Sir, – During the 1970s and 1980s I published socio-demographic and medical characteristics of Irish residents whose pregnancies were terminated in England and Wales following the introduction of the Abortion Act 1967. These were supplied to me by the Department of Health and Social Security of that jurisdiction and published serially in the Journal of the Irish Medical Association.
That Act allowed for the termination of pregnancy on a number of statutory grounds including ground B “the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman”. During the years surveyed 90 per cent of terminations involving women supplying Irish addresses were terminated under this provision.
In addition to stating the statutory ground, the notification form to the chief medical officer must state the medical ground for termination. In 85 per cent of Irish terminations the medical ground stated was “depression” with “risk to mental health” constituting another 5 per cent. Psychosis accounted for less than 0.5 per cent. The residue of medical grounds related to physical health. Eighty per cent of Irish women were single and 65 per cent aged 20-29.
These social and medical characteristics did not differ from those of the totality of women whose pregnancies were terminated in those years in England and Wales. And they remain very similar to all those terminated in England and Wales in 2011, 98 per cent of them on statutory ground B, including 6,151 non- residents, the majority of them from Ireland.
The claim that from 1900 to 1950 10 per cent of Irish women of child-bearing age dying by suicide were pregnant at death, recently reported in the media, rests on no secure ground of which I am aware. In fact the first comprehensive survey of suicide in Ireland of the modern era, although limited to Dublin, which I co-authored, covering the years 1954-1963 appeared in the British Medical Journal in 1966. Coroners' inquest records and post mortem reports did not allude to pregnancy in any of the 58 females of child-bearing age identified as dying by suicide. This does not exclude pregnancy in these cases, given the cultural mores of the time. Nor do we know the pregnancy status of the 66 similarly aged women recorded as dying by suicide in Ireland in 2011.
Finally the ability of psychiatrists to determine the likelihood of transition from suicidal threat to suicide itself, in the absence of any reliable biological marker, is fragile at best. Despite this shortcoming it seems to me Government has little alternative other than to proceed with this cumbersome and Machiavellian solution to an Irish politico-religious problem. – Yours, etc,
Dr DERMOT WALSH,
Consultant Psychiatrist,
Russborough,
Blessington, Co Wicklow.