Carol Hunt: Pregnancy does not protect us from suicide
Images of pregnant women being dragged, forcibly, into the cruel squalor of William's Blake's "dark satanic mills" kept entering my mind after watching TV3's abortion debate last Tuesday.
During it, we were twice cautioned (by William Binchy) about the inevitable arrival of "abortion mills" in Ireland if the X-Case was legislated for; the second time we were told that these terrifying creations would be places where "a well mother, with a well child" could avail of abortion.
For years groups like Amnesty Ireland, Aware, Console, Mental Health Ireland and Grow have worked tirelessly to make people understand that mental illness is a reality and that if not treated it can prove fatal. Recorded deaths by suicide in Ireland rose by 7 per cent last year (525 deaths as recorded in CSO statistics – the actual figures are probably much higher), proving to us that illnesses like depression can kill.
Yet there seems to be a commonly held belief that pregnancy is a protective mechanism against thoughts of suicide. This is despite the fact that many pregnant women who are suffering from a mental illness are often advised to stop taking their medication as it may harm the foetus (I know this from my own experience).
Last year a respected, objective, peer-reviewed report, one of the first of its size and breadth (Archives of Women's Mental Health), found that "pregnancy is not a protective factor against suicide ideation". A pregnant woman faces the same risk of death by suicide as a non-pregnant woman. In essence, to assert that a pregnant woman experiencing suicide ideation is actually "well" and therefore not entitled to a termination of her pregnancy is to dismiss and deny the reality and pain of mental trauma and the risk of death.
Firstly, we have no idea how many pregnant women die by suicide in Ireland. Many cases of what would seem like suicide are actually recorded as "open deaths" (such as the drowning of Anna Byrne, who was pregnant with twins and had suffered from depression).
Secondly, we do not know how many women's lives are saved by a traumatic visit to one of those aforementioned "abortion mills" in England and elsewhere on the European mainland. (Those who argue – against evidence – that women who undergo abortions suffer later suicide ideation tend to forget that post-natal depression is a very dangerous illness which can sometimes end in suicide, infanticide or both.)
Yet we are being asked to believe that a pregnant woman, suffering mental trauma and exhibiting signs of suicide ideation, should be classed as "well" purely for the purpose of denying her legal right to an abortion if she needs one?
Earlier on the TV3 debate, Breda O'Brien of the Iona Institute said that Fine Gael "didn't have a mandate to legislate for suicide as grounds for abortion" and, more worrying for those who believe we live in a republic, that "there is a higher court than the Court of Justice, and it is the court of conscience".
As a woman who has (a) been pregnant, and, (b) suffered from a serious mental illness, I would have to hold my hand up here and shout: "In all conscience, am I not entitled to the right to survive under Irish law?"
If a woman whose life is physically at risk through her pregnancy is entitled to an abortion under the law, then why, if I became pregnant and consequently suffered suicide ideation, would I not be entitled to an abortion also? Am I somehow a lesser person, with fewer rights, because my illness is mental and not physical? Should I be imprisoned in a "pregnancy mill" until I give birth, ensuring that no matter what my psychological trauma, I endure a pregnancy?
I ask these questions, not out of self-interest, but for all women currently in fear of their lives. In 2002, when Bertie's government tried to exclude suicide as a risk to the life of a pregnant woman, Dr Mary Favier of Doctors for Choice said that the referendum ignored the seriousness of mental health disorders – and the people agreed.
Since the X-Case there have been two attempts to remove the right of a woman to an abortion if her life, through death by suicide, is at risk. The first was the 12th amendment bill in 1992, the second the aforementioned 25th in 2002. Both were put to the people and both were rejected. How could Fine Gael need any more mandate than that?
There is hardly a town in Ireland which has not been touched by suicide. People know that the threat of lives being lost by suicide is only too real, and they are not prepared to play ideological games.
And thankfully, our Minister for Justice, Fine Gael's Alan Shatter, believes that suicide is a real risk to the life of a pregnant woman, saying on radio last week: "I would say to them [people listening], if it were their daughter or their niece or their wife who was threatening suicide and if psychiatrists fully accepted there was a very substantial risk of suicide, would they do nothing or would they ensure whatever action was necessary is taken to protect their lives?"
Minister Shatter insists that Ireland will remain a state with the narrowest of laws on abortion, even if legislation is introduced to include suicide in any consideration of risk to the mother's life.
Last week in a radio interview Dr Mary Favier said that until the 1983 referendum amendment is repealed, "we will not be able to legislate in any circumstances to protect women who have been raped or who are pregnant as the result of incest".
So, inevitably, there will be women who may be forced to attempt to persuade a psychiatrist that their life is at risk.
I've said before in this column that "if I were the mother of a recently raped and now pregnant teenager, I'd be first up to have a chat with her doctor and insist she was suicidal if it meant she didn't have to travel to another jurisdiction". Which is why, though legislation is vital at present to protect lives, eventually we will have to take responsibility for the health and welfare of Irishwomen – for the many thoUsands of "well women" who are forced to travel abroad, never mind the frailty of their physical or mental health – and repeal the 1983 amendment.