All we know at this point about the proposed abortion legislation is that suicidal pregnant women will not have to be assessed by six doctors before being referred for a termination. That’s good news, in so far as it goes.
But whether it was six doctors, or four doctors, or – as has been suggested elsewhere – two obstetricians followed by a perinatal psychiatrist, was never really the point.
Here’s what I believe: any woman so desperate for a termination that she is willing to throw herself at the mercy of a system which has historically regarded her as a criminal and claim she is suicidal, should probably just be taken at her word.
Think about it. If she is unable to get on a plane or procure herself the necessary pills over the internet, then she is very likely to be in the throes of a major crisis. The first rule suggested by organisations such as the Samaritans for dealing with someone in a mental health crisis is that if they indicate they are suicidal, you take them seriously.
After that, you offer them non-judgmental support; you make sure they are in a safe place and have the support of people who love them; you give them hope.
What you don’t do is suggest to them that you don’t believe them when they say they’re feeling suicidal; the very last thing you do is pressure them to prove they’re serious.
We don't know yet exactly what form the suicide provision in the Protection of Maternal Life Bill will take. But for any government – not least one which pledged to make suicide prevention one of its top priorities in office – to expect suicidal women to undergo an interrogation about their mental health before allowing them access to a service, to which the Supreme Court has ruled they have a right, would be unthinkable.
Of course, these guidelines are not about women who are actually suicidal.
In this country, there are people who, deep down, don’t really believe in the concept of a crisis pregnancy. They may now be in the minority – a recent IPSOS/ MRBI survey in this newspaper found those who oppose abortion in every circumstance now number just 12 per cent of the population – but they remain a very vocal minority.
This group apparently refuses to accept that there are women for whom being pregnant is so shattering that they would sooner take their own life than go through with it. If they accepted this, being “pro-life”, they would have to do something about it. Instead, they talk about “floodgates” and “normalising suicide”.
Even on the difficult subject of pregnancies arising from rape, they cite examples of women who went on to bond with the baby they conceived as a result of the attack.
The Iona Institute’s January 2013 submission to the Oireachtas Joint Committee on Health and Children quotes Shauna Prewitt, a woman who became pregnant through rape, who later wrote: “to my surprise, I did not altogether hate the life growing inside me ... I felt a bond.”
This is heartwarming – but rape victims surely do not need anti-abortion groups telling them how to feel about their pregnancies.
Similarly, these groups talk about termination not being a “treatment” for mental health problems – as though anyone seriously thought it was, any more than the new insolvency arrangements are a “treatment” for people with depression brought on by financial problems.
The subtext to all of this is that they regard the phenomenon of suicidal ideation in pregnancy as an invention by the liberal media, designed to tear open the much-vaunted floodgates to abortion on demand.
Whatever guidelines emerge to form the basis of legislation on the X case must not start from the default position that any woman who goes to her doctor saying she is pregnant, suicidal and wants a termination, is likely to be faking it.
I spoke this week to a mental health professional with experience of suicide prevention, who pointed out that any woman who is together enough to fake feeling suicidal will have long ago booked herself a plane ticket or ordered those pills from the internet.
But reality doesn’t come into this discussion. If we were dealing with reality, we’d accept that abortion already exists in this country in all senses but the geographical.
A suicidal woman in a crisis pregnancy needs the same thing any woman in a crisis pregnancy feels, only more urgently: she needs support, information about her options, a recognition of her autonomy to make her own decision and support when she does so.
I have no personal experience of a crisis pregnancy, though I have watched others go through one, and I would not wish it on anyone. But you shouldn’t need firsthand experience to be able to accept that mental health crises in pregnancy are very real, and utterly devastating to those involved.
You just have to be willing to listen to the women who told their stories of travelling to England for abortions to this newspaper last year, who spoke about the burden of the secrecy and the stigma, and how much more difficult it made coming to terms with the abortion.
You just have to be willing to take at face value the statistics from, for example, the Royal College of Midwives and Netmums, which found that 80 per cent of 260 women with depression in pregnancy went on to suffer postnatal depression afterwards, and more than a third had suicidal thoughts.
Abortion would not have been the right answer for all these women, or even for most of them – just as it’s not always the best answer for any woman with a crisis pregnancy. But that is a decision only she can make – and it is not a decision any woman takes lightly.
In the UK, pregnant women must speak to two doctors before being permitted to have a termination on physical or mental health grounds. But this is not designed to be an inquisition: for the most part, those doctors are willing to take the word of an autonomous adult – yes, even a female one – at face value.
Whether it’s six doctors or two, any proposal to put suicidal Irish women through an interrogation before allowing them access to a termination is not merely unworkable; it is demeaning, medieval and cruel.
Forcing them to prove they are serious about feeling suicidal is dangerous.