I am not a Vessel: Ireland’s Reproductive Rights

In a strangely prophetic report, the United Nations (UN) committee that monitors states’ compliance with the International Covenant on Civil and Political Rights warned Ireland last month that its poor record on gender equality and on-going human rights injustices certainly would result in continued human rights abuses if strong measures to remedy this were not taken.

Then, just last week, a case emerged that demonstrates how considerable these reproductive rights violations can be. The Eighth Amendment of the Constitution of Ireland, which introduced a total ban on abortion, was enforced on a woman who had become pregnant following rape. Earlier in her pregnancy (the eighth week, in fact), the woman had requested an abortion because she was suicidal and the pregnancy was thus risking her life. Her request was denied. Last week, she was legally forced to give birth at 25 weeks by caesarean section.

The Eighth Amendment to the Constitution of Ireland states:

The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.

This amendment came about in 1982 after a free vote in the Dáil [Ireland’s House of Representatives] reinforced existing legislation criminalizing abortion. Since the enactment of this amendment, two cases in particular have pushed forward reproductive rights in Ireland. The first was the 1991 X Case, in which a 14-year-old girl became pregnant following rape. She attempted to receive a termination in England, but was forced to return to Ireland following an interim injunction under the 1983 amendment to the Irish constitution, which put the right of a fetus on an equal footing to a woman’s right to life. Following a diagnosis of being at risk of suicide, the girl was permitted to travel for an abortion following an appeal at the Supreme Court. It was held by majority opinion at this time that a woman had a right to an abortion if there was “a real and substantial risk” to her life. However, this was not officially legislated until the Protection of Life during Pregnancy Act 2013, which guarantees a right to a termination when there is a threat to the life of the mother. This came about following huge public outcry and demand for reform after Savita Halappanavar’s death in 2012. Savita Halappanavar entered a hospital in Galway, was found to be miscarrying, but died of septicemia a week later. She had requested a termination several times over a three day period, but was denied.

The Protection of Life during Pregnancy Act was intended to avoid repeated deaths like Halappanavar’s or incidents like the X-case. This guarantee of protection, however, is contingent on three medical practitioners jointly signing off on the validity of the threat. While this act may be seen as progress, the UN committee disagrees and has highlighted in their report the “discriminatory impact on women and girls who cannot travel abroad for an abortion, and the excessive scrutiny to which pregnant and suicidal women and girls will be subjected by medical professionals.” The Committee has described Ireland’s access to abortion as “highly restrictive” and contends that “progress in this regard is slow.” The Committee recognizes that without this access, Irish women will have to “resort to illegal or unsafe abortions that could put their lives at risk.”

The current case is exactly what the UN committee warned against. The three medical practitioners who debated the woman’s request for termination decided to initially deny it, then waited until the fetus became viable, and forced her to deliver at 25 weeks by caesarean section, thereby invalidating the Protection of Life during Pregnancy Act. The reality is that, despite the act, little has changed for women in Ireland. While it is now marginally more acceptable for women to have children outside of marriage, women in Ireland are still facing violent bodily abuse and a lack of reproductive autonomy.

Moreover, reproductive rights in the Republic of Ireland continue to be ignored to the point where confusion over what exactly is legal is common. Most people are aware of the Magdalene Laundries and the ‘Mother and Baby’ homes, particularly the case in Tuam where the discovery of the remains of 796 children has roused public outrage and gained massive worldwide media coverage. The UN committee stated in its report that “despite considerable progress achieved in respect of equality in recent years, inequalities between women and men continue to persist in many areas of life.” The committee points to the laundries, Mother and Baby homes, and the practice of symphysiotomy as historical examples that demonstrate the ongoing problems with reproductive rights violations in Ireland. Symphysiotomy, a medical procedure which “unhinges the pelvis, severing the symphysis joint or sundering the pubic bones,” was performed on approximately 1,500 women in Ireland between 1940 and 1980. Two hundred of these survivors are now represented by the group Survivors of Symphysiotomy (SoS), which states that the operation left “many of them permanently disabled, incontinent and in pain.” According to SoS, many of the women  “were operated upon without their knowledge or consent under general anaesthetic during pregnancy or even after the birth of a baby by Caesarean section.”

The SoS website offers survivor stories describing the violence of these operations, often completed without consent. The video below shows symphysiotomy survivor Maria Kelly describing the impact of the continued impact of this procedure on her life, years after it occurred. In March 2014, SoS also submitted a 50-page submission to the UN Committee Against Torture that outlined long lasting physical and mental repercussions of the procedure.

Historian Dr Jacqueline Morrissey, the first to expose symphysiotomy in Ireland, charts the introduction of this practice to 1944, when the National Maternity Hospital (NMH) in Dublin, the leading Catholic-identified maternity hospital in Ireland, “pioneered the use of the symphysiotomy operation as the procedure of choice in certain cases where the woman’s pelvis was deemed too small to permit a normal birth (termed ‘disproportion’).” Doctors justified this procedure by the “perceived need to avoid the practice, common among non-Catholic doctors in Britain and elsewhere, of recommending sterilisation to women after a third Caesarean section (CS).”

SoS campaigns on the belief that symphysiotomy was undertaken by doctors practicing in Catholic hospitals with “a determination to control women’s reproductive health. They [the doctors] simply saw symphysiotomy as a gateway to unlimited childbearing” and was carried out without consent or consideration for future medical implications. The government commissioned Walsh Report states that while “the procedure has a potentially life-saving role to play in the developing world… [and] offers a clinically acceptable response to obstructed labour in environments where caesarean section is unavailable or unacceptable,” the practice declined as medical interventions became more sophisticated in the mid-twentieth century. This has therefore raised the question of why the procedure was used in Ireland when it was no longer used in other European countries, considering its potentially damaging effects on the mother’s skeletal structure.

The report issued by the UN committee last month focused on the lack of state accountability for the institutional practices that led to abuse and neglect in these cases. To remedy this, the Irish state has been advised to “prosecute and punish the perpetrators…and ensure that all victims obtain an effective remedy, including appropriate compensation, restitution, rehabilitation and measures of satisfaction.”

But the UN Committee’s conclusions spoke to a much longer history of the Irish government’s failure to take responsibility for the past and present dismissal of women’s reproductive rights. Irish Council for Civil Liberties (ICCL) director, Mark Kelly, has rightfully noted that the UN report has uncovered the root cause of these human rights injustices: “(It is) the ongoing failure in our law, policy and practice to respect the human rights, autonomy and bodily integrity of women.” All of the violations outlined by this report reveal Ireland’s ongoing suspension of reproductive rights. This report recommends that institutional change is needed at political, societal, and civic levels to avoid further injustice. Until this occurs, we will continue to see cases like Savita Halappanavar, X-case, and the woman who was first forced to continue a pregnancy, and then forced to deliver a premature infant.

This report and this latest case reveal to the international community what women in Ireland have known for generations: they are trapped in a reproductive minefield due to the conservative heritage of post-colonial Ireland. The creation of the Irish state relied heavily on the Roman Catholic Church, and in doing so marked women’s role clearly within the home as wife and, more importantly, as mother. This motherhood role, however, was conditional. Women and girls who conceived outside of marriage were at the mercy of the state-sanctioned Magdalene Laundries or Mother and Baby homes. Once married, the protection of a mother’s ability to conceive was so important that the violent procedure of symphysiotomy was performed on over 1500 women. Ireland no longer hides its “fallen women” in laundries, and symphysiotomy no longer occurs. Yet, little has changed in the way of consent or access to reproductive control. Without proper access to abortion in line with internationally sanctioned human rights directives, women continue to be at the mercy of a conservative state.

 

Further reading:

J. Schweppe ed, The Unborn Child, Article 40.3.3 and the Irish Constitution, Liffey Press, (Dublin, 2008)

Ailbhe Smyth ed, The Abortion Papers Ireland, Attic Press, (Dublin, 1992).

M. O’Connor, Bodily Harm: Symphysiotomy and Pubiotomy in Ireland, 1944–92 (Dublin, 2011).

U. Ranke-Heinnemann, Eunuchs for the Kingdom of Heaven: The Catholic Church and Sexuality (London, 1990).

Fiona Bloomer and Kellie O’Dowd, “Restricted Access to Abortion in the Republic of Ireland and Northern Ireland: Exploring Abortion Tourism and Barriers to Legal Reform,” Culture, Health & Sexuality, 16:4 (2014): 366-380.

Rossiter, Ann, Ireland’s Hidden Diaspora: The Abortion Trail and the Making of a London-Irish Underground, 1980-2000, (London, 2009)

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Featured Image: Savita Halappanavar rally, by William Murphy