Fergal Bowers reporting for RTE, again.
The consulting obstetrician said there were system failures.
Dr Katherine Astbury said Mrs Halappanavar’s clinical signs were not checked every four hours after her membranes ruptured, which was a breach of hospital policy.
She told the inquest that when Mrs Halappanavar requested a termination from her on the morning of 23 October, she outlined the legal position to her.
She said that Mrs Halappanavar had told her she was finding it very upsetting and difficult given that the ultimate outcome would be that her baby would not survive.
Dr Astbury told her “in this country it is not legal to terminate a pregnancy on the grounds of poor prognosis for a foetus”.
Pause to rant. That is disgusting. It’s sick. The issue in this case is infection and death and failure to treat, but even if it were “only” a matter of refusing to hasten the end of a doomed pregnancy, that is disgusting. As I understand it the fetus’s chance of survival was closer to zero than a very small percentage, and why should the mother be punished by being forced to wait for the fetus to die inside her? It is sick.
She said it was her view that Mrs Halappanavar was emotionally disturbed, but not physically unwell.
She told Mr Halappanavar’s barrister, Eugene Gleeson, that she felt at the time the prospect of viability for the foetus was poor as opposed to being non-existent.
The phrase “inevitable miscarriage” had been recorded in medical notes by a colleague of Dr Astbury on 22 October.
Dr Astbury told Mr Gleeson that “the law in Ireland does not permit termination even if there is no prospect of viability”.
She said this was her understanding based on the X case judgment and Medical Council guidelines.
She told Mr Gleeson it did not occur to her to consult her colleagues about the legal position.
Dr Astbury said she did not see Mr Halappanavar or his wife on Monday 22 October after a scan detecting a foetal heartbeat was performed and that there was no formal request made to her for a termination on that day.
Great. Fantastic. They just shoved her in a corner to wait, then.
Dr Katherine Astbury agreed with coroner Dr Ciaran McLoughlin there were systems failure at the hospital in relation to the monitoring of Ms Halappanavar and the processing of blood tests.
Asked about her decision to refuse Ms Halappanavar’s request for a termination, she said that under Irish law there had to be a “real and substantial risk” to the life of the patient before this could happen.
Which there was. And if there hadn’t been – why does Irish law want to force women to take risks?
I know why; it’s because priests; but it’s necessary to spell this crap out. Irish law sees fit to make gradations of risk and to force women to take what Irish law considers “unreal and insubstantial” risk to their lives.
At the time of the request, Ms Halappanavar was well and a termination was not permitted because of a diagnosis of poor foetal prognosis.
Dr McLoughlin urged the witness to get away from the “emotive term” of termination, which evoked the killing of the foetus. This was not the intention of the Halappanavars, he said. Dr Astbury said that if a patient was given medication to deliver at the time when there was a foetal heartbeat, her understanding was that this was a termination.
Dr McLoughlin quoted from Medical Council guidelines on obstetric complications, which state that it may be necessary to intervene to protect the life of the mother while making every effort to save the baby’s life.
Asked if she felt she had scope to intervene under these guidelines, the witness said she didn’t believe she could. Her understanding was that these guidelines applied to situation where a mother had been diagnosed with cancer or another life-threatening illness not related to her pregnancy. In that situation, intervention would be justified, Dr Astbury said. The issue was that there was no law to tell someone what was permitted or not. It was a question of law.
What an incredible dog’s breakfast.