Praveen can't listen to poignant description of tiny baby Prasa
PRAVEEN Halappanavar got up and quietly left the room so that he would not have to listen to the unbearably poignant details of his baby daughter. His barrister thanked coroner Ciaran McLoughlin for the forewarning.
A stillborn foetus, 17 weeks gestation, incompatible with life, was the description given by pathologist Dr Michael Tan Chien Sheng as to the cause of death.
Heartbreakingly, he referred to her as baby Prasa – the name bestowed upon this much-wanted baby girl by her parents, Savita and Praveen, before everything started to go wrong.
Her tiny body measured just 19cm long and her chest was just 12cm wide. Her little heart weighed 0.8 grams.
It was a marvel to hear the very precisely spoken doctor go into details of an origami-like intricacy in this minute infant – such as how the palate of the mouth was normal and even down to his analysis of the lobes of her lungs.
He had found no abnormality apart from an extra digit on her right hand, he explained.
The coroner turned to the jury and explained that a miscarriage can frequently indicate that there was something wrong with the baby.
"But so far we've proven that there was nothing wrong with this baby," he concluded rather firmly.
It was a complex but very important day in the inquest proceedings, one in which the full weight of the clash between the legal and the medical facts of this case came squarely to the fore.
This was a problem to which Dr Peter Boylan, former master of the National Maternity Hospital, more than hinted at when he said obstetricians in this country are working to a certain extent in a "vacuum".
"Unless the mother is going to die, we're on very sticky grounds," he said. "There are laws and statutes that are not pleasant for us to contemplate getting involved in."
He told how doctors coming here from abroad have "great problems in understanding the situation we have to work under.
"They cannot understand the law but we have to work within the law," he said.
And he shed further light on his own feelings on the legal situation here when he said under cross-examination that: "What is different here from everywhere else is that the woman has no input into her care here" when it came to continuing with a potentially non-viable pregnancy.
Summing up, the maternity expert asked in a rhetorical question: "Would Ms Halappanavar be alive if the termination had been allowed on the Monday, October 22, or Tuesday, October 23? On the balance of probabilities, the answer is yes."
The room suddenly turned very still and Praveen looked directly across at the reaction to this.
But a termination would not have been "practical" in the situation because of the legal situation in this country, Dr Boylan went on, his tone of voice remaining professional – but with a shadow of frustration clearly behind it.
Praveen listened with his arms folded, looking reflective.
It was only when Dr Boylan told how each hour of delay in treating sepsis increased the chance of death by 6pc that we noticed his hand shook slightly.
With the circuit court back in Galway this week, the inquest had been moved to the Galway County Council chambers. The change over to a "round table" layout seemed in some way to subtly alter the dynamic of the hearing.
Amongst the numerous concerns raised by Dr Boylan was the gap in taking the vital signs.
Though Savita's temperature was taken by the midwife at 4.15am on Wednesday, her pulse and blood pressure were not.
"It was a pity," noted Dr Boylan with regret, during the cross-examination.