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November 20, 2012
Legal abortion not the answer in Ireland deaths
By Stephanie Gray *

By Stephanie Gray *

Do the tragic deaths in Ireland of Savita Halappanavar and her pre-born daughter Prasa really make a case for legal abortion?  Many across the world are coming to that conclusion but overlooking an important piece of information recently reported in The Irish Times and The Guardian: an autopsy revealed that Halappanavar died of septicemia “documented ante-mortem” and E. coli ESBL.

Countless news reports are only talking about the septicemia (i.e., blood poisoning), but few are discussing E. coli ESBL, which, incidentally enough, can lead to, you guessed it, septicemia.  Just what is E. coli ESBL?  An antibiotic-resistant bacteria (not to be confused with regular strains of E. coli that cause food poisoning) that is associated with urinary tract infections (UTI). This strain of E. coli has been spreading in the UK and last year two babies died in nearby Wales because of it. The presence of E. coli ESBL is particularly problematic if Halappanavar was given antibiotics to fight an infection that was resistant to those very antibiotics.

According to the Journal of Antimicrobial Chemotherapy, E. coli is one of the most common organisms to cause a UTI and complicated UTIs are frequently associated with pregnancy. They write, “The likelihood of treatment failure and serious complications, particularly the development of antimicrobial resistance, is more common in cUTI (complicated urinary tract infection).”

So instead of jumping to the conclusions that Halappanavar needed an abortion and that Ireland needs to legalize the killing of the youngest of its kind, the reasonable approach would be to get to the bottom of what Halappanavar’s condition was and examine how it was, or was not, responded to.  We have yet to hear from the hospital and the medical professionals involved as to what precisely happened, but with this report of her dying from E. coli ESBL one wonders how killing Halappanavar’s baby Prasa would have killed the E. coli.

Is it possible that E. coli ESBL ascended her vagina and entered her uterus via the dilated cervix? Yes, that’s possible. But it’s also possible that her cervix dilated (thus initiating a miscarriage) because E. coli ESBL ascended her urinary tract and caused an infection in her kidneys, which can lead to uterine contractions, and if not treated, to cervical change. 

So the infection could have been elsewhere in her body besides the uterus.  Even if it was in the latter (a condition known as chorioamnionitis) then it is an ethical course of action to induce labor to eliminate this pathological and lethal condition (the presence of infected membranes) from her uterus. But that act itself wouldn’t have eliminated the E. coli ESBL if it actually originated in the urinary tract, which, if resistant to interventions like antibiotics, could have lead to the septicemia.

And yet, The Toronto Star would have you believe, “There’s a very simple reason why Savita died. It’s because she wasn’t listened to.”

On the contrary, much more needs to be known about how she died. But what we do know is that jumping to the conclusion that abortion should be legalized in Ireland overlooks the underlying medical condition and makes the dangerous assumption that we need to kill one person to save another.

Stephanie Gray is executive director of the Canadian Centre for Bio-Ethical Reform and author of “A Physician’s Guide to Discussing Abortion.”
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