The Limits of a Tragedy Story
In the early morning hours of October 28, 2012, a dentist named Savita Halappanavar died in Galway, on the west coast of Ireland.
Actually, she had been dying for days.
In a report released the following year, medical investigators found that Halappanavar, who was 17 weeks pregnant, had been showing signs of a possible pregnancy-related infection since her first visit to the hospital a week earlier.
But even after the amniotic sac ruptured–meaning that Halappanavar’s pregnancy couldn’t possibly be viable, and that her risk of developing a life-threatening infection was increasing by the hour–doctors failed to do the one thing that might have saved her life: give her an abortion. Halappanavar’s miscarriage was already too late by the time she miscarried herself. She died four days later. She died four days later.
Does this story sound familiar?
Maybe that’s because you’ve heard it before–or because it’s so similar to the stories of Josseli Barnica, Amber Thurman, and Candi Miller, three U.S. women whose abortion ban-related deaths were recently reported by ProPublica.
In Texas, where a near-total abortion ban went into effect in 2021, pregnancy-related deaths increased by 56 percent between 2019 and 2022, dramatically surpassing the national increase of 11 percent during that time. Barnica is only one name behind these numbers. These women didn’t die, but they could have. They are just like countless others who have bled in parking lots, had care unnecessarily delayed, or been life-flighted out of abortion-hostile states over the last few years. Many readers asked me, “Why aren’t the stories of denials and delays of care enough?” After the U.S. Presidential election. Why didn’t their deaths affect Americans in the same way that Halappanavar died affected the Irish?
For starters, although Halappanavar became a symbol both in Ireland and abroad, her death wasn’t the start nor the end of Ireland’s abortion rights struggle. And the country’s 2018 abortion rights referendum and its aftermath offer some important lessons on both the power and the limits of these tragic stories.
Ireland’s long fight
Abortion was outlawed in Ireland in 1861, which is around the same time many U.S. states began restricting or banning abortion. It was also heavily influenced, by the way, by American anti-abortion activists, who saw Ireland as a sort of constitutional laboratory. “It was also, by the way, very heavily influenced by American anti-abortion activists, for whom Ireland was a sort of constitutional laboratory.”
However, even after the passage of the Eighth Amendment, abortion rights advocacy continued in Ireland.
“While
death may have mobilized more people, or … acted as a tipping point for people to take their individual objection to the Eighth Amendment into an active mobilization phase, there had already been decades of activism to try to do something about this intolerable legal situation,” de Londras said.
A series of high-profile legal cases from the 1990s onward, in both Irish and international courts, led to small reforms. A 1992 referendum gave Irish citizens the right to travel abroad for abortion treatment. In 2013, almost a year after Halappanavar died, the Irish parliament passed a new law that clarified emergency abortions. However, these changes did very little to meaningfully improve access, said de Londras.
“Even in the years after that, if you talked to a politician, or if you heard some of the rhetoric, things felt slow to change,” said Anna Carnegie, an Irish abortion rights activist and writer living in London. From her perspective, repealing the Eighth Amendment didn’t become a realistic possibility until 2014 or 2015.[Halappanavar’s]”It was also, by the way, very heavily influenced by American anti-abortion activists, for whom Ireland was a sort of constitutional laboratory.”
– Fiona de Londras, a law professor at the University of Birmingham in the United Kingdom
In 2016, amid mounting public pressure, the Oireachtas established a citizens’ assembly to advise the government on potential abortion law reform. Carnegie says that many activists viewed this as a delay tactic but were surprised at the outcome: the assembly recommended the Eighth Amendment to be replaced and 64 percent agreed that “termination without restriction should be legal.”
And although lawmakers dragged out the process, they finally passed the legislation needed for a referendum. In 2018, Irish voters repealed Eighth Amendment by more than 66 per cent.
In their 2019 paper, Carnegie, along with her colleague Rachel Roth, an American reproductive justice activist, writer, and activist who lived in Dublin at the time of repeal campaign, noted only one Irish district that voted against the referendum. And even there, 48 percent voted yes.
‘People are generally way ahead of politics’
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This was sometimes borne out in some conversations with voters, she added. They would say that they didn’t want abortion to be available “on demand.” She said that this was sometimes borne out by voters who stated they did not want abortions to be offered “on demand.”
But in general, “when you dig into what people really think, most people are pro-reproductive agencies,” de Londras added. “People are usually way ahead of politics in these matters.”
A hyper-weighting these cases which are horrible but marginal and very rare, creates perceived social hierarchies for different types of abortions, she said. “And this exacerbates abortion-related stigma, which is actually pretty bad for health.”
The long shadow of stigma shows in the abortion law Ireland ended up with.
Following the repeal vote, abortion rights groups including Abortion Rights Campaign, Amnesty Ireland, the Irish Family Planning Association, and Lawyers for Choice, urged the government to fully decriminalize abortion, make it available for free without a waiting period, ban “conscientious objections” to providing abortion care, and avoid the use of vague and non-medical language in any abortion law.
One of these demands was met: Abortion care is now free in Ireland.
However, the law allows abortion on request only until 12 weeks of pregnancy. There is a three-day waiting period.
Beyond this point, abortions for health indications have to meet very specific criteria. There are also certification requirements when abortions are necessary to save the life of a pregnant woman. And doctors who provide abortion care outside the constraints of the law still face criminal sanctions, which creates a chilling effect exactly like the one that made Halappanavar’s care team hesitate to treat her appropriately.
This is not just an Irish problem: We’re seeing it right now in the U.S. with debates and legal fights over abortion ban exceptions. De Londras headed a team from Birmingham Law School who conducted a systematic review of similar problems around the world. There’s also the matter of the waiting period which pushes that functional deadline further forward. Fiona de Londras
There’s a lot of difference between the U.S. The recent U.S. Presidential election was a multiissue election and not a referendum on abortion rights. Many people hoped or saw the election as a referendum on abortion rights. Cox, Zurawski and Katilyn Josh all shared such stories at the Democratic National Convention. Kamala Harris often referenced these cases in debates and speeches.
Ballot measure campaigns also placed significant focus on denials of emergency care, and on the lack of meaningful exceptions to some states’ abortion bans for rape and incest, something that concerned many of my sources in the reproductive justice movement.
Even while they worked on these ballot measure campaigns–recognizing the critical importance of restoring even some abortion rights–my sources consistently expressed concerns that campaign leaders chose messaging that was stigmatizing. Most people who have abortions don’t have them because they were raped or because their life was in danger, but because they simply didn’t want to be pregnant or have a child at that time.
The language about fetal viability included in several of these ballot measures was also a source of controversy and infighting, as many advocates worried that restoring this flawed framework from Roe v. Wade could impair future advocacy efforts.
This echoes what happened in Ireland.
“Most of the activists that we worked with, at least, would agree that when there’s a lot of focus on certain stories … you do wind up reinscribing the dichotomy between ‘good’ abortions and ‘bad’ abortions,” Roth said. “I know a lot of people were really upset to be put in that position.”
Abortion is more popular than Democrats
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In the end, all abortion-related measures, even the ones that failed, outperformed Harris, and often by more than ten or fifteen points, in every state where they were on the ballot. The results were similar for many Democrats, especially in Senate races. You could use this fact to argue that voters were, indeed, motivated by stories of abortion denial in emergency or other tragic situations.
But, as was the case in Ireland, public opinion is ahead of politics here. Since Roe, the majority of Americans believe that abortion should always be legal. The number of Americans who think abortion should also be legal later in pregnancy has recently risen to its highest level ever. Eighty percent of Americans agree that laws cannot cover every circumstance where abortion is needed. We can’t say to what extent this is true. But it is most likely the case. Could this have led to the voter turnout that Democrats failed to inspire?
Harris, and the Democratic Party more broadly, never articulated a specific plan to restore abortion rights at the federal level. Nor did they spend much time communicating what it really would have taken to achieve national abortion rights reform: Democratic majorities in the House and Senate, with every member on board with plans to reform or abolish the filibuster, and reform the Supreme Court.
Nor did ballot measure campaigns, in their attempts to stay apolitical, communicate to voters how easily their votes in favor of ballot measures could be undermined by Republicans at both the state and federal levels.
Conventional wisdom may suggest that all this information is simply too complicated for voters. But is that really the case? Republicans educated voters on the importance of the Supreme Court and other judicial nominees for decades, and as a result, successfully transformed the U.S. judiciary at the federal level and in many states.
Harris did say she would support doing away with the filibuster “for Roe,” and also expressed tepid support for Supreme Court reform. One poll conducted in August found that 70 percent of Republicans supported the idea of term limits for Supreme Court justices and 51 percent supported a code of ethics. Democrats were even more supportive, with 89 per cent supporting a code and 83 per cent supporting term limits. But getting rid of the filibuster and enacting court reform were not major features of the Harris campaign–another missed campaign opportunity given the Supreme Court’s wild unpopularity.
Another uncomfortable truth is that abortion denial is not a new phenomenon in the U.S. It’s just happening on a larger scale now. Treating this as a new problem obfuscates the reality, which is that Roe always left our most marginalized and vulnerable behind–and that the Democratic Party of 2024 has yet to articulate any kind of stance on abortion that doesn’t simply involve restoring that same flawed framework.
The same states that now ban abortion had already legislated abortion rights nearly out of existence before Dobbs v. Jackson Women’s Health Organization, especially for young people, low income people, and people of color. The Hyde Amendment, which bars federal funds from being used for abortion care, has been harming and even killing people like Rosie Jimenez since 1977.
Incarcerated people often had no access to abortion. Catholic hospitals routinely denied emergency abortion care for decades before Roe was overturned, and even hospitals without religious affiliations often limited access to abortion above and beyond the requirements of state law.
And from the Turnaway Study, we know that being denied an abortion–even when it doesn’t result in grave medical consequences–affects the lives of pregnant people and their children for years to come.
None of this is to say that people’s stories of abortion denial under tragic circumstances don’t matter or shouldn’t be shared. These stories are important. But so do all the other stories–and so does the dignity of these storytellers.
How long will we ask people to bare their open wounds for the world, and stand by when nothing happens?
