My daughter Grace was rushed to intensive care soon after she was born. I felt the loss of her from beside me so keenly I cried for hours, but perceptions changed when I went to visit her in the Intensive Care Unit.
This baby I had just delivered was the biggest, healthiest new-born in the unit, despite her moderate disability, which was nothing that time and special loving couldn't fix. Her room-mates were all "prems", some were born as early as 23 weeks. Swaddled like space babies from Mir, they were so amazingly tiny you could cup them in your palms like real-life Thumbelinas. I spent a lot of time in the unit and later in the special care building reserved for young babies. Over a few hundred hours there, I watched Grace and the prems grow larger and healthier in the nurses' expert care. If they'd been born five years earlier, some of them could not have survived.
The news that Irish women are having late abortions at three times the rate of British women reminded me of those little babies. Abortion is legal in Britain until 24 weeks, after which the pregnancy is considered to be at a level of maturity incompatible with abortion. That time-frame has already been changed and may change again because of the extraordinary medical progress in sustaining the lives of very premature infants. The judgment call is whether the babies' quality of life will be enough to warrant such special intervention.
Ireland was long suspected of having a high late abortion rate, but this is the first confirmation that the level is dangerously so. In every other respect, our rate of crisis pregnancy is lower than in Britain, so why do we make late abortion the exception? Late abortions are defined in Britain as happening after 20 weeks' gestation, half-way through a pregnancy.
One reason to delay having the procedure until relatively late in pregnancy was because until recently, techniques for detecting foetal abnormality could not be carried out until 16 weeks, with a few extra weeks to confirm the results. For women whose pregnancies involved gross malformations, the lateness of the abortion was another awful burden.
Procedures now being introduced can increasingly detect certain lifethreatening or life-incompatible syndromes as early as nine weeks. This is a far more optimal time to abort. Standard gestational progress sets nine weeks and 13 weeks as milestones, with many spontaneous miscarriages happening then. Better detection procedures will spare more women the lonely waiting. However, most Irish women are not delaying their abortions for those reasons, according to the current reports. It is not that they are waiting for amniocentesis results and then having to travel to Britain; they are delaying their abortions until this stage because of the obstacles this community puts in front of them - information, money and access to locally available services. This is our fault.
The rates are scandalously high because abortion remains an unresolved political issue, but in apportioning responsibility, some groups may bear more than others. Those who adopt the comfortable position of opposing all abortions at whatever stage have created a situation whereby Ireland is in practice operating the same system as Britain, with the added disadvantage of making women wait until it is by any standards worryingly late. The rest of us have perhaps felt too ambivalent to make a difference.
No woman takes her crisis pregnancy lightly. Evelyn Mahon's report for the Department of Health identified some primary points about abortion. The unmistakable conclusion was that a blanket prohibition on abortion in Ireland was liable to increase the rate of women seeking the procedure, not decrease it.
Mahon's report demonstrated how pregnant women of all child-bearing ages from all backgrounds make their decision, not for reasons of abstract principle, but because of the life circumstances they are in. The eloquent testimony of some courageous single mothers, and parents of severely disabled children, tells us how far from adequate those circumstances are. We can do something to enhance their family's experiences.
IRELAND'S refusal to face facts about abortion is yielding an unduly high per capita rate of abortions and a scandalous, unnecessary rate of late abortions. Is this the cost of keeping principles intact? I listen to antiabortion spokesmen and women and wonder what world they inhabit. I'd like to be able to live with such luxury too. That neat little place might let us forget the 6,000-plus women who have to have abortions, by entrancing us with the promise that despite the weighty evidence of history and world experience, Ireland can force reality to work a different way.
Life and death are not measurable as they once were. People who 10 years ago would have been dead can now be kept alive indefinitely. People who would once have been condemned as barren can conceive because of the medical skills and know-how the community possess. On any scale, there is a qualitative difference between an embryo of 10 weeks and a foetus of 24 weeks. Pretending it is all the same condemns us to some truly barbarous consequences.
Every one of those late abortions might have happened much earlier, and more humanely, if Ireland operated its own abortion laws and facilities. Rather than abuse passers-by with photographs of abortion matter, the extreme antiabortion lobbies, and the moderates too, need to look at images of foetuses between 20 and 24 weeks, and acknowledge their responsibility in enabling that process.
If they really believe in the rights of the unborn, they might ask themselves why they are prepared to sacrifice those foetuses at that uncomfortably late stage in order to preserve the absolute principle they seek to enshrine. Six thousand too many? Sounds like rhetoric to me.
mruane@irish-times.ie