Written by Susan Yanow for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Recent press about the death of Savita Halappanavar, admitted to a hospital in Ireland with medical complications in a 17-week pregnancy, is a grim reminder about the impact of abortion restrictions on women’s lives.

In Ireland, abortion is legal only to save a woman’s life. In the last two years in the United States, nine states have passed laws banning abortion after 20 weeks (in Arizona abortion is banned after 18 weeks) except to save a woman’s life. But as the death of Ms. Halappanavar so poignantly illustrates, “risk to a woman’s life” in emergency situations is extremely difficult to assess.

Savita Halappanavar was 31 years old, and had a wanted pregnancy. She began suffering severe back pain, was admitted to the hospital and was told that she was miscarrying. As the pain increased and her health worsened, she and her husband requested that the pregnancy be terminated. Because the fetus still had a heartbeat, however, she was denied her right to a safe abortion. After three days in the hospital, Savita Halappanayar died. The doctors attending her did not determine that her life was sufficiently at risk to warrant performing an abortion.

Could this happen in the United States? In short, it certainly could. Let’s remember the 1988 case of Michelle Lee, a resident of Louisiana who had a serious heart condition and was waiting for a heart transplant. She became pregnant, and because of her medical condition could not be seen at an outpatient abortion clinic. She was sent to the only hospital in Louisiana with appropriate services, Louisiana State University. However, as reported at the time:

A committee of five LSU doctors concluded that Lee’s chance of dying was not greater than 50 percent. And under Louisiana law, a public hospital could not perform an abortion on Lee unless her life were endangered. They decided her case didn’t meet the test.*

What must the chance of dying be for a woman to “qualify” for a life-saving abortion? In Louisiana, a 50 percent chance of death was not enough. Who knows how the doctors in Ireland assessed the risk to Savita Halappanavar?

In the states that have passed limits on when an abortion can be performed, lawmakers are expecting physicians to juxtapose their assessment of medical risk to a given woman with the legal risk of prosecution if, after the fact, there are “second guesses” about whether the woman was at sufficient risk to trigger the legal exception the abortion ban.  This untenable intrusion of law makers into medicine puts physicians into an impossible situation. 

We have a sobering lesson to learn from Ireland – when doctor’s medical judgement is compromised by restrictive abortion laws, it is women’s health and women’s lives that suffer.

*Activists mobilized and raised $8,000 to help Michelle Lee get a life-saving abortion in Texas. Today, Texas is one of several states considering a ban on abortions after 20 weeks in the next legislative session.

Photo by ge’shmally under Creative Commons license.