, to go through the very bitter and divisive "right to life" Constitutional referenda campaigns of the 1980's all over again. The RC Church and "Pro-life" campaigns would attempt to spin any attempt to lower the Constitutional Standard (to real and substantial risk to the  Life OR Health of the mother) as tantamount to abortion on demand and point to statistics in the UK where, apparently, the justification of risk to the mental health of the mother is utterly routine and used in the vast majority of abortions.

I'm not sure, in that context, whether such a referendum would pass and it would be very unlikely to do so unless at least some of the major political parties campaigned actively and energetically in favour. They show little inclination to do so, and so  in that context I doubt such a referendum would pass.

Losing such a referendum could throw the the ongoing liberalization of Irish society into reverse and it might be at least another generation before women's rights to their own health and bodies were placed on a firmer Constitutional footing.

The bottom line is that Savita may have died because her medical team were justifiably reluctant to intervene aggressively and early enough in the context of current Irish law. It may sound callous (and it is), but the "Right to Life" movement will probably argue that one life lost in rare and exceptional circumstances is a small price to pay in the context of the thousands of "lives of unborn babies" that would be lost if Ireland were to introduce what they call abortion on demand on the British model.

A more winnable proposition, in the short term, for the pro-choice movement might be to argue that where the death of a foetus is inevitable, an abortion should be permissible if it would reduce ANY risk to the life or health of the mother. The "pro-life movement" will undoubtedly argue that this is a form of euthanasia and that it is open to abuse by doctors exclusively concerned about the health of the mother and who might be over eager to declare a threatened miscarriage unavoidable or a fetus unviable, and thus a foetal death inevitable.

However doctors generally, and maternity services more particularly, still have a very high standing and reputation in Ireland. Any attempt by the "Pro-life movement" to impugn the integrity of the profession would not go down well, and such a proposal would probably pass in parliament. What is not clear to me is whether it would require a Constitutional amendment to be passed. Any attempt by the Dail to legislate to that effect would probably be challenged as unconstitutional by the "pro-life" movement, and depending on how the Supreme Court ruled, a referendum might be necessary.

It might only be a small step forward for women's rights in Ireland, but at least it sounds to me like a winnable campaign and it would probably have saved Savita's life.

Index of Frank's Diaries