Two days ago, a law permitting abortion in extremely limited circumstances came into force in Ireland. The Protection of Life During Pregnancy Act, as it's called, will allow for abortions when doctors believe that there is a substantial risk to the woman's life, either through physical illness, medical emergency or suicide. It's a baby step in the right direction, but the legislation leaves a great deal to be desired.
The Protection of Life During Pregnancy Act was signed into law in July following the tragic and preventable death of Savita Halappanavar, who was refused an abortion while miscarrying in October 2012 because the doctors refused to terminate the pregnancy until the fetus' heart stopped. It's about as restrictive as a law that permits lifesaving intervention can get: abortion is still illegal in cases of rape or when the fetus has severe deformities, and the law comes with incredibly complex provisions dictating how "risk of death" is to be determined, which renders it nearly impossible for women with limited resources to obtain life-saving medical help. In cases of risk of death from physical illness, two physicians — one obstetrician and one specialist — must concur. In cases of risk of death from suicide, three physicians must concur: an obstetrician, a psychiatrist with experience treating women postpartum, and another psychiatrist. In cases of medical emergency, a single physician is responsible for providing the diagnosis and terminating the pregnancy alone.
Troublingly, the clinical guidelines mandating how doctors should assess what constitutes a "risk to life" are not yet in place. According to the Independent, a working group of obstetricians, general practitioners and psychiatrists set up by the Department of Health is currently attempting to establish the guidelines — but their progress has "been delayed by the range of different medical professionals involved." This is really bad. As Mary Elizabeth Williams points out at Salon, a lack of clearly-articulated guidelines puts doctors at risk of "breaking the law if they terminate a pregnancy and there's any dispute whatsoever over whether the woman faced imminent, certain death."
Ireland's Health Minister James Reilly insists that the guidelines will be in place "very early in the new year." Again: it's progress, but it's far from enough. As Mara Clarke, director of the Abortion Support Network, put it: "Even if this law is enacted, only a very, very small percentage of women who need abortions will be able to access them in Ireland."
Image via AP.