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Juliet Bressan is a GP working in Dublin City Centre.
Like most doctors who trained in Ireland, I had no idea how many women in Ireland need abortions, nor how to look after these patients, until I started working in General Practice. Because abortion is illegal here, medical students and trainee doctors are lead to believe that we don't need to know anything about these mysterious matters, which concern fallen women who are not the concern of good doctors. Until 1992, abortion wasn't even discussed in the media, other than to reinterate the belief that all abortions are evil, and that women must be prevented from succumbing to aborting pregnancies at all costs. The x-case changed all that.
I think that despite the national hegemony, I was always pro-choice on abortion, because I knew how very few choices women have in life in general, and that being able to choose whether or not to be pregnant is so fundamental to women's right to life. When I started to work as a doctor, I came across increasing numbers of women who are going for abortions. Some young, some older, many married, most were in relationships, many had serious health issues, many had had several children already. I also came across women in hospital who had abortions here in Ireland because their pregnancy was making them so ill. The doctors and nurses who did these abortions are brave and ethical practitioners, who know how to put a patients life before the idiocy of the law.
What is consistent about Irish women who go for abortions is their bravery, and their determination. All of the women who travel to England do so at extreme personal sacrifice, telling lies, spending money they don't have, hiding post-op pain, hiding their guilt and covering up their tracks when they get back. Most women don't take time off work, they put their own health at risk by traveling post-op, and all Irish women have to have late abortions, and abortions under general anaesthetic. Irish women are all sent home on antibiotics, because of the risk of the surgery involved. If abortion were legal here, we could offer abortions at six weeks, with the abortion pill only. The abortion pill, in fact, works to provide a safe aboriton for up to 20 weeks. We could do abortions up to 12 weeks, when there is no foetus yet developed, under a local anaesthetic and a manual procedure, at the level of a GP surgery, which is what doctors in Holland are doing. But because of the law here, all of the women have to go to much greater medical risk, as well as social misery. This is what I find to be medically unethical.
For younger women, matters are easier since the x-case, because society is now more open, and they do feel increasingly that they can seek medical advice before traveling, or talk matters over with their friends. The abortion counselling services here, such as the IFPA, are a very important help to GPs, who are often very isolated in providing medical advice to abortion patients. But doctors do need to be able to refer patients to local services, especially where there is foetal malformation, psychiatric illness, physical illness, or where the pregnant woman is herself still a child. To only be able to provide abortion abroad is just medically unacceptable.
The current proposed amendment is medically unethical, as every doctor knows. It specifically legislates to ban abortion for women with psychiatric illness, allowing abortion only to women who are already dying. No doctor would be able to operate under this law, without losing patients, and the danger of the anti-abortion law here has been proven time and time again, in the x-case where a 14 year old almost killed herself, in the C-case where a 13 year old almost killed herself, in the Waterford case where a dead woman was put on a life support machine against the will of her husband, and in the case of Anne Lovet who died during a self-induced abortion in a field in County Longford. Because of the ban on abortion, infanticide is still a regular event in Ireland. What will happen if the amendment is passed, is that women at suicidal risk, who can't travel, will go ahead and kill themselves. No doctor could stand over that.
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