Dr. Máire Milner:

Let me take the final point, on suicide. There were several questions on suicidal ideation and the termination of pregnancy at very early, intermediate or late gestations. We were asked directly whether we had had such a case. Psychological and psychiatric problems are very common in obstetrics nowadays as life is tough for a lot of people. We deal all the time with mental health issues. A question was asked about psychiatric support and whether it was adequate. We do not just go to the psychiatrist for psychological or psychiatric support; it is inherent in what midwives and obstetricians do. All members of the team are involved in supporting women.

With regard to delivering in the circumstances in question, it would be common to induce labour a week or two before, or usually within the ambit of, full term. Occasionally, it is slightly earlier on the grounds of mental health. Suicidal ideation is probably more common than we think because most people contemplating suicide do not tell anyone this during pregnancy. As far as we know, however, it is very rare.

Personally, I have had one or two cases in which a woman was in a psychiatric hospital for a condition directly related to the pregnancy. One woman almost died on her first attempt at suicide, but it was never related to the question of terminating pregnancy. It never came up. She absolutely wanted to have her baby; it was the hormonal effect that was in question. The Bill is about the threat to the life of the mother by suicide or physical illness. It would be very rare, but, as with everything, one will see everything in one's practice if one lives long enough.

With regard to the comment made by Senator John Crown on what we are going to see, I do not believe we see anything different in our practices from what is seen in Dublin. We see fewer of the most difficult medical cases. We may not have as many women with congenital heart disease or who are having cancer treatment in pregnancy. We have a lower concentration, but we see the entire gambit. Often, as Dr. Monaghan says, what one must deal with is what turns up on a Sunday afternoon. We are not exactly in a different category; we are dealing with the same spectrum.

I have never referred to the United Kingdom from the point of view of worrying about a woman's medical condition, or in terms of having concerns for her future during the pregnancy. Personally, I have never had to do that, nor has it come into my ambit of practice.

On the question of where I can find clarity in the Bill, I am not a lawyer. I have simply read the heads of the Bill. In several situations in my career I had a worry at the back of my mind about a woman who was very sick with sepsis, in circumstances very similar to those in the Galway case, and I had hoped nature would deal with it. In fact, that is what happened, very happily. Nineteen times out of 20, nature does deal with things, but, unhappily, it does not always do so. For me, my patients and the staff on my team, the Bill gives my practice more clarity. I note this from having talked to my colleagues.

On the conscience clause, I again refer to the comments of all of my colleagues. First and foremost, we save the woman's life. We do not set out to terminate a pregnancy, but one does what has to be done to save the woman's life. There may be time to play with and one's conscience can come into that in some way. It is as likely to be one's skills as one's conscience that will come into play. As Dr. McCaffrey said earlier, if one does not feel one is able to deal with something, if one has time to play with one can refer to another colleague. The woman has a right to life, and that is the primary right. I have dealt with most of the questions.