The Committee hearings: Proof abortion is NOT a treatment for suicide

See our latest project on why abortion is not a treatment for suicidality

The Life Institute has said that the government must now rethink its proposal on abortion following the report of the Oireachtas Committee on Health and Children which gathered evidence showing abortion was not a treatment for suicidality.

"The Committee heard evidence from leading medical experts - and they were all agreed that abortion is not a treatment for suicidality," said Niamh Uí Bhriain of the Life Institute. "The government now needs to show that it is listening to the evidence of its own hearings, and to the medical experts who have repeatedly stated that abortion is not an effective treatment for any mental health disorder or difficulty".

"The Committee's report shows leading experts from St Patrick's psychiatric hospital and from the maternity hospitals all agreeing that they had never had a case where abortion was required to treat a woman was suicidal, and other experts making the case that abortion increases the risk of suicide. This evidence cannot be ignored by a government who genuinely wants to do the right thing by mother and baby," she said.

Ms Uí Bhriain said that Fine Gael needed to stand up to the Labour Party who were dividing Fine Gael on the abortion issue. "The B&A poll for the Sunday Times last weekend showed that support for abortion legislation was lowest among Fine Gael voters at 42%, yet the party are buckling under pressure from Labour and moving against their base to become the party who legalised abortion in Ireland."

She pointed out that the former Fine Gael leader, John Bruton, had opposed legalising abortion on the grounds of suicide, when he said that: 'when you actually look at the words in the constitution which talk to an equal right to life. Well, a possibility is never equal to a certainty. All you can ever say about suicidal ideation is that there is a possibility that it might be fulfilled, whereas in the case of a termination you have the certainty of the ending of that other life'.

The Life Institute spokeswoman said that the evidence of the experts could be summarised as follows:

• All of the medical experts agreed that abortion is never a treatment for suicidality
• None knew of a case where an abortion was the only treatment for a woman who was suicidal.
• None knew of a case where a woman had died by suicide because abortion was not available
• Senior psychiatrists testified that abortion would be "completely obsolete" in respect of a person who is extremely suicidal.
• Evidence was given that abortion can actually increase the risk of suicide.
• Experts confirmed that suicide in pregnancy is very rare - and that treatment for suicidality included providing safety, nursing, psychological treatment and medication.

End

Further information and quotes from the Committee Report below

What the experts said on ABORTION AND SUICIDE

1. All of the medical experts agreed that abortion is never a treatment for suicidality

"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".
Prof James Lucey, St Patrick's University Hospital

On the suicide issue, we need to become very focused on the fact there are other treatments for suicide. If a male patient pitched up in accident and emergency tonight and said he wanted to kill himself, there would be medical treatments, drugs and therapies, and these would be reviewed in a couple of weeks. That is the first-line treatment, and cases are reviewed after a couple of weeks.
Dr. Mary McCaffrey, OB/GYN, Kerry General Hospital

All appropriate mental health supports need to be made available for women who are at risk of suicide, have threatened to commit suicide or have suicidal ideation. The committee can ask the psychiatrists, but most people would agree that the termination of pregnancy is not a treatment in this regard.
Dr Sam Coulter Smith, Master of the Rotunda Hospital

On the issue of suicide, nobody is suggesting that termination of pregnancy is a cure for mental anguish or the disorders associated with suicide ideation
Dr. Rhona O’Mahony, Master of National Maternity Hospital, Holles Street

..there is no evidence that abortion reduces suicide risk in pregnant women, and there is some evidence that it may have a negative effect in some instances.
Professor Patricia Casey, Mater Hospital and UCD

2. None knew of a case where an abortion was the only treatment for a woman who was suicidal.

However, we have not had the experience of seeing any women who were suicidal where the appropriate treatment for their suicidal feelings would have been a termination of pregnancy.
Dr Anthony McCarthy, College of Psychiatry

Although we have discussed this among the group [of 12 Obstetricians and Gynaecologists},  I personally have no knowledge of ever having cared for a woman who wanted to end her life specifically because of a pregnancy, and in my pursuit of information over the past week or so, I have been unable to identify any other consultant who did know of such a woman, which backs up the information we already have - i.e., that this is an extremely rare situation

That was their opinion having practised abroad. In all of their clinical experience and practise they had not met a woman citing suicidal intent or ideation purely because she was pregnant. That was the view of the 12 consultants involved
Dr. Mary McCaffrey, OB/GYN, Kerry General Hospital

I was asked if we have ever had to perform a termination of pregnancy because of risk of suicide; not in my experience.
Dr Sam Coulter Smith, Master of the Rotunda Hospital

I refer to Deputy Terence Flanagan's question on whether we, as perinatal psychiatrists, have ever seen a situation in which termination of pregnancy has been the treatment for a suicidal woman. To reiterate our statement, with more than 40 years of clinical experience between us, we have not seen one clinical situation in which this is the case.

Dr. John Sheehan, Consultant Perinatal Psychiatrist, the Rotunda Hospital

However, one must remember that it is absolutely individual and for us, with our 40 years of experience, we have never assessed a woman for whom our management would be to advise a termination and for the legislators, this must be taken into consideration.

Dr Joanne Fenton, Consultant Perinatal Psychiatrist, the Coombe Women's Hospital

In my work as a psychiatrist, I run the attempted suicide service in the Mater Hospital in which we see and assess more than 400 attempted suicides in women per year. I have never seen a pregnant woman who was suicidal for whom an abortion was the only answer.
Prof Patricia Casey, Mater Hospital and UCD

   

3. None knew of a case where a woman had died by suicide because abortion was not available

I am not aware of any death from suicide because a termination was declined.

Dr. Mary McCaffrey, OB/GYN, Kerry General Hospital

As regards mental health issues in pregnancy and following pregnancy, it was stated earlier that the incidence of mental health issues in pregnancy is approximately 10% to 15%. The risk of suicide in pregnancy is extraordinarily low. We all know that women can suffer from post-natal depression and that the risk of suicide remains following pregnancy. It is my belief that the risk of suicide can increase a little post natally. However, that is an issue which the committee can explore later in more detail with our psychiatric colleagues.
Dr Sam Coulter Smith, Master of the Rotunda Hospital

   

4. Senior psychiatrists testified that abortion would be an inappropriate treatment in respect of a person who is extremely suicidal.

Someone who is intensely suicidal often needs admission to hospital. It is exactly the opposite to the medical intervention and, consequently, even the notion of carrying out an emergency termination is completely obsolete in respect of a person who is extremely suicidal. I reiterate that in our practice, we see people who are profoundly depressed, who feel hopeless, worthless or utterly helpless to deal with situations. In such situations, one can see clearly the intervention usually is to admit such people into hospital, day hospital or home care but the intention is to support and help them through the crisis they are in. It is not to make a decision that is permanent and irrevocable.
Dr. John Sheehan, Consultant Perinatal Psychiatrist, the Rotunda Hospital

If the woman is profoundly depressed and mentally ill, she would be advised not to take any major life decision at that time, and frequently admission to hospital might be advised. Ongoing review and monitoring would typically be required.
Dr Anthony McCarthy, College of Psychiatry

   

5. Evidence was given that abortion can actually increase the risk of suicide.

There is also a study which was carried out in Finland, which I did not have an opportunity to refer and which focuses on related suicide in women who had abortions or miscarriages or who gave birth. That study indicates that among those who had abortions, the suicide rate was three times the national average. In those who gave birth, it was half the national average. There is data to support the proposition that there is no evidence that abortion helps women's mental health.

Prof Patricia Casey of the Mater Hospital on a study which has found that women who undergo abortions were six times more likely to die by suicide.

Every one of us working in the perinatal service will have seen women who had terminations of pregnancy and who will feel profoundly guilty about that during a subsequent pregnancy, and it will have a negative effect on them.

Dr Anthony McCarthy, College of Psychiatry, National Maternity hospital

    

6. Experts confirmed that suicide in pregnancy is very rare - and that treatment for suicidality included providing safety, nursing, psychological treatment and medication.

"The risk of suicide in pregnancy is extraordinarily low."
Dr Sam Coulter Smith, Master of the Rotunda Hospital

Suicide rates are lower in pregnant women than in non-pregnant women. International studies suggest that the suicide rate in pregnancy is from a third to a sixth of the expected rate in non-pregnant women, indicating that frequently pregnancy confers a protective effect against suicide.
Dr Anthony McCarthy, College of Psychiatry

On the suicide issue, we need to become very focused on the fact there are other treatments for suicide. If a male patient pitched up in accident and emergency tonight and said he wanted to kill himself, there would be medical treatments, drugs and therapies, and these would be reviewed in a couple of weeks.
Dr. Mary McCaffrey, OB/GYN, Kerry General Hospital

As Dr Jacqueline Montwhill, consultant psychiatrist, has said the treatment for suicidality in a pregnant woman "is to make sure that the patient is safe, make sure that patient is on the appropriate medication... and to make sure that the appropriate psychological treatment, support, intervention and nursing support is made available to her.

LINKS

Oireachtas Committee on Abortion Report Volume 1

Oireachtas Committee on Abortion Report Volume 2