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Coombe hospital denies board intervened to refuse abortion for woman with a fatal foetal diagnosis

Earlier Ruth Coppinger told the Dáil that two doctors confirmed it was a fatal foetal abnormality, but the board refused the abortion.

Updated Jan 17th 2019, 9:46 PM

Source: TheJournal.ie/YouTube

THE DÁIL HAS heard that a woman who was 14-weeks pregnant carrying a foetus with a fatal foetal abnormality was denied an abortion at the Coombe Hospital in Dublin.

Ruth Coppinger told the Dáil that the woman had the abortion signed off by two doctors but that the termination was refused by the board.

“At 13 weeks, this woman went for her 12-week scan, they could clearly see at that point the organs of the foetus were outside the body,” she said.

Coppinger said doctors confirmed it was a fatal foetal abnormality, but the board refused the abortion. 

The Solidarity TD said this was the first “test case” of the new abortion legislation and said it was the “chilling effect” of criminalisation of abortion that led to this case.

Bríd Smith said she spoke to the woman who told her “this isn’t what I voted for”.

In response, Tánaiste Simon Coveney said that the law is clear in this matter but concurred with the Ceann Comhairle that it wasn’t appropriate to raise a tragic case of “somebody who’s clearly under a lot of stress”.

“This place needs to be dealt with appropriately in hospital and not on the floor of the Dáil,” he said.

This led to angry exchanges involving Coppinger, Smith and the Ceann Comhairle.

The abortion legislation passed by the government following the result of the Eighth Amendment referendum allows for abortion for cases of fatal foetal abnormality after 12 weeks.

The law states: “A termination of pregnancy may be carried out in accordance with this section where 2 medical practitioners, having examined the pregnant woman, are of the reasonable opinion formed in good faith that there is present a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth.”

Earlier this evening, the Coombe issued a statement to say it cannot comment on individual cases for patient confidentiality reasons. 

However, it added that the hospital’s board had “no role whatsoever” in certifying a termination of pregnancy.  

“Insofar as recent media coverage has stated that the Board has had a role in determining whether or not the criteria for certification have been met, those reports are untrue,” it added. 

The Coombe says it has not started delivering abortion services to patients, despite the HSE and Department of Health’s work to have them operational by 1 January 2019. However the Department of Health released a statement tonight saying it had been advised that the Coombe Hospital is currently providing terminations in emergency situations and in cases of fatal foetal abnormality. 

The hospital issued a statement at the end of last month saying it would not provide the services until the board and management were confident in the nationwide system. 

On its website, it says: “The Coombe Women & Infants University Hospital is fully committed to providing Abortion Services under new legislation. To ensure the provision of safe, high quality, sensitive and compassionate care to women, these services will be provided when the Board and Management of the Hospital are satisfied that the necessary resources have been put in place. In this context, these services will not be available on 1st January 2019.

“The Department of Health and the HSE have been notified of the Hospital’s consistent position in relation to this.” 

TheJournal.ie asked a number of questions of the Coombe following its statement, including: 

Is the Coombe in a position to offer early termination to any woman who has received a diagnosis of a fatal foetal abnormality? If not, when is it envisaged that they will be?
Further to that, if one of their patients requests a termination in these cases under the 2018 Act, will they be referred onto another hospital which does provide the services to patients?

A spokesperson replied: “The Coombe won’t be commenting further beyond the information published on the website here.“ 

In a statement this evening, the Department of Health said that the Minister is aware that a case relating to the termination of pregnancy was raised in the Dáil today. 

It said that “while it is not appropriate for either the Minister or the Department of Health to comment on any individual case, it is important that the following points are noted”.

“Section 11 of the Health (Regulation of Termination of Pregnancy) Act 2018 sets out the law on access to termination of pregnancy in cases where there is a condition present affecting the foetus that is likely to lead to the death of the foetus before or within 28 days of birth,” it said.

“The operation of the legislation is entirely a matter for attending clinicians. Neither the Minister nor the Department of Health has any role in the medical management of cases.”

It added that “the Board of any institution, including that of the Coombe, has no role in such decision making”.

“However, it is clear that where a patient requires care not available in a particular location, the patient should be transferred to a hospital/service where the necessary care is available,” it said.

“The Health (Regulation of Termination of Pregnancy) Act 2018 makes provision for women in cases where a medical practitioner has not given an opinion, or has given an opinion that would not lead to certification for termination of pregnancy to be carried out. Section 13 of the Act provides that the woman, or a person acting on her behalf, may make an application to the HSE for a review of the relevant decision.

“Within three days of receiving such an application, the HSE must convene a committee of medical practitioners to review the relevant decision. The committee must complete its review not later than seven days from the date on which it was established.”

The Department of Health said it “has been advised that the Coombe Hospital is currently providing terminations in emergency situations and in the cases of fatal foetal abnormality”. 

“The National Women and Infants Health Programme continues to engage with the Dublin Midlands Health Group and the Coombe Hospital with a view to ensuring full commencement of service provision as soon as possible,” it said. 

‘Continue for four weeks’

Speaking to TheJournal.ie in more detail about the case, TD Bríd Smith said the woman called her looking for help, stating that two obstetricians outlined to her that the foetus would not survive. 

“The woman later received a phone call from the midwife, on behalf of the board, telling her she should continue with the pregnancy for another month. 

Bríd said the inference here is see if the a natural miscarriage might take place within that period. 

The woman said she was not referred to another hospital, which is why she wants to meet with her consultant as a matter of urgency. However, the woman has been told the consultant cannot meet with her until Monday. 

Smith said the woman is now considering travelling to the UK for a termination.

“The law is the law,” Smith told TheJournal.ie, adding: 

She is entitled to a termination. The law is clear. 

Earlier today, a spokesperson for Health Minister Simon Harris told TheJournal.ie: “We do not comment on individual cases. The Health (Regulation of Termination of Pregnancy Bill) is clear. The law allows for terminations when two obstetricians certify the foetus will not survive outside the womb.”

Senator Catherine Noone, who was chairperson Oireachtas Committee on the Eighth Amendment, said on Twitter that the situation is “completely and utterly unacceptable”.

She called for the board of the Coombe to appear before the Oireachtas Health Committee next week to explain their actions.

With reporting from Christina Finn, Sinead O’Carroll, Céimin Burke and Hayley Halpin

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Sean Murray

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