Good evening everyone!
My name is Fionán Donohoe. I am a
Gorey man – born and raised – and I’d like to thank the organisers of tonights
event for the opportunity to address you all on this very important topic.
I am here representing a group
called Doctors for Choice. This is a large group of doctors from all over the
country who are advocating a Yes vote in the forthcoming referendum on behalf
of ourselves and our patients.
I am a doctor in the field of
Obstetrics & Gynaecology, this means I spend between 50 and 80 hours each
week looking after women who are pregnant, in labour, have recently had a baby
or are faced with issues like miscarriage or ectopic pregnancy. I deliver
babies, I perform caesarean sections, I deal with emergencies for mothers and
for babies. It is an extremely rewarding, sometimes stressful and oftentimes
strange job – there is tonnes of good news and happy times with the safe
arrival of new lives and also times of unimaginable sadness and crisis. It is
all these experiences that have informed my decision to advocate for a Yes vote
in favour of repealing the 8th Amendment.
As we know, the current situation
means that an abortion is only permissible if there is a real and substantial
threat to the mother’s life from physical disease or suicide. This arrangement
fails to provide compassionate care to women in our country on multiple levels.
I know because I have met these women.
We have heard so many times
throughout this campaign from brave families who have shared their stories of
pregnancies affected by fatal fetal abnormalities/life limiting conditions. These
are conditions which mean the baby may die in the womb, during labour or
shortly after birth. These are stories which they should never have had to
share. I challenge anyone to listen to the stories of these women and not see
how the 8th amendment needs to be repealed. Removing the 8th
amendment will not make termination in these cases mandatory but it will allow
those families who wish to end their or their baby’s suffering, access care in
their own country surrounded by their own support network without incurring
financial, logistical costs around burial or funeral of their longed for infant
in addition to the emotional toll this must take. We have heard from one of
these everyday heroes already this evening.
Another cohort of Irish women
that the 8th amendment fails is those who find themselves pregnant
after rape or incest. The vast majority of people support access to abortion
for these women. If we are to be able to legislate for abortion for these women
then the 8th amendment must be repealed. However, difficulties arise
around ‘proving’ that sexual assault took place. Dr. Maeve Eogan, Clinical
Director of the Sexual Assault Treatment Unit at the Rotunda Hospital in Dublin
and director of SATU services nationally has told us that no single physical
finding when you examine someone after sexual assault proves rape. And as we
have seen in recent media reporting, proving that rape happened or didn’t
happen requires a long arduous confrontational process through the courts. On a
humane level, should someone who is a victim of these most terrible crimes be
required by law to relate the details of this heinous crime to a complete
stranger in order to ‘deserve’ a termination? That is not compassion, that is
compounding the trauma of the assault.
The proposed legislation to
replace the 8th amendment includes the open access to
abortion up until 12 weeks to give these women time to consider their options
and access safe care should they CHOOSE abortion because once again this will
not make abortion in these cases mandatory.
The 8th amendment also
has a massive negative impact on women with complex medical conditions for whom
pregnancy may pose a threat to their health. Cystic fibrosis is an example of
one such condition which effects women of childbearing age and depending on the
severity of the disease, pregnancy may pose a risk to that woman’s life and her
health. Indeed, I have looked after patients who have not made it through the
pregnancy because of complications of their condition which were worsened by
the pregnancy. They and their baby have died. Some of these patients
desperately wanted to be pregnant and we do everything in our power to support
them and keep them well throughout the pregnancy but those who have not wanted
to be pregnant have no choice but to continue the pregnancy and run the risk of
deterioration in their health unless they have the means to travel.
The current legislation means
that the risk to this woman’s life must be ‘real and substantial’. Doctors must
decide how sick is sick enough to permit termination of the pregnancy. This is
a grey area and completely ignores the fact that pregnancy may negatively
effect the woman’s overall health in the longer term also. That is to say that
the pregnancy may not kill the woman, but it may seriously disimprove her
health so as to leave her in worse condition afterwards and into the longer
term while trying to care for a newborn. As a society and as doctors, we are
encouraged to promote healthy behaviours for people, take exercise, lose
weight, stop smoking. For women with complex medical conditions, avoiding
pregnancy and having access to termination may be even more important than some
of these measures.
Doctors are trained to be
proactive and the saying that prevention is the best cure most definitely
applies in medicine. The 8th Amendment means that we must wait until
the woman is at ‘real and substantial’ risk of dying before we can intervene to
end the pregnancy. In no other field of modern medicine is this acceptable.
Since the death of Savita Halapannavar, patients have asked us fearfully if the
same thing that happened to Savita is happening to them, they have asked how
high does my temperature have to be before you can act? Can you imagine being
in that position at a vulnerable time when your much longed for pregnancy has
become much more complicated than you ever wanted it to be, to have to wait til
you yourself were at risk of dying? The right to life of the baby inside you
who’s chances of survival are extremely remote trumps your own right to life.
It is mind boggling.
This open access to
abortion up until 12 weeks gestation I think is a stumbling block for a lot of
people. They support access to abortion for fatal fetal abnormalities and in
cases of rape and incest but find it difficult to accept the unrestricted
access aspect of the proposed legislation. To anyone listening to this who
feels this way I ask them to ask themselves how many weeks would you feel
comfortable with? Most people will only realise they’re pregnant by 5 or 6
weeks and if the cut off is any earlier this may force them to make a rushed
decision which may not be right for them if given more time to consider. The
first 12 weeks of pregnancy are collectively called the first trimester and
abortion performed during this time is associated with fewer complications and
is safer. As I have mentioned already, the 12 weeks gives victims of sexual
violence a reasonable window of opportunity to decide what they wish to do.
I graduated medical school full
of optimism. I was going to be the best doctor in the world. All my patients
were going to follow my advice and treatment plans and get better and it was
all going to be wonderful. Quickly I realised that life is not that simple.
People will always do things that we would rather they didn’t. They do things
that you know you would never do if you were in that position. Women who are
addicted to heroin become pregnant and we deal with the complications for
pregnancy for mother and baby that comes with this, we help and support them
through the pregnancy. Women smoke during pregnancy and we deal with that, we
try to help them to quit and if they don’t we deal with the fall out that can
have on the pregnancy. I may not agree with these women’s choices but I don’t
refuse to look after them because I don’t agree with them. Women already access
termination of pregnancy in Ireland, whether that be by travelling to other
countries if they can afford it or by ordering medications online and taking
them unsupervised. Whether we like it or not abortion already exists in Ireland.
On May 25th we have an opportunity to face up to that fact and
provide compassion and care for women when they need it the most.
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