No, this is grossly incorrect and has wrongly been used as a reason to repeal the 8th Amendment. In truth, Savita did not die from lack of an abortion, her cause of death was the result of septic shock with the presence of an esbl ecoli infection.

The Irish media framed the story surrounding the tragic death of Savita as a death caused by the absence of legal abortion. As is clear from the recommendations at the Coroner’s Inquest, the exhaustive investigation of the sequence of events that led up to her death, established that the actual cause of her death was infection with a virulent anti-biotic resistant strain of E Coli, compounded by a series of system failures that delayed in the realisation by the medical team of the gravity of the risk to her life, and the timely implementation of the appropriate responses to it.

It is no exaggeration to say that RTE followed the line taken by the Irish Times, in effect channelling the public distress and concern at the death of Savita so that it reinforced the Government’s insistence that legislation for abortion in line with the X Case ruling was necessary, by supporting the opinion that had such legislation been in place she would not have died.  That view was not supported by the evidence uncovered at the inquest.

This lie is perhaps the driving force behind the push for a referendum to repeal the 8th Amendment to the Irish Constitution. The Repeal the 8th movement have used, and are still using, the death of Savita as a beacon for the ‘inadequacy’ of the 8^th Amendment. However, if time was actually taken to read through the events prior to her death, then the Repeal the 8th movement could see that denied access to an abortion was not the cause of Savita’s death. Let’s see what really happened.

Overview of treatment

The Health Service Executive (HSE) completed a thorough investigation following the death of Mrs. Halappanavar, and nowhere in that report does it say that restricted access to an abortion was the cause of her death. Here is just a brief overview of Savita’s care at the hospital leading to her death:

“Background to this Investigation On the 21st of October 2012 a 31-year woman in her first pregnancy self referred to the gynaecology ward (accompanied by her husband) at 17 weeks of her pregnancy complaining of lower backache radiating to the lower pelvic region for the previous 12 hours. Clinical examination indicated bulging membranes and no cervix to be felt. In the medical records the diagnosis noted was that of “an inevitable/impending pregnancy loss”. The patient was admitted to the hospital for management of inevitable miscarriage on the 21st of October 2012. The patient’s membranes spontaneously ruptured at 00.30hrs on the 22nd of October. Her condition deteriorated on the 24th of October and a diagnosis of sepsis secondary to chorioamnionitis was made. She was admitted to the High Dependency Unit (HDU) from the Gynaecology ward at 16.45 hrs on the 24th of October. The patient was post miscarriage at 17 weeks when admitted to the HDU. On admission the patient was noted to be drowsy, but rousable. During that night there was a clinical deterioration with an increasing oxygen requirement, vasopressor requirement, and worsening metabolic status. The patient was therefore transferred to the Intensive Care Unit (ICU) at 03:00 hrs on October 25th and was intubated and mechanically ventilated at 03:30 hrs on the 25th of October. The patient’s condition further deteriorated despite appropriate management in the ICU and she sadly passed away at 01.09 hrs on Sunday, the 28th of October 2012.” ¹

Causes of death

Many people claim to know exactly how Savita died, and use it as a smokescreen for abortion rights, but claiming she died because she did not have an abortion is a very simple assumption and not the truth. Savita’s death was brought about by “medical misadventure” the Guardian stated.²

Other sources, such as the Independent, reported: “The inquest heard earlier this morning that Savita died as a result of septic shock with the presence of an esbl ecoli infection.” ³

There can be no denial that the delayed realisation of the gravity of  her infection played an integral part in her death as well as the medical negligence on behalf of the hospital. All factors are reported in the HSE Final Report, but here are three key causal factors which ultimately lead to Savita’s death:

“Key Causal Factor 1: Inadequate assessment and monitoring that would have enabled the clinical team to recognise and respond to the signs that the patient’s condition was deteriorating due to infection associated with a failure to devise and follow a plan of care for this patient that was satisfactorily cognisant of the facts that: → the most likely cause of the patient’s inevitable miscarriage was infection and → the risk of infection and sepsis increased with time following admission and especially following the spontaneous rupture of the patient’s membranes.

Key Causal Factor 2: Failure to offer all management options to a patient experiencing inevitable miscarriage of an early second trimester pregnancy where the risk to the mother increased with time from the time that membranes were ruptured.

Key Causal Factor 3: Non adherence to clinical guidelines related to the prompt and effective management of sepsis, severe sepsis and septic shock when it was diagnosed.”⁴

You may read these factors and think how can we trust doctors after they made such errors, and the simple answer is that following Savita’s death recommendations were made to ensure these errors do not happen again.

The big changes needed were clear guidance on how to treat patients with similar infections as Savita, and clarity as to the law surrounding the 8^th Amendment and  at what stage a doctor can legally perform an abortion. The HSE Final Report discussed the legal uncertainties that arose in Savita’s case and proposed solutions began to formulate to ensure the law was clear to all medical professionals from then on. The Final Report reads:

“The investigation team is satisifed that concerns about the law, whether clear or not, impacted on the exercise of clinical professional judgement. The investigation team did not have the remit to attempt to review this aspect of Irish Law. The investigation team received an outline legal context of the law in relation to the termination of pregnancy in Ireland from Senior Counsel.”⁵

Further legal clarification occurred a year later when the Protection of Life During Pregnancy Act 2013 was introduced clearly stating at what point termination of pregnancy may be possible and under what circumstances. You can read the Department of Health’s guidelines here.

Savita and the 8^th Amendment

Savita’s case should never have been used to restart the push to repeal the 8^th Amendment. Many news outlets jumped on the denial-of-abortion bandwagon before the facts were clear. Now that the facts are clear it is important that Savita is not further used as a beacon for removing the 8^th Amendment.

Restricted access to abortion did not cause Savita’s death, in fact termination of her pregnancy would have been possible from the time she entered the hospital, had an actual risk to her life been clearly present at that time. One of the consultants who worked on Savita’s case stated:

“Under Irish law, if there’s no evidence of risk to the life of the mother, our hands are tied so long as there’s a foetal heart’. The consultant stated that if risk to the mother was to increase a termination would have been possible, but that it would be based on actual risk and not a theoretical risk of infection ‘we can’t predict who is going to get an infection.’”⁶

Sadly in Savita’s case, detection of the fatal infection was too late.

So yes, there was an error in the hospital’s judgment, but not one that should call for the removal of the 8^th Amendment.

Clarity of the law was what was needed, and clarity we now have. Women should not feel that abortions are necessary because hospital’s cannot care properly for them. In 2009, the BBC reported that a UNICEF report put Ireland as the safest place to have a baby in the world, and the maternal mortality rate is one of the lowest globally:

In fact here’s how India, the U.K. and the U.S. compare:

• India – Maternal Mortality Rate is 33x higher than in Ireland

• Britain – Maternal Mortality Rate is 2x higher than in Ireland

• United States – Maternal Mortality Rate is 3.5x higher than in Ireland

^Source: World Heath Organization (WHO)⁷

The reality is that Savita’s death was a tragedy, but not because she was denied an abortion. The tragedy is that the medical professionals did not do all that was necessary to save her in time.

Any questions about the death of Savita? Read the HSE Final Report here.