Galway doctors’ decision on Savita divides gynaecologists

The tragic death of Savita Halappanavar, the young dentist who died last month in an Irish hospital, appears to have set off a debate among gynaecologists here in Bangalore.

Gynaecologist Hema Divakar defended the Irish doctors for not aborting Savita’s foetus saying that under the circumstances, it may have been equally dangerous to have done the procedure.

Two other doctors, however, said the doctors at University Hospital Galway in western Ireland had blundered in denying the 31-year-old’s plea to terminate her pregnancy two days before she developed complications resulting out of septicaemia.

Savita, a dentist from Belgaum, was refused an abortion of the live foetus when the hospital told her it was illegal in the Catholic country.

Explaining the complication Savita found herself in, Dr. Divakar — president-elect of the Federation of Obstetric and Gynaecological Societies of India (FOGSI) for 2013-2014 — told The Hindu on Thursday: “Based on information in the media, in that situation of septicaemia, if the doctors had meddled with the live baby, Savita would have died two days earlier.”

Cause of death

“Delay or refusal to terminate the pregnancy does not in itself seem to be the cause of death. Even if the law permitted it, it is not as if her life would have been saved because of termination,” she said. “Severe septicaemia with disseminated intravascular coagulation (DIC), a life-threatening bleeding disorder which is a complication of sepsis, major organ damage and loss of the mother’s blood due to severe infection, is the cause of death in Savita’s case. This is what seems to have happened and this is a sequence which cannot be reversed just by terminating the pregnancy.”

Pain and infection

Analysing the situation, Dr. Divakar said: “Based on available information, Savita would have reported pain and infection and doctors would have indicated a miscarriage as the 17-week foetus may not have grown as expected. Its growth would have been deteriorating because of the infection. Having understood that the baby was not going to make it, the couple would have asked for termination. But as Savita’s infection may have required aggressive treatment at that stage, doctors must have felt the need to prevent complications. The usual [practice] is to meddle the least till the mother is stable.”

Asserting that it is wise to wait in cases with such complications at 17 weeks, Dr. Divakar said: “As per reports, the baby’s heartbeat stopped after three days. But that was expected.”

Amending the law

Vasundhara Bhupathi, former member of Pre-Conception and Pre-Natal Diagnostic Techniques (PC and PNDT) Bangalore District Advisory Committee, and N. Venkatesh, former president of Bangalore Society of Obstetrics and Gynaecology, said there is a need to amend Irish laws on abortion.

‘Decision proves costly’

“It is unfortunate that the doctors refused to terminate the pregnancy although they had said Savita was miscarrying the foetus. The doctors should have expedited the [abortion] process as soon as they sensed trouble. In this case, they waited for the baby to die, which proved costly for Savita,” Dr. Venkatesh said.

More In: Bengaluru