Last October, Savita Halappanavar died at University Hospital Galway in Ireland. She was a dentist with a popular practice in Galway, thirty-one years old, and seventeen weeks pregnant. Having woken up with back pain on Sunday, October 21, Savita went to the hospital and was found to be miscarrying. She requested an abortion, but the fetus still had a heartbeat so the hospital refused. The pain got worse, and for three days, she and her husband, Praveen, repeatedly requested termination of her pregnancy, to no avail. The fetal heartbeat finally stopped on Wednesday, and the abortion was done. But it was too late; Savita died of septicemia.
Praveen Halappanavar, an engineer at Boston Scientific in Galway, was angry, and he told the news media what had happened. He reported that one of the doctors had explained, when refusing the abortion: “This is a Catholic country.”
The blogger Dr. Jen Gunter, an ob-gyn, was precise about the medical realities: “As Ms. Halappanavar died of an infection, one that would have been brewing for several days if not longer, the fact that a termination was delayed for any reason is malpractice. Infection must always be suspected whenever preterm labor, premature rupture of the membranes, or advanced premature cervical dilation occurs (one of the scenarios that would have brought Ms. Halappanavar to the hospital).”
It’s strange. The doctors at University Hospital Galway must have known the same facts that Dr. Gunter knows. They must have known that the fetus couldn’t survive and that the mother was in danger, yet they refused to provide the standard of care. What could have been the point? Since refusal could not have saved the fetus, it appears that the point was to punish the woman—to throw away her life for the sake of a principle. But what is the principle—other than throwing away the woman’s life?
When the story hit the national newspapers on November 14, there was outrage. Protesters who organized on Twitter gathered outside the Dáil (Ireland’s national legislature) within hours. A larger rally, estimated to have attracted twenty thousand people, was held in Dublin a few days later, with other rallies taking place in Galway, Limerick, and elsewhere.
People outside Ireland were also horrified. The Irish Times reported on how shocked Americans were by what had happened: “The sad bewilderment among liberals here, when they heard the news of Savita Halappanavar’s death in a Galway hospital in October, is worse than any aggression. The thing is, Americans just can’t understand why surgical treatment for a miscarriage can be withheld from a woman on the grounds that the foetal heart is still beating, when medical staff have already agreed that the pregnancy has no chance of survival, as is claimed to have happened in this case. This is proving rather difficult to explain.”
Those who were so shocked and bewildered must not have been aware that the same thing can happen in the United States. They must not realize that Catholic hospitals here are tacitly allowed to set their own policies in this area, and that they can and do refuse to perform abortions even when the fetus can’t survive and the mother will die. Widespread outrage was directed at Ireland in the global news media, but there was barely any mention of the fact that the United States is no better in this regard.
The issue of abortion to save a mother when the fetus can’t survive was the center of the much-discussed case of St. Joseph’s Hospital in Phoenix, Arizona. In 2009, a twenty-seven-year-old mother of four entered that hospital eleven weeks pregnant and with pulmonary hypertension. Doctors determined that she needed an abortion to avoid death from heart failure, and a nun who was a senior administrator approved the termination. The bishop of Phoenix, Thomas Olmsted, excommunicated the nun as a result.
The bishop didn’t stop there. He also tried very hard to compel the administration of St. Joseph’s Hospital to agree never to do it again. Bishop Olmsted made that demand very explicitly in a letter to Catholic Healthcare West and St. Joseph’s Hospital dated November 22, 2010.
I now ask that CHW agree to the following requirements by Friday, December 17, 2010. Only if all of these items are agreed to, will I postpone any action against CHW and St. Joseph’s Hospital. Specifically, I require the following in order for me to postpone any further canonical action directed against St. Joseph’s Hospital:
1. CHW must acknowledge in writing that the medical procedure that resulted in the abortion at St. Josephs’ hospital was a violation of ERD 47, and so will never occur again at St. Joseph’s Hospital.
What is ERD 47 you wonder? Some law you’ve never heard of?
No. It’s section 47 of the Ethical and Religious Directives for Catholic Health Care Services issued by the U.S. Conference of Catholic Bishops. It’s a religious law, in other words, that the bishops want all Catholic hospitals to obey as if it were actual federal or state law.
ERD 47 says: “47. Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.” To the crassly secular mind, that looks as if it says abortion is permitted in certain cases, but no. The key is that phrase “direct purpose”—along with the interpretation that the only direct purpose of an abortion is the death of the fetus. If it is the pregnancy itself that is killing the mother, then—alas, we’re so sorry, it simply can’t be helped—abortion is not permitted.
So the U.S. Conference of Catholic Bishops firmly holds the view that a life-threatening condition caused by a pregnancy is not a sufficient reason to terminate that pregnancy, and it substitutes a religious ruling for a medical finding.
Fortunately, the administration at St. Joseph’s Hospital politely but firmly refused to obey the bishop’s order, and it was duly stripped of its Catholic status. But it is not safe to assume that all administrations of Catholic hospitals in the United States would do the same. The National Women’s Law Center issued a paper in January 2011—just a month after the bishop’s letter—titled “Below the Radar: Health Care Providers’ Religious Refusals Can Endanger Pregnant Women’s Lives and Health”—that describes many hospitals the bishop could be proud of.
We don’t know how many cases like Savita Halappanavar’s there have been in the United States, because they are indeed occurring under the radar.
Ophelia Benson is the editor of the website Butterflies and Wheels and the coauthor (with Jeremy Stangroom) of Does God Hate Women? (Continuum, 2009). The Dictionary of Fashionable Nonsense (Souvenir, 2004), and Why Truth Matters (Continuum, 2006).