The Savita Effect? How abortion policies really get liberalized

Ed. note: This is a guest post from Grace Wilentz. Grace is a feminist activist and writer based in Dublin, Ireland. She is also a member of the South-based feminist alliance RESURJ: Realizing Sexual and Reproductive Justice. View previous  coverage of Savita Halappanavar and abortion in Ireland here. 

At the start of this year, a new law went into effect in Ireland, signaling a small but significant change for access to safe abortion services in Ireland. Before introduction of the law, Ireland had no practicable framework for accessing safe and legal abortions, making these services virtually unobtainable. Introduction of the law was widely reported, particularly in international media, as a reaction by the government to the death of Savita Halappanavar. But as an Ireland-based activist who fights for liberalized reproductive health policy, I can tell you there was much, much more to the story.

Many are familiar with Savita’s story. In 2012, she presented at a Galway hospital where doctors found she was miscarrying. Despite the fact that her pregnancy was not viable, her requests for an abortion had been repeatedly denied, and she died one week later of sepsis (the immune system’s response to a severe infection in the blood). An investigation and subsequent report carried out by Ireland’s Health Service Executive found that doctors at the hospital had placed the welfare of her unviable fetus in higher regard than Savita’s life. It recommended as a matter of urgency that guidelines be put in place, making it explicit when a medical professional can and should legally interrupt a pregnancy.

This was a time in Ireland when the case of a real woman’s death and a process of law reform coincided dramatically, and it’s understandable how many would infer that legislation was brought in as a reaction to this tragedy.

However, while I would like to believe that I live in a country where a woman’s unnecessary death has the power to stir a government into action, this isn’t strictly true. If our government were characterized by immediacy and response, would we still be waiting for the Health Service Executive to issue the guidelines for doctors, which were called for in its own report on Savita’s death?

Savita’s death was reported on the 14th of November 2012, and just over a month later, the Irish government announced it would introduce legislation and regulations to give effect to the 1992 decision of the Irish Supreme Court in the X Case, and the 2010 decision of the European Court of Human Rights in ABC v Ireland. It’s clear that the government’s action ties back to these long-fought human rights battles.

In 2005, three women known only as A, B and C challenged Ireland’s criminalization of abortion services at Europe’s highest regional human rights mechanism. The case wasn’t heard until 2009, and in 2010 the Court ruled that Ireland had violated the rights of one of these women because it failed to provide access to abortion services in circumstances where her pregnancy posed a potential risk to her life. However, the significance of these legal processes requires close monitoring and decades-long memory.

Just before the story of Savita’s death broke, Minister of Health Dr. James Reilly received the report of an ‘expert group’ appointed to advise the government on how it should react to the binding European Court of Human Rights ruling in ABC v Ireland. The report of the expert group identified legislation and regulations as the only practical solution for realizing access to lawful abortion, and the only option that would fulfill the requirements of the judgment. It was clear that the binding decision of the European Court of Human Rights required a government response.

I don’t mean to suggest that the tragic and unnecessary death of Savita Halappanavar didn’t have a significant effect. She did. However, this effect was not an immediate change in the law. Outrage at her needless suffering led to large-scale protests in Ireland. As people gathered on the streets and in front of the Parliament, they put real faces and voices to the 75% of Irish people who, opinion polls have repeatedly told us, favor expanding abortion access in Ireland. The consensus became incontestable.

With the shock of Savita’s death, dormant indignation was awakened and rose to the surface. Suddenly conversations in the media, and within communities, had a sense of urgency, because of the immediacy of what had happened. The conversations and demonstrations were crucial to giving us a visible understanding, as a country, of the importance of reproductive autonomy to Irish voters.

It’s important to recognize that the actual change in the law came from the binding decision of the European Court of Human Rights. However, Savita’s death sparked a national discussion in a way that human rights processes and decisions rarely do. While ABC v Ireland crucially showed us that human rights mechanisms can operate with full respect for the anonymity and privacy of those whose human rights have been violated, Savita’s death also showed us that cases of women’s rights violations are all the more powerful when the woman has a name and a face. When a real person dies as a result of being denied an abortion, it becomes almost impossible to discuss abortion as an abstract issue.

We’re still far from achieving full sexual and reproductive rights in Ireland. With the Protection of Life During Pregnancy Act, the Irish legislature defined the processes by which someone can legally access safe abortion services. However, it limited this access to the narrow circumstances of a life-threatening pregnancy, as this is the only ground for which abortion is legal in the country. Further, this bill will likely touch few women — and do nothing for the more than 4,000 per year who travel to the UK and other countries to access safe and legal abortion services, at the expense of their own money, time, and mental health (there are implications both physically and mentally when you’re in need of a health service and your country turns its back on you.)

To say that a woman suffered and died and the Irish government reacted omits crucial parts of the story. It invisiblizes human rights defenders working to change the law, and perhaps gives the government more credit than it is due. The pressure for legal reform often comes from pro-choice advocates in Ireland, because women who travel to access legal abortion services, or obtain illegal abortions in Ireland, often keep silent for fear of social stigma and recrimination. However, it’s the response of an outraged society that has the power to shift the paradigm, create cultural transformation, and break the stigma that has kept over one hundred thousand women silent. The greatest challenge to the status quo may be with them, and with us.