Savita Halappanavar and the Doctor’s Plague
Friday 23 November 2012 12:24
When my sister was born my mother began to haemorrhage badly and was in danger of bleeding to death. My father and my aunt (a nurse who qualified in England) pleaded with the doctor to carry out a hysterectomy - then the only treatment. He refused on the grounds that a hysterectomy would prevent her having future children. In effect it would be a form of contraception. When my father threatened to take him to court he held out both hands and said, ‘Mr Wall, these hands were blessed by the Pope’. Nevertheless, under threat of legal action, he buried his conscientious objections and did the deed and saved my mother’s life. This was more than fifty years ago.
The recent denial, in similar circumstances, of appropriate treatment to Savita Halappanavar by staff at University Hospital Galway and her subsequent death from septicaemia has caused much controversy here and abroad, not least in her home country where the India Times ran a headline that said: ‘Ireland Murders Pregnant Indian Dentist’. It is, I think, a fair accusation.
There are a few things I would like to say on the matter.
Firstly, what Savita Halappanavar died of – septicaemia – used to be called ‘puerperal fever’ and puerperal fever was nicknamed the ‘doctor’s plague’. It resulted from the increasing tendency to medicalise childbirth from the 15th century onwards. By contrast, incidence of puerperal fever was much lower for traditional births where midwives attended women in their own homes. In other words, for many centuries it was more dangerous to give birth in a hospital than at home. Puerperal fever achieved it’s ‘plague’ status because of the presence of large numbers of women giving birth at the same time in a factory-type situation – and, significantly, the handling of their bodies by men, namely doctors. It was not a plague that affected doctor’s but one that they created. In that sense it was truly ‘the doctor’s plague’.
Before that process of medicalisation women who gave birth at home had the benefit of the experience of the midwife, who herself most probably was a mother, and of the midwife’s apprentices, and, if things went wrong, of the local doctor, who anyway was more likely to kill than cure. But the move to medicalise birth, to insist on women ‘lying-in’ for childbirth, brought a perfectly natural bodily function within the ambit of the medical profession, the market and the law. It was, in effect, the commodification of women’s reproductive processes. Ultimately, this commodification extended to other aspects of women’s bodies – contraceptives, for example, coming within the purview of law and the patriarchal state apparatus wielding morality as its weapon.
So the death of Savita Halappanavar took place within a barbaric history of medical exploitation and mistreatment of women by the once exclusively male medical profession. I say exploitation, because of course the commodification of birth redounded to the benefit of doctors in the first instance. It was an area of expertise in which hitherto they had not been wanted.
Ms Halappanavar need not have contracted septicaemia. Had the attending staff acted on her demands – and it must be remembered that Ms Halappanavar was a dentist and most likely had a clear understanding of what was happening to her – they might have saved her life. But what is clear is that she died not just because of the absence of legislation on abortion here in Ireland, but because of the fact that the Ireland is a Catholic country.
It seems, in fact, that Ms Halappanavar was told that ‘this is a Catholic country’ and the racist implication archived in that apparently simple statement is the fact that she and her husband were Indians living and working in Ireland who could not be expected to understand the delicacy of conscience of the Irish state. Fifty years ago the same kind of conscience almost killed my mother. How much progress have we made in that half-century?
The protests which have erupted over the death of Savita Halappanavar are focused on forcing the government to enact legislation for what is known here as the ‘X Case’. This refers to The Attorney General v X, a case in which the Attorney General for Ireland sought an injunction to prevent a fourteen year old girl who had been raped from travelling to England to terminate the pregnancy that resulted from that rape. For brevity sake we will pass over the biopolitical implications, the medico-legal fascism that led to the case in the first place. Eventually it was appealed to the Supreme Court and the judgement turned on whether X was suicidal or not. Because she was found to be desperate and had considered suicide, the constitutional balance was deemed to have tipped in her favour. That is to say, the Irish constitution contains an article which ‘defends’ the equal right to life of mother and child; if the girl/mother committed suicide as a result of the rape and pregnancy then that right would not have been vindicated*. It is worth noting a corollary of the judgement which is that if there had merely been a risk to her health she would not have the right to travel to England for an abortion. (In the event X suffered a miscarriage.)
It is this final element of the judgement that causes confusion for well-meaning doctors who for many years had been quietly assisting women in Savita’s circumstances. Had Savita Halappanavar, for the sake of argument, merely been crippled for life by the circumstances of her pregnancy, then Catholic conscience would have been salved. Her life would not have been endangered, merely her health. Because the doctor thought she could treat her successfully she did not have to carry out an abortion. In the event she was wrong.
Many protesters are now demanding that laws be enacted (laws again, to be enacted by a mainly male parliament) which will prevent such circumstances arising again. ‘Never again’ is a slogan frequently heard.
However, it is not sufficient to call for action to legislate for the X-case judgement, which would merely have the effect of making an abortion possible where the life of the mother might be in danger. Certainly, such a law is necessary. But merely legislating for those relatively rare circumstances in which a pregnancy is likely to be fatal to the mother, will not reverse the medicalisation and commodification of childbirth and the abrogation of power over women’s bodies by the patriarchy – by which I mean the entire structure of church-state power in Ireland, which even in the rrare occasion when it is exercised by a woman is masculine in its context, force and strategies.
The only way to affect that change is the withdrawal of the state apparatus from women’s right to control of their own bodies.
The nexus of power that has assembled to prevent that happening includes the Catholic Church, pressure groups like the odious and well-funded Youth Defence and the pro-life movement in general, all the large political parties, the health industry, and the legal profession. At the present moment the Irish government, for example, has attempted to set up an enquiry into Ms Halappanavar’s death that included three doctors from the hospital where she died, colleagues of the staff who attended her in her last days, as well as various other people with a vested interest in covering things up. Defeated in this attempt by Praveen Halappanavar, Savita’s brave and steadfast husband, they have now decided to hold a statutory enquiry. Praveen Halappanavar has stated that he will cooperate only with a public sworn enquiry. At the present moment the government is refusing such a measure.
Why, we may well ask, are all these overwhelmingly masculine powers aligned against women? The answer, I’m sorry to report, would fill an encyclopaedia.
I suggest that whatever the feelings of Praveen Halappanavar, and I have no idea whether he supports abortion or not, Ireland should enact laws not only to prevent another instance like this, but to enable those girls and women who seek to terminate their pregnancies to undergo the procedure here in Ireland where they might eventually have the close support of their loved-ones, families or friends and where they might reasonably expect that society will not weigh their health or life in a balance like butchers weighing meat in a market stall.
I know from experience that this proposal will meet with a barrage of questions and objections? Until what stage of the pregnancy would I advocate allowing abortion? On what grounds should abortion be permitted? Do I believe that a foetus is a human being?
Firstly it should be observed that each of these questions invites us to enter into yet another medico-legal construction of women’s health, well-being and reproductive processes. I do not intend to enter such a trap.
Secondly, it is not for me to answer these questions. Why? because I am a man.
Who then should decide? Not the law, not the legislature, not the medical profession, certainly not the Catholic Church or any other church for that matter. Such questions, if they have any relevance at all, can only be decided by women.
Therefore, I support the woman’s right to choose.
Excellent article on the law around the case at Critical Legal Thinking
*It is ironic that the article which permitted X to travel to England for an abortion was inserted in the constitution after intense agitation by the so-called ‘pro-life’ movement and was intended to prevent, among other things, the very circumstances that ultimately it permitted.