Is abortion necessary when the mother is affected by suicidal ideation in pregnancy?
There is no scientific evidence to justify abortion as an effective treatment for suicidal pregnant women. We believe that Psychiatrists should be supported by the government and the Minister for Health in using only treatments which are based on sound scientific evidence in Irish hospitals. In 2013 a conducted survey found that 113 of Ireland’s Consultant Psychiatrists believed any legislation that includes a proposal that an abortion should form part of the treatment for suicidal ideation has no basis in the medical evidence available.
As the evidence given by the majority of Psychiatrists to the Oireachtas committee in 2013 indicated that there is no clear evidence from international research that abortion provides any overall benefit to women’s mental health, and there is no evidence indicating abortion is an appropriate treatment for pregnant women with suicidal ideation. In fact the evidence is very much to the contrary: there is abundant evidence that abortion is harmful to the mother’s mental health especially if there is a history of mental health problems, if they are young, ambivalent or coerced, with children already, with poor supports, have moral objections or have previously experienced abortion.
Psychiatrists themselves are the first to admit they cannot accurately predict suicide. Consequently, there would be a very large number of terminations in order to potentially get it right. Review of the evidence shows the risk of suicide is significantly less in pregnant females, one-third to one-half of the risk of non-pregnant females of similar age. However, the risk of suicides increases significantly after an abortion. Pregnancy appears to confer a protective role against suicide. This has been shown in studies published by the British Medical Journal (1996) and the American Journal of Psychiatry (1997). Indeed, the Finnish studies looked at all their registers between 1987 and 1994 and found no cases of suicide in pregnancy but a 3 fold increase in suicide in the first year after abortion.
Doctors for Life Ireland issued a statement/letter to print media on the 17th of May 2013 highlighting that:
“We would like to make a clear statement to the members of the Oireachtas that there is no evidence that termination is the treatment for threatened suicide in pregnancy and that if they vote for the proposed legislation (Protection of Life in Pregnancy Bill, 2013), they do so because they want abortion to be legalised in this country. Those members of the Oireachtas who believe that they are only doing what the Constitution permits since the “X” judgement, should examine the psychiatric evidence heard by the Supreme Court in 1992. They will find none. They might alternatively examine the statements of the psychiatrists called before the Oireachtas Health Committee hearings in 2012, to see what evidence there is that might support the Supreme Court decision. They will find none. We would also remind them that the WHO consistently places Ireland in the top five countries for women’s safety in pregnancy, out of 171 countries surveyed. This has been the case for the past 25 years and without abortion.”
In Doctors for Life Irelands recommendation to the Dail in relation to the Protection of Life in Pregnancy Bill 2013: Head 4 There is a real and substantial risk of loss of the pregnant’s woman’s life by way of self-destruction, stated:
“It is striking that this head proposes that a threat of suicide would make something legal that would otherwise be illegal i.e. the taking of innocent human life. Furthermore it proposes that the medical profession would be complicit in the direct and intentional taking of innocent human life. As far as we can ascertain, there is no other situation in law or medicine where a threat of suicide would be deemed a justification for an attack on the life of human being.
In proposing this the government claims they have no choice but to implement the Supreme Court decision in X. We reject this claim. The Supreme Court in that case did not hear any medical or psychiatric evidence, and the young girl at the centre of the case was not referred for, or offered, any treatment or counseling. A bad or mistaken judgement is not a sound basis for a good law.
Doctors should seek only to care and to cure and to provide the best possible care for all their patients, born or unborn. They should not be complicit in the direct and intentional taking of human life. All doctors, including psychiatrists must practice evidence-based medicine and refuse to act as ‘social police’. There is no evidence that abortion (the direct and intentional killing of the unborn baby’s life) is a treatment for suicide ideation…….and we therefore move that they strike it (Head 4) out.”
In 2014 Doctors for Life Ireland issued a letter in response to the birth of a baby at 24 weeks gestation under the PLP Act. The letter was published in local and national papers:
In pregnancy, Irish medicine has a long held tradition of treating both patients: the expectant mother and her developing child. The recent case of the young woman who was raped and became pregnant has suffered greatly. However, it is wrong to think that an abortion would solve the problem. Having an abortion does not reverse the pregnancy- it kills the child. The hurt continues. In this case the child was delivered prematurely at 25 weeks, but may die or may have serious illness as a result. It is important to note that there are cases of children who were delivered at even earlier gestations and have grown healthy and strong.
It is understandable to think that terminating the pregnancy, or having an abortion, would help the young woman through lessening her suffering. However, there is abundant evidence that abortion is harmful to the mother’s mental health especially if: there is a history of mental health problems; if she is young, ambivalent or coerced; has children already; has poor supports; or has previously experienced abortion. The suffering of the mother in this case is inestimable. One can only hope that she avails of the excellent help and support available from Ireland’s world-class psychiatric services.
The terms of reference of the HSE enquiry into the medical care of these patients relates to the time line of events. The government and the HSE should realize that each baby is the same baby, the same life, at 25 weeks as it is at 12 weeks and as it is at birth. Due to the inclusion of the suicidal ideation clause, the current legislation is misguided and ineffective in what it is supposed to do, i.e. Protect Life in Pregnancy.
Doctors for Life Ireland. Dr Eileen Reilly, (Chairwoman) Galway. Dr Orla Halpenny (Treasurer), Dublin. Dr Deirdre Gleeson (Secretary) Kildare. Dr Rita O Connor, Shannon, Dr Rory Maguire, Dublin”