Midwife told Savita refusal of termination was “a Catholic thing”, inquest hears

A MIDWIFE at Galway hospital told Savita and a close friend that they could not perform a termination of the foetus because it was "a Catholic thing".

Mrudula Vasealli, a close friend of Savita's had been by her side on Tuesday, October 23 several after she was admitted to hospital, while Savtia's husband Praveen left to bring his wife's parents to the airport.

Mrs Vasealli told the inquest that Savita had been told there was no way the baby could survive but could not bear to watch the foetal heartbeat while she waited for it to stop.

"She cried 'What kind of a mother am I waiting for my baby to stop it's foetal heartbeat'," recalled Mrs Vasealli.

The inquest heard that both Savita and Mrs Vasealli had asked the midwife was it possible to save the baby as it still had a heartbeat after three days. Savita told the midwife that she could not take the waiting for the baby to die.

The midwife checked with the consultant if a stitch could be performed but returned and told Savita this was not possible because the membrane had bulged.

Savita then asked if there was any way the heartbeat could be stopped as the baby could not be saved but was told; "We don't do that here dear it's a Catholic thing", according to Mrs Vasealli.

Savita replied; "I understand you can't do anything but I can't stay like this."

Mrs Vasealli described the midwife in question as tall, with a big built and short light hair and having been in her late fifties.

Coroner Ciaran McLoughlin asked if the midwife in question could be named. However, he was informed that because of the description of a woman simply as dressed in blue it was difficult to ascertain for certain who the person was.

After a brief break, Declan Buckley Senior Counsel for the HSE said he believed from the description that the person was a clinical midwife manager as opposed to a midwife. He told the inquest that the Clinical Midwife Manager on duty that day was Annemaria Burke, accompanied by student midwife Elaine Finucane.

Both had made statements to the coroner, but neither refer to that statement "it's a Catholic thing" having been made.

Neither woman was due to be called as a witness but Dr McLoughlin requested that Ms Burke be called if possible.

Mrs Vasealli received a text from Savita that Tuesday evening thanking her for being a good friend. She rang her back urging her to come back home. That was the last time the pair spoke.

Speaking of Savita's deterioration in the coming days, Mrs Vasealli recalled how large numbers of the Indian community gathered at the hospital.

Mrs Vasealli confirmed to Mr Buckley that she had not seen Dr Katherine Astbury throughout that morning,

The inquest also heard from Dr Rupanjali Kundu, the Obstetrics and Gynecology senior house officer at the Galway hospital.  Dr Kundu was also a personal friend of Savita and Praveen Halappanavar and had known Savita since 2009, meeting the couple regularly through events organised by the Indian community

Dr Kundu was working in the hospital on Monday when she saw Praveen. When she was informed that Savita had been admitted she spent 10 minutes with her on Monday on St Monica's ward in the hospital.

"She was very upset because she knew the baby would not survive. She was very upset, very tearful. I tried to console her. I tried to turn the conversation to future pregnancies," she said.

The inquest heard how the pair had spoken about Savita's job in Westport which she had lost after the contract was terminated and she was no longer working. They also spoke about Savita's parents who were not aware that she had suffered a miscarriage.

Dr Kundu called to Savita again on Wednesday morning when she described her as being "very sick". That was the last time Dr Kundu saw her friend before she was moved to the high dependency unit.

"She was lying on the bed and she was not able to speak that much, she looked really ill. It was a significant change she was quite well on Monday and she was very sick on Wednesday," she recalled.

Dr Kundu spoke to Praveen inside the room but did not speak to Savita who she felt was too unwell to speak.

Opening the inquest yesterday Coronor Ciaran McLoughlin also requested two further medical doctors be requested to attend and give evidence. He requested that the pair give their evidence prior to hearing that of the expert witnesses.

Yesterday the inquest heard statement evidence from five witnesses including that of Savita's widower Praveen Halappanavar.

He told the inquest his wife had asked for a termination on three separate occasions but was refused. On one occasion, he told the inquest, the reason given for refusing the termination was because "Ireland is a Catholic country".

However, Obstetrician Dr  Astbury, who is due to give evidence in the coming days, denies ever having made the remarks. She is also disputing Praveen Halappanavar's timing of events.

Savita Halappanavar (31) died on October 28 last at Galway University Hospital. She was 17 weeks pregnant when she was admitted to the hospital a week earlier suffering a miscarriage.

Referring to the identification of the midwife, Mr Halappanavar's legal team told the inquest they had requested the hospital roster but this was not provided.

Mr Buckley told the inquest providing such documentation was not appropriate and did not fit the parameters for an inquest.

The inquest also heard that Praveen Halappanavar had not attended at the hospital on Tuesday morning as previously stated.

Mrs Vasealli, told the hearing that Mr Halappanavar  did not attend at the hospital until lunchtime when he returned from leaving his wife's parents to the airport.

It was also accepted that no conversation could have taken place between Mr Halappanavar and  Dr Astbury that morning.

"They did not meet that morning on Tuesday as he has claimed and therefore the conversation he claims took place didn't take place," stated Mr Buckley.

However, it was accepted that Dr Astbury had spoken to Savita that morning and on that occasion she had raised the possibility of a termination, which Dr Astbury said she could not carry out in her case because of the legal position in Ireland.

Dr Olutoyeke Otatunbosun, SHO in the gynecology ward of the Galway hospital who was working when Savita Halappanavar first presented also gave evidence.

She diagnosed lower back pain and discharged her. Two hours later Ms Halappanavar returned to the ward with a dragging sensation. It was then that she was admitted and diagnosed to be suffering a miscarriage.

Meanwhile, it has also transpired that a warning chart which would have monitored Savita Halappanavar's condition was not in use in the hospital at the time she was admitted.

The MOEWS chart, modified obstetric early warning score, which monitors heart rate, temperature, blood pressure and respiratory rate was not due to be rolled out in the obstetrics department until last November, a month after Ms Halappanavar was admitted to the hospital.

UHG registrar, Dr Andrew Gaolebale who saw Savita on her second presentation at the hospital on Sunday, October 21 when she was admitted  gave evidence that on examination his diagnosis was of "inevitable pregnancy loss".

However, he said he had no recollection of using the phrase "no going back" or setting out a time frame of four to five hours when informing Savita and Praveen Halappanavar about the miscarriage. This information was included in Mr Halappanavar's account given to the inquest yesterday.

He told the inquest that he had not been informed of the results of a blood test carried out on Ms Halappanavar which showed an elevated white count, saying he did not believe the results were known for a number of days. Dr Gaolebale said he was aware that infection was a common cause of second trimester loss.