Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I move motion 3:

That the Committee recommend that termination of pregnancy be lawful where the life or health of the woman is at risk and that a distinction should not be drawn between the physical and mental health of the woman. Provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation – any assessment in relation to the termination of pregnancy where the life or the health of the woman is at risk be made by no fewer than two specialist physicians.

I would like to explain the genesis of this motion. As a committee, we were tasked with looking at the recommendations of the Citizens' Assembly. Some 72% of members of the assembly voted to recommend that "a distinction should not be drawn between the physical and mental health of the woman". That is why this motion mentions physical and mental health. I understand that termination of pregnancy where the life of the woman is at risk was dealt with in the Protection of Life During Pregnancy Act 2013. This motion seeks to bring everything together. I realise that members have concerns about health risks. We heard extensively at this committee about individual cases in which the level of risk can be very low in the morning, but the woman's life can be in danger by the evening. In order to deal with that, this motion provides that where the life or the health of the woman is at risk, this determination shall be made by no fewer than two specialist physicians. The 2013 Act provides for a determination to be made by two or three physicians. This committee has not heard of any case that has happened up to now in which a second or third physician has not been available to sign off on it.

I promise I will not go on all day. It is important for members to understand what we mean by risk to the health of the woman. Severe hypertension - blood pressure - can be difficult to control in the case of a pregnant woman. It is often the case that when high blood pressure kicks in around the 20th or 22nd week, it gets to a point where the only way to rectify the problem is to deliver the child. Severe hypertension, which is difficult to control, is often associated with kidney disease in the woman that is likely to deteriorate in pregnancy. The outcome for the woman in such circumstances is often a stroke.

I would like members to think of a woman who has one, two or three children at home - I have three at home - and is going to have a fourth child, but who has hypertension at 23 weeks and faces the possibility of being rendered disabled and unable to communicate for the rest of her young life. Often, diabetes can be more difficult to control during pregnancy. There are also clotting disorders. On its own, a clot in a leg is not a major problem, but if it becomes a pulmonary embolism, that is, a clot in the lung, it can pose a serious risk of stroke during the pregnancy if the pregnancy is not terminated.

Members may have concerns regarding gestational time limits. The motion reads: "Provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation". I cannot understand how anyone could have any issue with that, given that the Royal College of Obstetricians and Gynaecologists comprises the experts in this field.

Generally, the issue of gestational age limits only applies to late diagnoses of foetal abnormality, for example, anencephaly, due to scanning being unavailable, which we have addressed in the ancillary recommendations. If viability is reached, it is not regarded as an abortion, but a pre-term delivery. Doctors always make every effort to save the baby's life. Viability now sits at approximately 23 weeks. Although survival rates are low at that gestational level and disability rates in survivors are high, we have maintained the lives of people born at 23 weeks.

I wish to reassure members that the health risk to the mother would be defined by two doctors and the gestational limits would be set by the doctors' governing or ethical bodies.