Pregnancy, risk and magic heartbeats: A post about abortion and life

Eight years ago my partner and I became addicted to “gritty hospital drama” Bodies. Set in the obstetrics and gynaecology department of a fictional UK hospital, the series tracks the moral descent of registrar Rob Lake, who becomes aware that his superior is bungling procedures and maiming the women he treats. Two years after watching the series I became pregnant for the first time and tried to forget I’d ever seen it. Of course, I knew that real life wasn’t like that. Your average registrar isn’t as fit as Max Beesley, for starters, plus you’d hope your average consultant wasn’t as incompetent as Patrick Baladi’s Mr Hurley. All the same, things can go wrong, just like on TV, and just like on TV, sometimes all you can do is watch.

I enjoy being pregnant, but I’ve always feared it, too. As a pregnant woman so much is beyond your control. You might appear powerful – a life creator – yet what happens is never an act of will. It is an act of waiting, enduring and hoping. After losing my first pregnancy – probably before the first heartbeat – I longed to jump start the next one into being. Yet you can’t manipulate the darkness inside your belly; all you can do is wait and see. The spark will light or it won’t and even then neither of you are safe.

My recent family history offers its own Bodies-style narratives: three miscarriages followed by a stillbirth; one baby starved of oxygen at birth, leading to lifelong disability; another infant dying two days after arrival, his neck broken by the over-enthusiastic use of forceps. Suffice it to say that I was pretty bloody terrified of the miracle of childbirth and yet for some reason, all went well when each of my sons was born. Unlike several of my friends, cut open by emergency caesareans or left with third degree tears, I was left relatively unscathed. I don’t know why. Raspberry leaf tea? Perineal massage? I suspect it was merely luck.

And yet despite all this, pregnancy – risky, unpredictable, routinely ending in pain and disappointment – still maintains its mystique. We know miscarriage is common, but we prefer to keep it hidden, encouraging pregnant women not to go public until the most risky period has passed. We downplay the physical and mental cost of continuing with a pregnancy, especially if it is unwanted – the worst one experiences is inconvenience, nothing more. Perhaps much of this is down to a desire not to frighten pregnant women (who are in any case persuaded to worry about things they can’t control).  All the same, we promote a lie, and it’s one that can harm us.

In the case of Savita Halappanavar, who died following several days during which doctors refused to terminate a doomed pregnancy due to the persistence of a fetal heartbeat, there will be people who see what occurred as an unhappy accident. While abortion is permitted in Ireland if there is a “real and substantive threat” to a pregnant woman’s life, some will argue that this risk was impossible to assess. Dr Ruth Cullen of the Pro Life Campaign finds it “deplorable that those who want to see abortion available [in Ireland] are exploiting Mrs Halappanavar’s tragic death”, while the group Youth Defence claim that “according to the information that is available […] a delay in administering antibiotics may have been the cause of the septicaemia which tragically led to her death” (while I don’t even have GCSE biology, I am pretty certain that scepticaemia is not the natural outcome of not being administered antibiotics).

At the risk of cynically exploit tragedy in order to argue against further tragedy occurring, it seems clear to me is that what happened to Halappanavar could have happened to anyone (anyone with an occupied uterus, that is) in an anti-choice country. It’s the fetishisation of the fetus, the hopeless investment in the heartbeat, the mystical reading of the runes. Doctors knew that Halappanavar’s fetus would not survive yet refused to remove it from her body, despite her suffering. Regardless of whether you view a 17-week fetus as a person – and why shouldn’t one? – this was not a finely balanced situation. It was not a situation involving two separate individuals, one in dire distress, the other increasingly so. It was a pregnancy – messy, unpredictable, physically costly – and it involved a very specific relationship, one which necessarily involved risk and compromise on the part of the gravida. In such a situation the heartbeat can mean everything, but it can also count for nothing.

Pregnancy can be the happiest time of your life – as it first seemed to be for Halappanavar – but even with the best medical support available, you are not necessarily safe. There is no magic ring of protection in place simply because babies are lovely and life is miraculous. When you are pregnant, you need to know that people are on your side. That they will listen beyond the heartbeat, discard the myths and do what is right and humane. Whether or not Halappanavar could have been saved, it is especially tragic that she died knowing others were unwilling to do this for her.

8 thoughts on “Pregnancy, risk and magic heartbeats: A post about abortion and life

  1. There was a heartbeat – it was Savita’s. But in a culture in which “the unborn” are sacrosant while living, breathing women and their bodies are so disregarded, it didn’t count.
    The medics who left her to die after three days of agony should face manslaughter charges, at the very least.

  2. Agree with the sentiment and much of the opinion in this blog. I do feel it correct to point out that scepticaemia is an absolutely inevitable consequence of being denied antibiotics, if you should have a severe bacterial infection e.g. bacterial meningitus or necrosis following an injury or operation. Not familiar that facts of this case though

    1. That framing seems to imply that it’s the “inevitable result” if no other treatment is offered, in the circumstances leading to the presence of said infection in the first place.

  3. One OBGYN has been quoted comparing a fully dilated cervix to an open wound.
    Given that, if I, in my past as a Naval Paramedic, had a girl at sea presenting with miscarriage- and I couldn’t land her straightaway- I would CERTAINLY be administering by IV (prophylactically) appropriate antibiotics.
    So it strikes me as frankly odd that,heartbeat notwithstanding, this didn’t happen.
    As Irish law allows any lifesaving,non directly abortive(inc chemo)treatment to save a pregnant woman’s life–even if there’s a risk it causes miscarriage.
    So — if the Drs were ignorant of this law they were negligent.
    And if they were petrified of a foetal heartbeat they were cowardly.
    As its said in the medical world…
    If something behind a curtain whinnys and has hooves, its most likely a horse, not a zebra.
    And this doesn’t need to whinny to make me think its malpractice.

    1. It may well be that the medics concerned need to be fired, struck off, and dragged through Eyre Square on a hurdle, depending on what the assorted inquires into the facts determine; but the issues here manifestly go beyond whether antibiotics were administered in a timely or appropriate manner. The family assert that they requested a termination, and were refused this (in seemingly fairly offensive terms, and apparently without any note of this request having been made). If the circumstances are anywhere close to what’s been reported (not just dilated cervix, but ruptured membranes and leaking amniotic fluid), best medical practice seems to be to do just that.

      It’s actually far from clear what Irish law allows. There’s no legislation for the X Case judgement, so essentially anyone relying on that is attempting to play staffroom lawyer. Relying on pre-1983 law risks reinterpretation or challenge in light of the 8th Amendment. The IMC’s guidelines are just some vague waffly aspirations on the back of an envelop. Actual practice has been reported to rely on copious nods and winks. To which of those standards should we be expecting the doctors to adhere?

  4. I need to to thank you for this great read!! I certainly enjoyed every
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