Dr Siobhán Donohue speaks to Rachel Cunningham about travelling to the UK to terminate her pregnancy in 2011. The 45-year-old GP and mother of three is one of the directors of the group Termination for Medical Reasons, Treasurer of the support group Leanbh Mo Chroí and a member of Doctors for Choice. In light of Saturday’s (30 September) March for Choice, attended by over 40,000 protestors, and with a referendum on the Eighth Amendment in the pipeline for 2018, Siobhán offers her view on why doctors should be making their voices heard.
How did you get involved with Doctors for Choice?
They sort of found me really; I’m a GP, although I haven’t been working since my youngest of three children was born four years ago.
What brought me to all of this was a previous pregnancy where I had a baby with Anencephaly. We got into the whole abortion debate on a firsthand basis because we travelled to Liverpool to terminate that pregnancy at 21 weeks, in 2011.
Before I knew there were any support groups, such as Doctors for Choice, I went on my own personal experience.
The following year a new group was formed called Termination for Medical Reasons (TFMR) and I became quite heavily involved with them. It was through that involvement and going to various meetings that I was approached about joining Doctors for Choice.
So, I come at this from two angles really, from a medical background but my personal experience also puts a different slant on it.
That must have been a very isolating experience?
When you’re going through an abortion, you think you’re the first person to do so. At the time I had barely heard anyone speaking about it and it felt like there was very little awareness and very little support.
There was very much this feeling of having to sneak out of the country and that I couldn’t tell anyone what I was doing; it is absolutely an isolating experience.
You shouldn’t have to think about booking flights and hotel rooms when you’re about to lose your baby. The knife has already gone in when you get a diagnosis like that and then all the added stress is like the final twist.
It’s small things that people don’t realise, getting a taxi to the hospital and dreading the chatty taxi man asking you why you’re visiting Liverpool. You shouldn’t have to worry about that.
At the time, it’s as if your whole world has fallen apart and nobody is aware of it. When I spoke to family and friends about it, many of them couldn’t actually believe what you had to do, that this was the shocking reality. I think it is being talked about more and there is a shift in that regard.
There certainly has been an improvement in the focus on abortion and the support that is there since I went through it but it’s still not easy to find.
We have two organisations; TFMR and Leanbh Mo Chroí, which is a support group for people who are going through the process.
We run a support network to give people guidelines and to share experiences. We don’t advocate a particular route anyone should take but if we know they are going to a particular hospital then we can usually put them in touch with someone else who has been through it, so they have an idea of what to expect.
I think the crux of the argument for choice is that, until you’ve actually been in this situation, it is very hard first of all to imagine how you would feel and secondly to realise the horror of what it is you have to do.
I would say that it’s very much a case of: ‘walk a mile in my shoes, don’t judge me until you do’.
“Doctors feel they can’t talk candidly to patients about it, so they’re working with one hand behind their backs”
Is this a subject doctors are comfortable speaking about?
I think doctors in general are afraid to speak up; as a bunch we tend to be over thinkers who go by the letter of the law and the fact that there is law surrounding this issue means that they are effectively silenced.
Doctors feel they can’t talk candidly to patients about it, so they’re working with one hand behind their backs.
I remember from our experience, when we went to see our consultant in the hospital a couple of days after the initial diagnosis, how carefully he was trying not to be seen to be influencing our decision; he was treading on eggshells.
There’s this fear of someone reporting you when you’re just trying to help your patient, which is an appalling situation.
Realistically, doctors don’t like to discuss it because there is a 14-year prison sentence hanging over their head if they put it up too high.
Not to mention that they are already stressed out of their heads by other issues, so sometimes they may not want to engage with it. This is just another area where doctors feel they need to be cautious.
People want to hear from those who have been through abortion and they want to hear from doctors. They trust doctors and I think it would be useful if doctors had a safe space where they could express how they feel and Doctors for Choice is one such place.
I’ve thrown caution to the wind because the more I talk about it, the better I feel personally and the more response I get. I’m not afraid to speak out about this because I feel it needs to be spoken about.
“Historically this is something we’ve always done well, shipping off our problems for someone else to deal with. But it’s not stopping abortion. It’s happening, it’s just happening somewhere else”
Where does the stigma towards abortion stem?
The stigma is less to do with making the decision to have the abortion as it is with having to leave your country and your support system.
You’re paying for the abortion itself, for the flights, for accommodation, and for everything else while you’re there, while travelling with hen parties and couples going away for romantic weekends.
That’s the bit that’s hardest to take, then you come back and life begins to move on. I feel that taking the decision to terminate the pregnancy helped me to begin grieving and rebuilding.
It’s a devastating situation but it’s helpful to be able to make this decision when you’re in a scenario where you have so little control.
The idea of having to wake up each day wondering whether it would be the day your child’s life would end, or of meeting people and to have them asking about the baby, I knew I wouldn’t be able to cope with that.
Really the stigma, if there is one, is this veil that hangs over people when they feel they can’t talk about it. But actually, once you start to break that down you find that this is a compassionate country filled with compassionate people, which is quite reassuring.
I suppose it suits certain groups not to talk about these issues. Historically this is something we’ve always done well, shipping off our problems for someone else to deal with. But it’s not stopping abortion. It’s happening, it’s just happening somewhere else.
The feeling I’m getting is that this attitude is changing and that people are horrified by what you have to go through.
How would repealing the eighth amendment affect medicine in Ireland?
Well, I wouldn’t know from a financial point of view but I think it would mainly be a case of making some rearrangements and offering some additional education.
Many doctors who work here have actually trained in the UK and abroad and would know procedures anyway. I would say that the knowledge and the ability are there.
What gets to me sometimes are politicians and other members of the public who weigh in on these things when really it’s a matter of just allowing medical people to do their jobs.
For instance, there are people who claim that fatal foetal abnormality doesn’t exist, which is disingenuous and not very helpful.
Doctors don’t feel they have the freedom to do their job as they would like to.
I know of one consultant who tells patients who have a fatal foetal abnormality and who have chosen to end the pregnancy: ‘I’m afraid that I can’t complete your care’. That’s what it boils down to and there’s something very wrong with that.
The compassion and kindness that we were dealt with by the staff in Liverpool, from the nurses and doctors to the chaplain, was amazing. They were just so apologetic that we had to be there and if they can do that, then why can’t we?
A problem that comes with the increased awareness of Liverpool Women’s Hospital is that it is the victim of its own success. At times, they can’t cope with the demand and some people can’t be seen for five weeks or at all.
To have to hang around for that number of weeks knowing that your child isn’t going to survive is torture, it brings you to the point where you would will your child’s heart to stop beating.
It’s not easy feeling your child’s movement in your body and knowing that you’re basically acting as its life support machine.
“At the end of the day I’d say; let doctors do their job”
I’m thinking of my children, I have an eight-year-old daughter and if something like this should ever happen to her I don’t want her to have to go through that. I want her to be able to deal with this in her own country.
At the end of the day I’d say; let doctors do their job.
These cases are often not black and white, people say that medicine is not pure science; it’s also part art form. That’s very true here and each case needs to be judged on its own merits.
There is no one size fits all scenario, and you cannot strictly legislate for this kind of issue because it makes it too difficult to run it.
This isn’t actually about abortion, it’s about options and it’s about choices. If someone in my scenario decided to spend as much time with the baby that they possibly could and live with the uncertainty and the comments then I would support them 100 per cent because that’s their choice. In my case, that wasn’t the right option for me.
This is about letting people live their lives as best as they can because we’re all just trying to struggle along. Why not make the world a kinder place to be in and make one less barrier for people who are trying to get through their lives? Why make it so difficult to get through something that’s difficult enough already?