The flood of women claiming to be suicidal in order to procure terminations in Ireland never opened following the introduction of the Protection of Life During Pregnancy Act, Dr Rhona Mahony told a maternity conference on Saturday.

Dr Mahony, master of the National Maternity Hospital in Dublin, also said the rate of terminations had remained unchanged at Holles Street since the legislation was commenced in 2014.

Under the Act, an abortion can be carried out if there is a risk to the life of the mother. In order for a termination to take place, two medical practitioners have to examine the woman and jointly certify that the risk to her life can only be averted by carrying out the procedure.

“People worried that the floodgates would open when we had legislation,” said Dr Mahony. “And it’s quite interesting; in my hospital we perform about five or six terminations to pregnancy every year and that figure has remained absolutely stable. It hasn’t changed,” she said at the La Touche Training conference Maternity Protection: The Way Forward in Dublin.

Complex area

On the issue of suicidal intent, which, in certain cases, can allow for a termination, Dr Mahony told the conference it was a complex area and one which society could not specifically “treat”.

During the pre-legislation debate, she recalled, “people said that women would make it up”.

“[An argument existed that] the floodgates would open and there would be women all over the country telling their doctors that they really want to kill themselves in order to procure a termination of pregnancy. Well you know what, that hasn’t happened,” she said.

“There is a misogynistic message in that. Women who say they want kill themselves should be taken seriously. We need to listen to them because it’s quite likely that there is something very serious going on.”

Despite the suicide element to the law, Dr Mahony opined that most women would not enter into what was a complex process but would simply travel to the United Kingdom instead. In this area, children and women of limited means, unable to do so, were of particular concern, she said.

Prof Chris Fitzpatrick, consultant obstetrician at the Coombe Women & Infants University Hospital, told the conference there was a need to establish common ground between two extreme views on abortion.

Decisive action

In a note outlining the content of his talk, Prof Fitzpatrick addressed the broader area of Irish maternity services and said the system requires up to 100 more obstetricians as well increased numbers of midwives, neonatologists, perinatal psychiatrists and perinatal pathologists.

Improved equipment, new hospitals and expanded community services are also required.

“It is time for decisive action. Ireland has the lowest ratio of obstetricians in the OECD,” he said.

“Despite the lack of investment, the clinical outcomes for mothers and babies are very good in Ireland – comparable to those of equivalent income counties – due to the dedication and professionalism of staff.”

Regarding litigation, Prof Fitzpatrick said there was a particular need for reform in relation to expert witnesses.

“It is increasingly difficult to accept the continuing use of professional experts, sometimes long-retired from clinical practice, who will, for a significant fee, offer a specialist opinion on an implausibly wide range of problems,” he said in a written summary.

“The law, like medicine, is an imperfect system. Legal judgments, like clinical decisions, are sometimes wrong.

“The consequences of a wrong judgment will not, however, usually result in a judge being door-stepped by journalists or his or her children being photographed for the newspapers or him or her being abused in the local supermarket.”