Professor Fergal Malone:

With regard to the Deputy's last point on decision making between the woman and the doctor, we want to preserve that as much as possible. I do not know of any other aspect of medicine - for instance, an oncologist sitting with a patient who is dying from cancer and his or her family - where they must involve outside agencies or legalities in the decision on when to stop offering further care. In paediatric care, when an unfortunate baby in the neo-natal intensive care unit is dying from prematurity, the paediatrician, the neonatologist and the family speak to each other, rationalise what is going on and together make a decision on when to withdraw care. That does not involve external agencies or any legal impediment. It is a common sense doctor-patient relationship and we want to do whatever we can to preserve it. Yet, in this aspect of foetal care there is an external force or cloud hanging over what can or cannot be done.

The Deputy asked about the terms "miscarriage" and "stillbirth". Traditionally, miscarriage is the loss of a pregnancy before viability at 24 weeks or 500 g. Stillbirth is the term beyond that. It is for that reason many obstetricians say and families decide not to tell other people that they are pregnant until after 12 weeks. It is because most spontaneous miscarriages will reveal themselves by then.

The Deputy asked for a percentage. About 30% to 40% of all human conceptions will end in a miscarriage. If the patient reaches 12 weeks, they can generally be very confident that at that stage it is highly unlikely to be a miscarriage. The Deputy asked how that is recorded. It is simply recorded as a miscarriage; that is the term we would use.