Dr Ciara Kelly: 'Unlike politicians, doctors have to look distressed pregnant women in the eye'
I wasn't expecting to write about abortion again so soon - I like to keep things varied - but during the fallout from the recent case of a teenage girl who was locked inside a psychiatric unit instead of being given an abortion she was entitled to, there was lots of talk about how our system handles such cases. And yes, I said cases.
I was talking about this with another GP and he said something I simply can't get out of my head. Many GPs, like most obstetricians I know are pro-choice, often having come from a pro-life background because of our age - but having seen the reality for women through our work, we've changed position. We don't have the luxury of the ivory towers like politicians - we have to look distressed pregnant women in the eye and actually deal with them.
And what he said was this. Last year he had contacted a psychiatrist to ask about an abortion assessment for a young woman who was pregnant and suicidal, and the psychiatrist had responded, not by agreeing to do one - but by saying he could instead "get her a place in a home for nine months". Nine months!
And why this has stayed in my head was this - that psychiatrist actually believed that was perfectly reasonable. He believed it was reasonable that instead of assessing and facilitating a young woman in getting an abortion she was legally entitled to (in Ireland abortion is permissible under The Protection of Life During Pregnancy Act for pregnant suicidal women) she could be put away in a home for nine months instead - like that was no big deal.
He believed that was so reasonable that he could say it out straight to her GP - as if that GP would surely think it was reasonable too. Doctors mostly don't suggest care plans for patients to other doctors that they don't think are acceptable - so he clearly thought this was fine.
And that's why it's stayed with me - because it gave me insight into the mindset that allowed young women to be locked into Magdalene laundries and county asylums for generations in this country.
People thought it was reasonable. And some people still think it's reasonable today.
We like to look back on that era and believe Ireland was a different country in the bad old days of Ann Lovett and mother and baby homes and forced adoptions. But in Ireland now we have pregnant teenage girls sectioned, we force rape victims to continue with pregnancies they don't want until an early C-section can be carried out on them, and we keep brain-dead women on ventilators - forcing their families to watch their loved ones' bodies break down and be denied a decent burial - so an utterly hopeless pregnancy can be continued at all costs.
That psychiatrist viewed - just as the European Court of Human Rights said the legal system of Ireland viewed (in its recent verdict against Ireland on how we treated a pregnant woman with a fatal foetal abnormality) - women as reproductive instruments. Reproductive instruments! That's the nub of it. And he thought that was perfectly reasonable. I suspect he's never thought of things any other way. Never thought how it might be to be a young, suicidal woman in a home for nine months until she gave birth and could be released. And I'm pretty sure he didn't care much what happened next. Job done, pregnancy completed. Reproductive instruments!
Whether that suicidal woman could cope with being a parent was irrelevant. And if she couldn't - sure she could give the child up for adoption or fostering. Isn't that how we always handled such things? Didn't that work out fine? Wasn't that perfectly reasonable too?
So I'm going to say this once very clearly. Doctors, irrespective of their personal position on abortion or any other matter of conscience that affects the treatment of patients, if they aren't willing to provide care or assessment to a woman for personal reasons, they are still obliged to send them on to a doctor who is.
And by the way - that way of viewing women, the whole sticking them in a home thing - that's not the high moral ground. It's not reasonable. It's entirely shocking.
Sunday Indo Living