Response to head 2 of Bill: Risk of loss of life from physical illness, not being a risk of self destruction.
This head is almost identical to the current medical council guidelines. The only difference is that they ask that two doctors, one being an obstetrician /gynaecologist working in that location and the other on the specialist medical register who agree in good faith that “terminating the pregnancy is necessary to save the life of the mother”. It also states that if the unborn baby is viable outside the womb “doctors must make all efforts to sustain its life after delivery”. Therefore there is nothing new in this Head.
This Head outlines the current practice in all maternity units in the country, most commonly in the management of severe pre-eclampsia where it may be necessary to deliver the baby early in order to cure the condition. Obstetricians are always weighing up the balance between maximising the potential for both patients- the pregnant woman and her unborn baby. For example if a pregnant women presents at 24 weeks with severe pre-eclampsia. The ultimate treatment is to deliver the baby. But initially treatment entails controlling her blood pressure and monitoring clinical symptoms and biochemical parameters to assess the severity and progression of the disease whilst simultaneously monitoring the unborn baby and giving the mother steroids in an effort to mature the baby’s lungs to improve the baby’s chance of survival once delivered.
On occasions delivery may have to be induced at a gestation where the baby is unlikely to survive. In practice on these occasions most doctors would consult another colleague when making these difficult decisions.
Recommendation:
We agree that professional guidance should be developed by the relevant professional bodies. This is not abortion but appropriate medical treatment where the intention is to preserve the life of both if possible. Therefore the current situation does not require a change in the law merely clarification on what constitutes a real and substantial risk to the life of the pregnant women.
