Dr. Sean O Domhnaill
I began my career in Psychiatry in Jersey in 1997, sixteen years ago, in the year that the States of Jersey legalised abortion in accordance with the broad guidelines of the British Abortion Act of 1967.
My very first assessment of an attempted suicide in Jersey General Hospital was in the context of a nineteen year-old girl who had taken a significant overdose in an attempt to end her life, because she had developed a major depressive disorder some six months after obtaining an abortion in Southampton in the UK.
I remember, in particular, the rhetorical question she posed to me when I suggested that she could move beyond that awful place she now found herself in, where life held no further attraction for her and death seemed to offer a welcome relief from her suffering.
She told me that she had been pressured by her parents and her boyfriend into having an abortion. As I attempted to assist her to gain some perspective on her mental state and the likelihood of recovery from a depressive illness brought on by her sense of loss, she asked me: “Can you tell me that I haven’t killed my own baby? Can you tell me that I can undo what I have done? Can you tell me how to bring my baby back?
I thought of her again recently as I listened to the evidence given by medical experts to the Joint Oireachtas Committee on Health and Children on abortion and suicide.
The Committee was holding hearings because the government is looking at legalising abortion on suicide grounds. The evidence given at the hearings confirmed what I know to be true from my own clinical experience - abortion does not treat suicidality and it can cause serious mental health problems for women.
It was hugely significant that. at the hearings, all of the experts in maternal healthcare, including obstetricians and psychiatrists, agreed that abortion was not a treatment for suicidality.
Senior figures such as Dr Sam Coulter Smith of the Rotunda Maternity Hospital confirmed that they had not come across any cases where abortion was the only solution for a pregnant woman expressing suicidality.
And the head of St Patrick’s University Hospital - Ireland’s leading psychiatric hospital - said that there is “no evidence either in literature or from the work of St Patrick’s University Hospital that indicates that termination of pregnancy is an effective treatment for any mental health disorder or difficulty”.
I would agree whole heartedly with Dr John Sheehan, Consultant Perinatal Psychiatrist at the Rotunda, who said that he and his colleagues had not seen one clinical situation in which “termination of pregnancy has been the treatment for a suicidal woman”.
Dr Sheehan also pointed out that “the notion of carrying out an emergency termination is completely obsolete in respect of a person who is extremely suicidal”, and noted that it would not be wise in such a situation “to make a decision that is permanent and irrevocable”.
I am aware too that a growing body of evidence shows negative mental health outcomes for women following abortion. Recently a 13-year epidemiological study was published in the European Journal of Public Health. It looked at data between 1987 and 2000 on all deaths among women of reproductive age in Finland.
The research found that the suicide rate among women who had abortions was six times higher than that of women who had given birth, and double that of women who had miscarriages.
The findings of the research carried out by Dr David Fergusson and others, and published in the British Journal of Psychiatry in 2008, were equally troubling. They found that women who had abortions were 30 per cent more likely to experience mental disorder.
Interestingly, Revision Notes in Psychiatry (the most popular textbook among Irish and British psychiatric trainees) informs us that one in 10 women who aborted suffer “severe and/or prolonged psychological sequelae”, which is a devastating experience, as any mental health practitioner will tell you.
Having treated many women who have indeed suffered severely following abortion, my experience is that this evidence should not be ignored by any policymakers or legislators.
The government now needs to look at the evidence given by the medical experts which shows that abortion is not a treatment for suicidality. Their conclusion must be that it would be folly to use suicide as a reason to legislate for abortion in Ireland.
Women, and their babies, deserve better than abortion - and the government needs to recognise that and act accordingly.
Dr. Seán Ó Domhnaill is a Consultant Psychiatrist and an advisor to the Life Institute.