WOULD Savita Halappanavar still be alive if we had legislated for the X case?
The draft report released by the HSE does not make for easy reading for anyone who has given birth in this country – or for anyone contemplating it.
For the majority of us who have had babies in safety – until recently blissfully unaware that this kind of situation can happen in this century in an Irish hospital – the details are horrifying.
But behind the justifiable public anger at the death of this lovely young woman – and the understandable public concern at the clarity of our laws surrounding abortion – lie the quieter questions that may not grab the headlines in the same way but are perhaps all the more urgent because of that.
On admission to hospital on Sunday, October 21, Savita was told a miscarriage was inevitable, infection the likely cause.
It is unusual for staff to be able to ascertain the cause of any miscarriage at such an early stage, so the fact that "infection" was so pinpointed should surely have sounded alarm bells.
Yet a doctor had decided that evening that it was "too late to stitch the cervix to prevent a miscarriage" and instead Savita and her husband, Praveen, were told to "await events".
The next three days saw matters escalate. By Tuesday, the young woman, in growing agony, was begging for a termination.
Staff noted that her temperature had spiked on Wednesday morning and bacterial infection was identified that same day.
Savita's death was not yet inevitable. Though rare, septic miscarriage happens. It is discovered, the pregnancy is induced and the woman is rushed to intensive care. But this did not happen in Savita's case. It was not until Wednesday that medical staff conceded sepsis was "probable".
The report found a "lack of knowledge" among staff about quick-fire diagnosis of sepsis/blood poisoning.
Her condition progressed from sepsis to septic shock which the draft report described as "like falling from a cliff".
The report points to a litany of errors, of signs missed. It speaks of doctors too busy caring for other patients to deal with Savita; of a "difference in the recollection" of a phone conversation between a junior doctor and a registrar discussing her rising temperature; and of blood tests that were never followed up.
Staff should have considered performing an abortion even before the couple requested it, the report says.
Added to this catalogue of errors was a situation where doctors were unsure about their legal guidelines and felt their "hands were tied."
The report say the absence of legislation in which abortions can be carried out was a "contributory factor".
But in a situation where Savita slipped further into danger while doctors apparently never realised, how could legislation possibly have saved her?