Dr. Rhona Mahony:

Similarly, in regard to fatal foetal abnormality and danger for women, there are the medical disorders, such as preeclampsia, as discussed, but there can also be significant surgical complication. I cited the example of a case of conjoined twins where, if this pregnancy goes to term and significant organs are shared, there is no prospect of survival for the conjoined twins but in order to deliver them, there is great technical difficulty and very complicated surgery which can create a high risk indeed for a patient.

In terms of travelling, we diagnose approximately 400 foetal anomalies a year in the National Maternity Hospital and approximately 60 women travel. A lot of women would choose not to travel. Among those 400, there will be anomalies that are less severe, for example, a number of heart issues, that are amenable to treatment and to surgery. That is why we work so hard to pick up an anomaly so that we can offer the best possible care to babies when they are born because that can really improve outcome.

Of the 60 women who travel, they tended to be chromosomal and genetic anomalies. They tended to be neural tube defects, cranial abnormalities and complex heart abnormalities. They tended to have abnormalities that were at the very severe end of the spectrum indeed.

In regard to criminalisation and reluctance of clinicians to participate, women should be very much reassured in the first instance that when it comes to a risk to a woman's life we will do all that we can to save her life.

That is normal obstetric practice. We will always endeavour to save a woman's life, and that is really important. There are underlying maternal conditions that do create a very high risk in pregnancy, for example, portal hypertension, very advanced cystic fibrosis where there is very reduced lung function, some congenital heart disease, some cancers and some very complex haematological disorders. There will be very rare disorders as well of which we have limited experience but there is no doubt that there are underlying maternal diseases, and when the physiological burden of pregnancy is added to them, it creates substantial risk for women.