Joan Collins (Dublin South Central, People Before Profit Alliance) | Oireachtas source

This is the fourth report and yet again it states what we know needs to be done: we must legislate for abortion. Article 40.3.3° is clear on that basis. The dogs in the street know that needs to be done but we are still waiting for the smallest door to be pushed open to secure the right of a woman to have an abortion when her life is threatened up to the point of suicide. The report once again makes the point that legislation is required to give effect to the rights of women under Article 40.3.3°.

There are two issues - the Supreme Court judgment on the X case, and the European Court of Human Rights judgment on the A, B and C v. Ireland case - that place an obligation on the State to plan for the five main points in the report. It must provide effective and accessible procedures to establish a woman's right to an abortion as well as access to treatment, which means facilities must be provided; establish criteria or procedures in legislation or otherwise for determining risk; make provision for the criteria by which a doctor is to assess that risk; and set up an efficient, independent review system where a patient disputes her doctor's refusal to certify that she is entitled to a lawful abortion or where there is a disagreement with her doctor as to whether the treatment is necessary.

The Bill we introduced last week generally covered those points. As Deputy Daly said, if this legislation is not introduced in the new year, we will have no problem reintroducing our Bill to the House.

The last point is to address sections 58 and 59 of the Offences against the Person Act 1861. They have been discussed at length in society in recent years in regard to legislating for the X case. The only way to do this is to provide the legislation, possibly with regulations to back it up, as recommended in the report.

I want to deal with some of the arguments that I believe we will hear, including that Ireland is the safest place to give birth. This has nothing to do with the debate on abortion. The argument is irrelevant because the level of these deaths is extremely low in advanced capitalist economies. Last week The Irish Times health section contained a very good report. It stated:

Ireland, we have been told over recent weeks, is one of the safest countries in the world to be pregnant and have a baby. According to figures from the Central Statistics Office (CSO) for 2009, there were four maternal deaths per 100,000 live and still births.

However, experts here now say that figure is an underestimate and the rate is double that.

The World Health Organisation (WHO) defines a maternal death as: “The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”

According to figures in the Confidential Maternal Death Enquiry (MDE) in Ireland, Report for the Triennium 2009–2011, the maternal death rate here is eight per 100,000. Dr Michael O’Hare, consultant obstetrician at Daisy Hill hospital in Newry, Co Tyrone and chairman of the Maternal Death Enquiry group, says the higher rate comes from far more thorough data gathering than that gleaned solely from the civil register of deaths.

That figure can be compared with other countries in favourable and unfavourable conditions. The Irish figures compare favourably with Britain, which had a death rate of 11 per 100,000 births between 2006 and 2008, though not as well as with Norway which had seven maternal deaths per 100,000 births, or Sweden which had five maternal deaths per 100,000. These countries have different levels of abortion access. Some countries have abortion on request and other areas are somewhat more restrictive. I believe that contradicts the argument about Ireland being the safest place as measured by maternal deaths and using that as a reason not to have real discussion and debate, and bring in laws on abortion.

I dealt with the issue of suicide last week, but it is important to continue to make the point. The anti-abortion side of the argument is trying to make an issue of suicide and abortion, and it is deliberately trying to distract the discussion away from the real issue. Speaking on radio last week Anthony McCarthy, one of the country's most prestigious perinatal psychiatrists, made the point that while the risk of suicide is small, it is nonetheless real and must be addressed. This is also the view of the other two perinatal psychiatrists. This is a very important point to make because the idea that suicide is not an issue is ridiculous. It is a real issue and one that people face every day unfortunately.

There is also an attempt by the anti-abortion lobby to mislead by arguing that abortion is a contributor to mental health problems. This has nothing to do with this issue. Last year, the Academy of Medical Royal Colleges in the UK undertook a comprehensive review and the key conclusion was that the mental health outcomes for women who have an abortion are the same as for those women who go on to have a baby. All those arguments are thrown in to distract from the real discussion, which is that the Government must legislate for the X case very quickly. There is evidence that suicide is associated with unwanted pregnancies where abortion is not available.

The point was made that people's views in the debate on abortion have changed and I agree. A recent RED C poll indicated that 85% of those polled said that legislation must be introduced to deal with a threat to the life of the mother up to and including suicide, as was proposed by Mr. Justice McCarthy following the X case. The Government must now legislate. It is no longer the privilege of Government to ignore the right of a woman in such a situation to have legislation allowing her to discuss the matter with her doctor and come to a conclusion that an abortion must take place.

Some 83% of those polled said that there should be access to abortion for women who became pregnant as a result of rape or incest. The report of the expert group does not really deal with this aspect. It does not really deal with the C case issue - A and B are not really part of the discussion from the point of view of the expert group. We must broaden the scope, which can only be done by repealing the Eighth Amendment to the Constitution. The Government must face up to that. If we go back to Europe claiming we are dealing with these issues, we need to outline concrete steps as to how we will enact this and we must repeal the Eighth Amendment to the Constitution. We must repeal the horrendous 1861 Act. As I said last week, in India that Act was repealed in 1971. One of the first things the Government must do is take that absolutely chilling legislation out of our laws.

We have heard of many cases of women who had fatal foetal abnormalities and they are not included in regard to having access to abortion here. These women are still travelling to Britain in terrible and traumatic conditions. I wish to read an e-mail I received from a woman:

Sunday the 2nd of December 2012 it will be one year to the day since I delivered my baby girl Aoife stillborn, after finding out 3 weeks before that she had a terminal genetic condition called Edwards Syndrome and would not survive outside the womb.

I was, and in ways I still am, devastated. I miss her every day, and I probably always will. Upon being given the news at 22 weeks in to my pregnancy, myself and my husband made the excruciating difficult decision to end the pregnancy early.

For us, it was the most humane and sanest choice, as I could not have functioned, knowing of her condition, spending every second of every day wondering if she had died inside me.

Nor could I see any kindness in bringing her into the world to watch her suffer massive organ failure and die in front of our eyes. I would not put my baby through that.

This is a decision we should have been able to make in private, with the support of a medical team in Ireland.

But to do what we thought was best for our family and for our darling girl, we had to travel to Liverpool Women's Hospital, where we were treated with such kindness and compassion, it may be the only thing that saved my sanity. I felt, and still feel, so hurt and frustrated that this situation continues, and unless cases like ours our considered along with the X case and ECHR judgements, this will continue to happen to several couples per week.

As a public representative, your laws added such unnecessary pain to what was already the worst time of myself and my husband lives. Why? To what end?

Our darling daughter, that we longed for more than any anyone else on this planet, was never going to live. Yet we still found ourselves falling under Ireland's 'abortion laws'.

This needs to change now.

Please, do not forget about cases of fatal foetal conditions, when you are considering action on termination of pregnancy in the coming weeks.

This is a matter we must address. We need to show responsibility and take on board the situations in which these women find themselves every day of the week. The RED C poll indicated that 36% of people are fully pro-choice regarding accessing abortion in Ireland. I cannot understand the hypocrisy of people saying they do not want abortion in Ireland. If they felt that strongly they would be calling for a repeal of the laws on access to information and travel. It is absolutely hypocritical for people for say we do not have abortion in Ireland because we send it away. This debate must widen and we must be serious, responsible and mature. I believe the people have done that.

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