It Could Happen Here

Protestors outside Leinster House in Dublin Wednesday Nov. 14, 2012 against the death in October of Savita Halappanavar, pict
Protestors outside Leinster House in Dublin Wednesday Nov. 14, 2012 against the death in October of Savita Halappanavar, pictured, a dentist aged 31, who was 17 weeks pregnant, after suffering a miscarriage and septicaemia. The woman's husband Praveen Halappanavar claims she had complained of being in agonising pain while in Galway University Hospital. He has said that doctors refused to carry out a medical termination because the foetus's heartbeat was present. Ireland's constitution officially bans abortion, but a 1992 Supreme Court ruling found the procedure should be legalized for situations when the woman's life is at risk from continuing the pregnancy. (AP Photo/ Julien Behal, PA)

In Ireland last month, Savita Halappanavar died a completely avoidable death because she was denied an abortion. Could this kind of tragedy happen in the U.S.?

Sadly, yes. Her infuriating, unnecessary death should alert Americans that this tragedy could happen here.

Savita, a 31-year-old dentist from India, died at University Hospital Galway on Oct. 28, after the Irish hospital refused to treat her miscarriage because the fetus, with no chance of surviving, still had a heartbeat. After prolonged pain and nausea, Savita pleaded with her doctors to end her doomed pregnancy. They refused citing the Catholic abortion law. Her husband told the Irish Times, "Savita said 'I am neither Irish nor Catholic' but they said there was nothing they could do."

The Catholic prohibition on abortion, by which Irish hospitals abide, equates the use of surgery or medication to complete the miscarriage, even when there is no chance the baby will survive, to an abortion.

This death sentence for Savita is exactly what the U.S. House of Representatives prescribed in the Orwellian-named Protect Life Act, which it passed in October of last year. Thankfully, it died in the Senate and President Barack Obama had vowed to veto it.

But, suppose a handful of U.S. Senate races and our close presidential election had gone Republican. Savita's tragedy could have foretold many American women's funerals.

The conflict between emergency care for a pregnant woman and religious doctrine comes up regularly in my research with doctors practicing in Catholics hospitals in the U.S.

Savita and her husband were told the reason that the physician would not intervene to end the pregnancy was because "this is a Catholic country". And when patients are refused similar care by their physicians, my research shows they are told "this is a Catholic hospital."

This is no small dilemma. One out of every six patients in the U.S. is treated in a Catholic hospital. Catholic health care is financed by all taxpayers through Medicaid and Medicare, and by private insurance dollars, not church coffers. Still, Catholic doctrine prohibits provision of contraception, tubal ligation, vasectomy, abortion and certain fertility and miscarriage treatments. Physicians working in these hospitals are not necessarily Catholic; nor are their patients; nor do even the Catholic physicians and patients necessarily want care to be restricted according to the Catholic doctrine.

Yet, patients at Catholic hospitals unknowingly bear the danger of these conflicting views.

Catholic hospitals defend their role as a major provider of reproductive health care in the U.S. and argue that prohibited services conveniently can be sought elsewhere. But women in Savita's situation rarely are aware of the risks they face when seeking treatment in a Catholic hospital. In many cases, they have little choice about where to get care.

Ob-gyns I interview fear being fired or losing their right to practice in their hospitals if they offer miscarriage treatment too early. However, unlike in Savita's case, they are usually able to intervene before irreparable harm comes to the patient.

I imagine that many Americans are surprised that patients and physicians have little power over these care decisions in the United States. Instead, a hospital's religious doctrine trumps all. Until now, though, there has been one line Catholic hospitals would not cross. A woman should not die as a result of withheld care, as one Phoenix nun decided. She authorized an abortion at the Catholic hospital where she worked for a pregnant woman in medical distress. Her bishop excommunicated her. But the woman lived.

With legislation like the Protect Life Act threatening in our wings, and church hierarchy overruling emergency care, Savita's story could repeat time and again on our shores.

Lori Freedman is a sociologist working in the ANSIRH program in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco.