The Ghost of Savita Halappanavar
January 9, 2023
by Steven A. Foley, MD
The official journal of the American College of Obstetrics and Gynecology (ACOG), Obstetrics and Gynecology, (often referred to as the Green Journal because of its traditional green cover) recently featured an article entitled “The Ghost of Savita Halappanavar Comes to America.” The article refers to a pregnant woman in Ireland named Savita Halappanavar who died in 2012 from an inappropriately managed second trimester miscarriage.
I have several issues with this article and the fear mongering it provokes. First, there is no evidence this clinical situation is an issue or will become an issue in the U.S. In addition, this article promotes an extreme pro-abortion argument that attempts to make any pro-life legislation appear harmful to women. The clinical situation regarding Savita Halappanavar is clearly, as the Irish Health Information and Quality Authority states, a case of malpractice. It has nothing to do with governmental overreach.
Ms. Halappanavar presented with membranes protruding to the introitus and a white count of 16,900. Regardless of the stage of pregnancy, any expectant management should be considered malpractice, no matter the physician’s personal views about abortion. This patient was showing signs of infection and needed to be delivered. That would have been the appropriate medical course that almost certainly would have saved her life.
The conclusion of this article was that Savita Halappanavar was sacrificed on the “altar of fanatical adherence to antiabortion religious orthodoxy” that had been enshrined in laws of Ireland. I am a pro-life physician, but there is no religious orthodoxy that condones malpractice. To say the physician put the life of the baby above the life of the mother is irresponsible. For the baby to live, the mother must live. It was clear early on in this case that the mother would not live without intervention. There certainly are times when the mother’s health requires delivering the baby before viability. Early delivery of a baby to save the life of the mother is vastly different than using a case such as this to support terminating the life of the baby. Finally, the physicians in this case were found to be medically negligent, giving no credence to the fact they were following the laws of the land.
ACOG is attempting to use this case to support unrestricted abortion rights, but the use of this example is irresponsible and does not meet U.S. standard of care. The article failed to mention the maternal mortality rate of Ireland during this time. Even with restrictive laws against abortion, the average maternal mortality rate for Ireland between 2000 and 2017 remained extremely low at 5/100,000 live births. Similarly in countries with restrictive laws, such as Poland and Chili, the rates were 2/100,000 and 13/100,000, respectively. In countries such as Russia, China, Canada and Australia with no restriction on abortion, the maternal mortality rates ranged between 6/100,00 and 29/100,000. The U.S. maternal mortality rate during this same time was 19/100,000. This information does not support the fact that stricter abortion laws lead to higher maternal mortality.
In conclusion, the authors state that the ghost of Savita Halappanavar, like the ghost that haunted Ebenezer Scrooge, is warning that we must change our ways or a dismal fate awaits us. At least the ghost in Charles Dickens’ famous 1843 novella spoke the truth.