Termination in Cases of Foetal Abnormality: Ms Liz McDermott, One Day More

I welcome back the viewers who may be tuning in at home. I would like to extend on behalf of the committee a welcome to our witness for our second session this afternoon, Ms Liz McDermott. She is very welcome and I thank her for attending. She represents One Day More, the support group for parents who have received a poor prenatal prognosis for their babies. Is Ms McDermott happy to have questions asked of her?

Ms Liz McDermott

Yes, I am happy to answer questions if I can.

If there is anything that you feel uncomfortable answering, please let me know. Would you like to make a presentation?

Ms Liz McDermott

Yes, I would.

Please go ahead.

Ms Liz McDermott

I thank the Chair, Senator Noone, and the members of the committee for inviting me here today. I am a member of a group called One Day More, a support group that came about because of the experiences of parents who received a poor prenatal diagnosis for their babies, that they would not survive either until or for very long after birth, or that their babies had significant developmental defects or anomalies that would impact them for life. When we received the poor prenatal diagnosis for our children, some of us were fortunate enough to speak to someone who had gone through a similar experience. We found this emotional and personal support to be of enormous help and in the end it is what prompted the setting up of One Day More.

The experiences of mothers like myself and families generally in maternity hospitals varies from very good indeed to very difficult and disappointing. One mother was told at her initial scan that her baby looked like a Michelin man and was asked why she was persisting with a futile pregnancy. This was followed up at each of her antenatal appointments, when she was asked to consider abortion and had to keep refusing until eventually she was advised to pick a plot to bury her daughter in. This kind of language is very insensitive, as the committee will appreciate. This little girl celebrated her third birthday last week. Another mother who refused to abort her baby who had Down's syndrome was contacted after each hospital appointment to change her mind and consider abortion. She did not change her mind and gave birth to her daughter last summer. That experience was a very negative one for her.

Couples have also contacted One Day More after they came home from England having had an abortion and told us that if they had known of One Day More, they might have considered continuing with the pregnancy had they known there were supports and perinatal hospice care such as the kind we are offering and trying to develop. All of this shows how necessary these supports and efforts are and I think it is safe to conclude that many couples would not choose abortion if perinatal hospice care was talked about more than abortion.

Some medical experts try to reassure people that abortion would only be available to women who want it, not to those who do not; they and their babies would be given every care and support throughout pregnancy and birth. However, we can see from the experiences of women who contact One Day More that they did not receive this kind of support. They were dealt with insensitively and felt like they were almost causing problems for the hospital in not going for abortion. Some of our members’ babies died before birth, and some very shortly after birth. Thankfully, some of those children are still alive and many are thriving against all predictions and expectations.

There is a very important point to make about this, which is that medical prognoses can be inaccurate, wrong, and occasionally very wrong or wide of the mark. Doctors cannot always accurately predict outcomes and parents of sick babies can be amazed at how much better things turn out for their baby than was initially thought. Hope is a vital human instinct and gives us strength and support at difficult times all through life. Challenging pregnancies are really no different. One Day More exists to offer support and hope to parents of very sick and disabled babies before, during and after birth.

As well as providing direct support to parents, One Day More raises funds for better provision of perinatal hospice care. We also provide care boxes for families awaiting the arrival of their baby with a focus on making the time they have together as precious as possible. When death is expected, the experience is bittersweet but it is incredibly uplifting to hear families describe the wonderful memories their time with their baby gave them and how much love they all felt towards each other and the baby. Even babies who do not live very long can bring with them tremendous gifts which cannot be predicted or quantified but only felt by going through the experience.

The committee may not be aware of my own personal experience. I became pregnant with my son, John, in early summer 2002. He was my second child. All was fine as far as I thought and I felt okay, though very tired, having a very active two year old daughter. I had a routine scan at 24 weeks - I could not attend the appointment at 20 weeks, which is the more typical time for this scan - in mid-December 2002 and on that occasion the nurse said she saw something amiss. She saw what she described as “shortened limbs” and could not see hands, although she said that might be positional. My husband and I had to come back the next day for an in-depth scan and the committee can imagine how we felt overnight. It was a very traumatic and difficult 24 hours

The next day, we went into the hospital and a consultant obstetrician carried out a very detailed scan which seemed to take forever, but was probably about 20 minutes. He wanted to check everything out very intensely and take measurements. I remember just looking away from the scanning machine the whole time, facing the wall. I did not want to look anywhere near this machine. I was numb and very anxious. Afterwards he said these words which I will never forget: “I’m afraid it’s a very serious abnormality. The baby’s limbs haven’t grown, there are two very short arm buds and I can’t even get a measurement on the legs.” He then showed us the pictures that he had saved and described in detail what he saw. I remember looking at the baby’s face on the scan and thinking he looked like my husband, especially round the eyes. The doctor told us it was a little boy. He finished by saying: “He’ll never do anything but lie on a bed. I am obliged to tell you that if you want to travel to England it won’t be a problem.” Obviously, he was referring to the time limits that applied at that time, that there would not be a difficulty, because of the abnormality. I remember instinctively replying that, no I would not go to England. I had just seen my baby’s face and even though I had no idea how I was going to cope, I felt very strongly that I had no right to interfere with this child’s life in any way. I just did not have that right. This certainty was instinctive protectiveness on my part more than anything else at that time, but it does not mean I was not extremely scared. I did not relish the prospect of how my life and my family's life would have to change.

I recall that during my pregnancy I felt jealous of women whose babies were not going to survive - their babies were destined to die in the womb or shortly afterwards - because at least their stories had a beginning, middle and end. My story was not going to end soon and the future looked extremely uncertain and scary.

I had a number of friends who were expecting babies at the time. All of them were healthy, they had no problems and their babies arrived safe and sound. I felt very sorry for myself in the midst of them and almost felt like I was living on another planet. My bump attracted comments like "Gosh, you're so neat" or "I'm sure you're all thrilled to be having another baby". I heard Claire Cullen-Delsol refer to this kind of experience during pregnancy. I can certainly identify with all of those harrowing experiences and the feelings of isolation that all mothers with difficult pregnancies go through. I agree with Claire and with others who have called for much more antenatal care to be provided to women and their families when they have received a difficult diagnosis. The fathers are also affected. They do not know how to process their emotions or how to be. The situation may not be happening to them but they feel so responsible. As a country, looking forward, we need to invest in antenatal services, carry out research and provide for care.

I was very fortunate that I had support from family and friends, but I also pushed myself to stay connected to the world I lived in rather than go completely in on myself. That is a human survival instinct. When times are tough, one digs deep and one is frequently surprised by what one can cope with. It is only afterwards, looking back, that one asks "How did I cope with that?" One does cope.

I do not say this lightly, but we did not receive much in the way of support from the hospital, with one exception, namely, the "scan doctor", as we called him, who I had to attend separately from my own doctor. All the other medical staff appeared unconcerned about us and our baby. We just went through the motions and did what we had to do. We turned up to the hospital, kept all of our appointments and I was repeatedly scanned. I hunkered down and just wanted to get the birth out of the way.

I asked my consultant what would happen when John was born. He said that nothing would happen because there was no reason to think there would be a need for medical intervention and the birth would be treated like a normal birth. On the day that John was born, I went into hospital around 10 a.m. The doctor broke my waters and I went into labour. My husband and I were in a room and there was only a student midwife with us. A neonatologist who I think was a senior registrar, came in and spoke about our baby. He took a phone call while there and said "Oh yeah, weird case - no limbs". That is a typical example of the treatment we received. I was so focused on blocking everything out and getting on with having my baby that I said nothing. I restrained my husband from objecting because he was rather upset by that comment.

John was born just after 2 p.m. that day. My consultant told me about half an hour before John was born that he had to leave the hospital to see other patients in his consulting rooms if that was okay with me. At that point, I really did not care who was there because I felt very alone. I got the feeling that the consultant was choosing not to be present at the birth. It was not as if he was not leaving to deal with an urgent matter. He did not return to the hospital that day. I recall that he came to me the next day. I do not know if he ever went to see John. I will explain why I say that. I was separated from John after he was born and I do not recall seeing him for the rest of the time I was in hospital, which was about four days.

John was delivered by a doctor who I had never met before. Right after John was born, I recall seeing other doctors. I remember seeing a whole lot of people wearing white coats standing at the foot of my bed when John had literally only been born a few minutes before. One of them announced that the baby would be taken to the special care baby unit for tests. He was not sick and I recall that his APGAR score was 9. John was physically hale, hearty and healthy other than the physical abnormality. I was heartbroken that he could not be with me as I wanted to breast-feed him. I had let the hospital know that but they were just taking him away, I felt, in a way that just suited them rather than me. At such a time one is vulnerable and tired. These people were complete strangers and they looked serious and expressionless, so I did not challenge them.

John spent his first two days in the special care baby unit while I was in a room on another floor of the hospital. I do not quite know where I was; I was not in the typical maternity wing. I can only describe this as a horrendous time because no provision was made for me and John in terms of our comfort and privacy.

I remember that the weather was warm that April. The sun shone through the window of the special care unit and I had to sit on a plastic waiting room chair. Any woman who has had a baby will know that is not a very comfortable place to be for the first few days. I felt that I was in the way because there were lots of sick and premature babies around me. John was not sick or premature but he was in an incubator. I just felt that I was in the way. There was no nurse there for us. The feeding did not go at all well and I was very distressed by the whole event. I so wanted to give my son, John, an experience of closeness because he could not use his hands or feet to move or comfort himself at all. He just did not have them and I really wanted to bond with him. After two days, John was unceremoniously, and unannounced, brought down to me. Finally, we got some privacy and I was able to breast-feed him in peace and that went very well for ten months or so.

I remember that it was very awkward going into the communal changing room for nappy changing. I tried it a few times but silence fell as soon as I came in the door. All of the chat between the new mothers just stopped. So, I just did it in my room. I just could not deal with it really. Overall, I could not wait to get out of that hospital. I did not feel anybody was particularly nice to us except the one doctor who carried out the scans and who I went back to during my third pregnancy.

So, back to a vision for future prenatal and perinatal care. One Day More, Every Life Counts and organisations like Hugh’s House represent concrete examples of reaching out to women with very poor prenatal diagnoses and prognoses. These efforts are a drop in the ocean compared with what could be achieved in the way of supports if our Government would undertake research and investment in these areas. Women who have gone through this know what it is like and what would help other women. They are a tremendous resource to tap into if there is a will on the part of the Government to really look at giving women meaningful support.

It is very disappointing to see that all through this process, and that of the Citizens’ Assembly, and during the past five years or so, the only serious focus of political effort has been towards introducing abortion. Looking back, I can honestly say - hand on heart - that the experience of having my son in 2003 has had a hugely positive impact on me, my family and beyond. I could not have foreseen this at the time that I was carrying him but that is the nature of life. We cannot predict the future, how things will go, how we will feel or what help we might be able to get down the line. It is a mistake to plan these things out because we risk painting for ourselves a bleaker picture than what actually happens. That is a human tendency. We always look at the dark side or the worst-case scenario. Doctors feel duty bound to provide that in order to avoid unrealistic expectations. It is very important, therefore, to have these positive supports there for women.

I would see the introduction of abortion as something akin to deeming people like my son as unworthy of legal protection before birth - removing his right to life. I fail to see how that could become a new definition of progress. Repealing the eighth amendment would amount to that. My story is not an isolated one. Every day, new stories about women and families feeling pressure to have abortions emerge. Some people will find it hard to believe the stories I have mentioned. However, pressure from hospitals and medical staff to abort babies with special needs does happen. It is sadly what happens to people; it is their experience.

I must ask why the medical system seems to want to encourage women to opt for abortion. If we do not acknowledge this as a reality, it will keep happening and the pressure will grow more intense and direct, particularly if abortion is legalised and takes place in hospitals and clinics here. This type of pressure must logically account for the current position in England where 90% of babies diagnosed with Down's syndrome are aborted. The figures for Denmark and Iceland are even worse and would be 100%. Abortion can happen at any time up to birth at nine months. I have read that such abortions can even happen during birth, for instance, in cases where the disability or defect has not been picked up antenatally and the woman states she cannot cope.

The provision of abortion is increasingly being questioned in other countries as people see where legalisation leads. Alternatives to abortion and support for women with difficult or unplanned pregnancies are also offered in these countries. However, because they do not have anything like the eighth amendment in place and abortion is widely lawful, they face obstacles and difficulties carrying out their work. Organisations which do life sustaining work are stymied and prevented from reaching out to women in a supportive way to give them the opportunity - not a choice - to keep their baby.

We can see from other countries that abortion is a large and profitable global industry. Its practice, standards and methods are not always women centred, as is claimed, but may be more about profit. Just last month, the Care Quality Commission in Britain issued a damning report on the abortion provider, Marie Stopes. It revealed that staff were being paid bonuses to encourage women to go through with abortions. The inspectors found evidence of a policy in all 70 Marie Stopes clinics in the country directing staff to contact women who had decided not to go through with an abortion, offering them a new appointment. This is tantamount to placing pressure on women to opt for abortion and is rightly causing people to rethink their support for abortion and look at alternatives which genuinely care for women and babies. This is just one of several recent scandals involving the abortion industry in England and elsewhere.

It is extraordinary that we are discussing having a referendum to introduce abortion and no committee is examining what abortion has led to in other countries. I am not saying this to disparage or offend anyone but because I genuinely find this extraordinary. A few years ago, a conference attended by a well known abortionist, Dr. John Parsons, was held in Britain under the title, Don't Mention the 'A'-Word. Britain is a country where abortion is viewed as okay. The title of the conference betrays that nobody likes to talk about abortion and it was referred to as "the A-word" for this reason. Dr. Parsons stated the following at the conference:

When you are doing termination procedures, especially later terminations, you are exposed to a rather gross, destructive process dealing with bits and pieces of fetuses, which are not very nice... That is why we are not keen on people observing abortions. I was recently asked if I would have a journalist join me at work, who wanted to write for The Daily Telegraph.

I am sorry to interrupt but do I have an incorrect copy of Ms McDermott's presentation?

Ms Liz McDermott

This is additional material I have put together. I can read it into the record.

That is fine.

Ms Liz McDermott

I can also make it available to members.

That is absolutely fine. Please continue.

The Deputy's intervention was completely unnecessary given the experience of the committee thus far.

As was Senator Mullen's intervention.

No, it was not. The intervention was a discourtesy to the speaker.

I am chairing the meeting. I have asked the witness to continue and I am happy for her to do so. I do not want any interruptions, including from the Senator.

Ms Liz McDermott

Dr. Parsons continued: "After discussing with other people, we decided this was probably not a terribly good idea because it does not really help women who have got to make this decision to hear how unpleasant it is." These are not the words of a pro-life activist but someone who performed abortions as part of his career. When I first read Dr. Parsons's words, I could not help thinking about the abortion movement's repeated claim that women must be trusted to decide about abortion. If the movement really believes women can be trusted with this decision, which ends their baby's life, the abortion debate would and should be more open about telling women what happens to their baby during abortion and how the procedure is carried out. I reiterate that I am not raising these issues out of any disrespect for the committee but because I respect democracy and want complete fairness and openness in the debate.

Since 2012, there has been a working group on abortion established by the Government, two sets of exhaustive Oireachtas hearings and legislation in 2013. We had five Private Members' Bills introduced in the Dáil, a Citizens' Assembly and now another Oireachtas committee examining the issue, all of which have focused on broadening the grounds for abortion. None of these committees or debates focus on alternatives to abortion. Earlier today, the committee heard from the British Pregnancy Advisory Service, England's largest abortion provider. The Citizens' Assembly also heard from this organisation. Why has no space been provided to explore positive alternatives to abortion and hear from the many life care groups and service providers here and in other countries? What about wonderful projects such as Hugh's House, which provides a home from home for families of babies who are in hospital with potentially life-limiting conditions, or A Perfect Gift, a group of dedicated mums who prepare and deliver welcome baskets to families of all newborn babies with Down's syndrome, or Anew, an organisation which works hard to address the scandal and alleviate the problem of up to 20 homeless pregnant women living on our streets on any given night, which is scandalous? These are just some of the initiatives already taking place to offer support to women and families experiencing challenging pregnancy related circumstances. They are initiatives that work to unite rather than divide society and they should be front and centre of any debate on the eighth amendment.

Speaking from personal experience, I agree with those who say abortion is an outdated procedure, which is being increasingly undermined by scientific knowledge about life in the womb and the humanity of pre-born babies. In the 50 years since abortion was legalised in England, nearly 9 million babies have lost their lives in a brutal and sudden way. This has caused a deep, hidden pain for countless women who were convinced by the sloganeering about choice that denies abortion has any adverse after-effects on women. The experience of many women who have experienced pain and regret for long periods, some of whom eventually seek and receive counselling and help to recover from their trauma, shows that the claim that abortion has no repercussions for women is untrue.

The eighth amendment on the other hand acknowledges the right to life. It does not claim to be its author - it protects it. Those campaigning for repeal of the eighth amendment do not seem to regard the right to life as inalienable and innate to every human being. Instead, they seem to wish to treat it as something granted or limited by the State based on a majority consensus on who falls within the categories of persons who are entitled to have their lives protected against all comers. If this is true, the State can also remove the right to life, which leaves all of us vulnerable at some stage of life to falling within a category of persons whom the State does not protect.

We must learn again what human rights are and that no one has the authority to grant or remove them from any human being. On World Prematurity Day last week, members may have heard a consultant paediatric cardiologist, Dr. Paul Oslizlok, explain on RTÉ the reasons there are more cases of complicated heart problems in babies in Ireland than in England, Scotland and Wales. His response to a question as to why Ireland's rate of operations is so high was revealing. He stated we do not have termination of pregnancy on the island of Ireland, whereas in England, Scotland and Wales these pregnancies would probably have been terminated. We can see, therefore, that our doctors have gained world class experience of paediatric heart surgery precisely because of the presence of the eighth amendment and we do not resort to aborting these babies. This expertise would most definitely be lost if the position were to change.

We have two paths ahead of us. If the eighth amendment is repealed or amended, we will deny certain unborn babies the legal protection to life. If we vote to keep the eighth amendment, we can and must commit to making Ireland a society worthy of the most vulnerable and defenceless members of the human family by fully resourcing the provision of high quality support and care for pregnant women during and after pregnancy in order that they will have the opportunity and confidence to keep going and know they will continue to be cared for and helped, irrespective of the challenges they may face.

That is the end of my submission. I thank the committee.

Thank you very much, Ms McDermott, for telling us your personal story. We appreciate that it is difficult for you to do so and we are grateful that you attended because many who would be of a similar viewpoint to you chose not to attend. We are indebted to you for attending.

Ms Liz McDermott

I was in two minds myself I have to say. I nevertheless chose to give a voice to this story.

I think you did your side of the argument a service. We are grateful to you for attending here today.

I thank Ms McDermott for attending and telling her story, which is a heart-rending one. Our hearts go out to anybody in that kind of situation. On the degree to which non-directive counselling was available to the witness, this is something we have raised in this committee on numerous occasions. The witness attended an Irish hospital and she referred to directive counselling towards abortion rather than non-directive counselling which sought to help her out in the circumstances in which she found herself. We note and accept the points the witness makes about that. How many such instances does the witness know of? Ms McDermott referred to the fact that there have been countless similar cases with abortion as the solution. Does she recognise that there may be some women in cases of fatal foetal abnormality, for want of a description, who may not be able to deal with the eventual outcome and trauma? Some people have the gift of being able to stand up to a situation, as the witness did, even alone, as it were. Some may not. How does Ms McDermott see that and how does she feel about the fact that some women who are pregnant and maybe isolated and alone and who might not have any counselling except of a directive nature might fear the outcome? What advice would Ms McDermott give them?

Ms Liz McDermott

I do not think we got counselling of any sort at the time. That was 2002. I would not describe it as counselling in the sense that there was nobody who stepped in and heard our side of things. On the day it happened I remember we asked if there was anyone we could talk to and the doctors and the staff looked around generally and eventually somebody went and got a chaplain because there just was not anybody. The doctor just said there would not be a problem going and he said he was obliged to give me certain information. He was performing that. It was not directive or non-directive. He was just complying with his legal obligations. When the Deputy talks about fatal foetal abnormalities, again that is a term that does not have a medical meaning and I think it is very important. It keeps being trotted out but it is medically meaningless.

For the purpose of this exercise.

Ms Liz McDermott

Very sick babies or babies with a substantial abnormality are nevertheless babies, they have a life to live, and they are alive when they are being talked about. In so far as abortion being a solution to a life that is like that, again I have tried to say that not being able to deal with the eventual outcome is not something that can be predicted, and any woman in any kind of crisis pregnancy will feel frightened and will feel that she cannot cope. That is how I felt. I am not painting myself as any particularly strong member of society. I felt I could not cope. I often crumbled and was found in a puddle of tears in the corner of a room. My daughter was probably largely abandoned during that time.

That is why I think the answer to that dilemma is the provision of proper supports. At the time a diagnosis is given, right there and then there should be a pathway of care that is immediately activated for women and their families to support them and which does not describe their babies as anomalies or fatally ill. They are their babies, they have been pregnant, they have carried their babies, they have a bond and a relationship with them already and then suddenly all this information is coming at them kind of to turn away from that. I can understand why women feel that way and that abortion is the only way out and the only way that they are going to cope. However, that is the challenge for us as a country and I think it is one that people increasingly are coming to recognise, that we have to provide proper, meaningful and sustained antenatal support which women should not have to go looking for. That is how I would deal with that. It cannot be predicted in advance that women are going to be able to cope with it or not.

In the witness's case, she had the fortitude and strength to believe and her maternal instincts rose to the occasion. How does Ms McDermott see that other group of women who may not be able to stand up to the potential trauma, who may be frightened, and who may have no counselling of any description either? What do they do? How does she think we should treat them?

Ms Liz McDermott

I think we should be supportive of them. However, the reality is they are pregnant with a very sick baby. They have to be supported in some way. Even if they have an abortion, that is going to be a hugely traumatic experience for them. They will likely be quite far on in their pregnancies and abortion is an invasive procedure and can be quite a violent procedure for any woman to endure. She can feel very isolated in any event. That is the reality. We cannot take this away, we cannot itemise one experience, and I am particularly strong and I have a strong way of coping with things. It is instinctive for women to nurture and we do it physiologically. Our bodies nurture the babies when we are pregnant. They do not distinguish between the fact that they are sick or they are not going to live for very long. A woman's body does what it needs to do and a woman lives out of that place, very much on a physiological level, during pregnancy. That is why abortion is a very destructive and invasive procedure that interrupts entirely what the body and the mind want to do. Women must be dealt with very compassionately. I do not judge or criticise. I fully understand the fear that creeps in. That is the word that was used and was exactly what I felt at the time: huge fear. The challenge for the rest of society is to support, in a real and meaningful way, the woman who is feeling that. Her baby should also be supported in order that the baby's rights are upheld in all of this, and in order that she does not have to walk this walk alone, be it to an abortion clinic or through a natural labour at some point. Either way that baby is going to have to be delivered. There is a compassionate and humane way to do it, which I would say is the natural way, with all the supports. Sometimes that is a physical propping up of women and it should be constantly there for them rather than sending them on the lonely journey to an abortion procedure.

I do not ever mean to rush the witness, and I am not, because I am very conscious that she is talking about personal circumstances, so I will try not to interrupt. However, I still have a time situation to manage, just to let her know that.

I thank Ms McDermott very much for attending the committee meeting. It is really important that she has come and she has told us her personal story. We were all probably horrified at the cold way in which she and her family were treated in the hospital. That would certainly be a cause of concern to all of us here. I refer also to the experiences that she described in the beginning of her presentation around women being asked at each appointment to consider abortion and women being contacted after their hospital appointment to change their minds.

Everyone present would view that as wrong and inappropriate. As Deputy Durkan stated, all counselling should be non-directive. There should be no attempt to make a woman make a decision that is not the one that is right for her.

My question is on this issue. Ms McDermott described that experience as well as her own, but that practice seems to have been at variance with medical guidelines. One Day More provided examples, although I only got them shortly before I arrived. They include the examples of Anna Kate, Grace and Laura. In each case, there seemed to be a more positive experience of the hospital's treatment. To what extent does Ms McDermott's group have information on the various ways in which people are treated in Irish maternity hospitals?

My next question is on perinatal care. We received a presentation in which that type of care at a particular maternity hospital was described. Everyone would be supportive of that as well as the case that Ms McDermott makes for high-quality support and pathways of care for pregnant women. In the experience of Ms McDermott's group, is there much difference in how women are treated by various hospitals? If so, what recommendations should our committee make in that regard?

Ms Liz McDermott

One Day More only hears the experiences that women relay to it. We are not in a position, and do not have the resources, to conduct meaningful research in hospitals. The Deputy is right, in that some people thankfully have a positive experience. They are given support and are not put under pressure. Increasingly, however, other people feel like they are being put under pressure. We do not have answers as to why. We can only report that it is happening based on what people tell us. On occasion, people even change hospitals because they cannot withstand the pressure.

The Deputy is right about this not being in line with medical guidelines. It is anecdotal evidence as reported to us, but we have no reason to doubt it. It should not happen. No hospital should treat in that way a woman who has stated her intention to continue with her pregnancy. That should be fully supported. Perhaps the problem is that there is an additional cost in the provision of perinatal hospice care within the antenatal setting. Hospitals must manage budgets and so on. I cannot say, but it is for the Government to inquire as to why women are going through this kind of experience. I am glad to be able to report that it is what they are going through. It should not happen. Where women have declared their intention to proceed, they and their families should be fully supported and their babies' lives, no matter how deformed or short lived, should be honoured and respected fully.

I thank Ms McDermott.

I thank Ms McDermott for attending. To join with Deputy O'Sullivan, I am disgusted to hear that Ms McDermott was treated that way in a hospital. It is not okay. There should be proper care, counselling and support for every family in that situation. I hope that it is not a regular occurrence. It is good that we got to hear that side of things.

Could Ms McDermott tell us more about One Day More? When did she get involved in the organisation and how many others are involved? How many parents does it represent?

Ms Liz McDermott

It was a coming together in a conversational way after discussing the issue of abortion and women's experiences. When people have a story like this one, they tend to meet eventually. It came about so as to determine what could be done to reach out to women in pregnancy. The One Day More name came from one of our members. She knew that her baby was not going to live for very long and she wanted to have one day more with him.

There are approximately 25 members. It is small - there is no head office or resources. We operate locally. We have managed to reach out to approximately 20 families. There are leaflets in hospitals as well as an online presence, so people can make contact that way or by phone. Much of our support is provided over the phone, given the geographical limitations.

We provide care boxes to hospitals containing blankets, hats and memory-making things, for example, footprint and handprint kits, as well as photo frames and baby books to read to a baby. There is a particular book called A Gift of Time: Continuing Your Pregnancy When Your Baby's Life Is Expected to Be Brief, which is available in a perinatal hospice care setting in America and answers questions that people in this situation have. People tell us that the care boxes are valuable to them because they have heard a great deal of negative information from doctors and hospitals about the worst case scenario, what will happen and dire predictions. They love getting something that is a positive, a box that says, "Your baby is your baby", there is another way to perceive the situation and they can have time with their babies.

That is what we try to do. It is a grassroots, low-key group, but with will, resources and investment, it could become tremendous. It tries to feed into Hugh's House and other organisations like Anew to provide care. Some people who make contact after having abortions might need counselling. We put them on that road. We cannot provide it ourselves, but we try to support them at that point in their journey.

I thank Ms McDermott. That was informative. It sounds like One Day More is doing fantastic work.

A lady presented to us a number of weeks ago. She was from a group that was searching for services in cases of fatal foetal abnormality. I realise that Ms McDermott does not accept that as a medical term but, like her, the lady told her story. I was moved by it and found her story upsetting. There were some similarities. She spoke about how she found people asking when the baby was due and their personal commentary on her bump, her and her baby extremely distressing. She had all of the guidance and support from her doctors and her family and everyone knew that the baby was not going to survive. She did not have the means to travel and, even if she had, travel was not an option because she had a young child. She said that she suffered from post-traumatic stress disorder following that experience. This is an individual who was not pressured and knew all of the facts. She is saying that the absence of choice has had a severe impact on her mental health. Does Ms McDermott see people's difficulty when dealing with such a situation? What would she say to a woman like that?

Ms Liz McDermott

I agree that Ms Claire Cullen-Delsol's story was extremely difficult to hear. We share that common ground. We had the bumps that people commented on and we did not have answers to give. It was traumatic. She had supports, but not of the professional kind. When I talk about support, I mean support in dealing with that kind of experience.

The Deputy is right about it being harrowing. When one has a difficult pregnancy, there is no easy way out. It is traumatic and painful and there is a great deal of emotion.

However, in my experience, while after John was born I had moments of extreme sadness when I looked at him and thought of all the things he could not do, I had the consolation of knowing I was doing my best for him. This was his life and this was how it had to go for him. I do not like the idea of any woman suffering post-traumatic stress disorder, PTSD, and I think that is avoidable if she is supported properly and fully in the way she endures and suffers that. Part of this would be just going through one's pregnancy and facing the world and facing people.

I will tell the committee an awful story. My baby was nine days old, and I remember going around Superquinn, as it was at the time. I had him in a flat pram with a blanket, so all that could be seen was the head, and he was asleep. A woman - I did not know who she was; she was one of those ladies in supermarkets who loves coming up to new babies - came up to me, literally pulled the blanket back and just stood there in shock and said nothing. I felt so invaded. My privacy was invaded and I just ran away. That is people. We all have these stories and experiences. I think people like this kind of experience of people coming together to support one another. There is a kind of emotional propping up of one another that needs to happen, and women who have gone through these kinds of pregnancies can do that. I do not think abortion takes any of that away, and the trauma and invasiveness of abortion can almost contribute to a worse mental outcome, perhaps. I do not have medical data to back that up, but sometimes people say they felt stronger because they did the right thing, did right by their baby and kept going with it. There is a strength to be derived from doing that, and that support is still the answer.

I have taken up all my time. This is a very personal experience for each and every woman as an individual. I thank Ms McDermott.

I welcome Ms McDermott and thank her for her presentation and for sharing her thoughts with us. Many people remark to me that there is a real lack of support for parents who find themselves in unplanned and difficult situations in Ireland, and Ms McDermott's experience has proven this to be true. She spoke about the contrast between the two visions, as she sees it, for these parents. Will she talk to us about whether she feels we can provide the right support while introducing abortion as well?

Ms Liz McDermott

No, I do not think we can. I do not think those two care paths sit well together. The experience in England is that when abortion is an option, it becomes the default option, the expected option, and women can lose their choice and their freedom and can feel almost that people want them to have an abortion because it seems the easiest thing for everyone else and all round. If abortion is legalised in this country, there will not be the will to invest in anything that will conflict with it. People will go one direction for the abortion clinic in a hospital and another direction for all the perinatal hospice care. Those two things seem to me to be mutually exclusive, and it would be very difficult in a concrete, real way for the two to sit together.

Ms McDermott mentioned perinatal hospice care. She believes unnecessary abortions happen because people do not know about perinatal hospice care. That is a real tragedy for women and their families. How many people does Ms McDermott think are affected by this every year?

Ms Liz McDermott

It is hard to say because perinatal hospice care is patchily provided. In America they have recently developed this into a whole separate path of care, which is something the committee and the Government generally could look at.

To be fair to the witness-----

Ms Liz McDermott

I am not at all an expert in this-----

-----she has had an experience but she is not a medical expert.

Ms Liz McDermott

-----but I think the Deputy is right in saying many people do not know about perinatal hospice care. It really needs to be developed and advertised.

This is my last question. Ms McDermott says the eighth amendment acknowledges the right to life and that it does not claim to be its author, merely its protector. Will she elaborate on that?

Ms Liz McDermott

I meant that in the sense that the eighth amendment declares what this country stands for, that we uphold the right to life of all our citizens, all our human beings, unborn and born. There are circumstances in which medical intervention is required to save a woman's life, and we understand that. We understand that a woman may die in the event of her baby being ill or of her getting sick during pregnancy, but the eighth amendment is a positive, life-saving measure because it says we as a country stand for the rights of all our citizens. However, we cannot just have the eighth amendment and then leave women without the supports, and this is where we need to go forward. The eighth amendment has given some women a little time to come to terms with crisis or unintended pregnancies. It is a valuable tool for us to build on for the future to create a new vision for difficult pregnancies. Abortion is old. It is an old procedure and process and has created a lot of wreckage. We can do better, and the eighth amendment is a good starting point, but we need to provide proper supports.

I thank Ms McDermott for attending the committee meeting and sharing her very personal story with us. I know everyone very much appreciates it, and not one of us thinks it was in any way easy for her to attend here and do this. We are very grateful for the perspective she has given us.

It is true to say, and Ms McDermott echoes this herself, that every pregnancy has its own uniqueness and that every woman who is pregnant is deserving of support. It is fairly obvious from the picture Ms McDermott paints that that support just is not there. The word "patchy" probably does a service to access to perinatal hospice services in this country. It is a very generous description because such services are practically non-existent. To be able to provide women with a full range of care, such services should be in place.

I would like to try to build a picture in my head. Ms McDermott provided for us stories of people who are members of her organisation. Grace and - I will probably mispronounce this - Maite were born in Galway and the Coombe, respectively, but the papers do not say where Anna Kate, John Paul, Laura, Lily or Luke were born. Were they born in Ireland, as in, the Twenty-six Counties?

Ms Liz McDermott

Yes.

There is no uniformity to this. It happens throughout the country.

Ms Liz McDermott

Yes, absolutely.

Is Ms McDermott's organisation a 26-county or a 32-county organisation, or is it international?

Ms Liz McDermott

It is a 26-county organisation. It is very much local. We are typically based in Dublin. As I said, we are women who met and had this common experience. However, we would love to grow the organisation. We can contact people in the Twenty-six Counties.

The reason I ask is that some, though not all, of the stories, including Ms McDermott's, refer to very directive counselling, or whatever word one wants to call it. I have just two questions for her. First, will she bring us up to date on the experience her members have had in reporting this and how it was dealt with? That level of directive counselling is not provided for within the law. These are very serious matters. Ms McDermott talks about conversations that have happened within her earshot and she refers to women who felt, or were, compelled to abort babies. That kind of directive instruction should never happen and is not allowable.

I imagine it made those women feel extremely angry and upset.

Would Ms McDermott not agree that any woman who chooses not to go down that road also has the right to feel angry and upset if she is prevented from making the choice that she feels she should? If a woman in this jurisdiction who simply cannot continue with a pregnancy is compelled to go through with it, would Ms McDermott not accept that those women also have the right to feel angry and upset that they have been forced into that situation? Two wrongs do not make a right. It is not right to compel a woman to terminate a pregnancy, but a woman has a right to feel angry if she is compelled to continue with a pregnancy. We have heard descriptions and personal evidence from women here and from one woman in particular, Claire Cullen-Delsol, and the post traumatic stress disorder, PTSD, experienced, a very serious medical condition that can occur as a direct result of being compelled to continue with a pregnancy. Would Ms McDermott not agree that those women have the right to feel angry and upset just as other women do who feel they were compelled in any way?

Ms Liz McDermott

How they feel is how they feel. It is not for me to say if they have the right to feel that. I am no doctor but it has been reported that PTSD can be a consequence of having an abortion. It is difficult-----

I am specifically referring to evidence given to us about a woman who was suffering from PTSD.

Ms Liz McDermott

Fair enough. As I understood from Claire's experience, the whole pregnancy was very difficult for her. Perhaps the PTSD might not have happened if she had been better supported. Identifying the root cause of the PTSD as being her inability to access abortion conveniently and locally for her-----

I do not think convenience came into it, and I do not think that is-----

Ms Liz McDermott

She could not travel. I am not saying it was about convenience but that she said it was not possible for her to travel, as I recall. That meant she had to continue with her pregnancy. I think that is the point the Deputy is making. That awful experience that she had during her pregnancy gave rise or contributed to the PTSD.

She was being forced to continue with it.

In fairness, the lady in question is not present and we have heard from her already. It is not a road to go down in that sense.

Will Ms McDermott reply to my first question, if that is all right?

Ms Liz McDermott

We are a small organisation and we do not have resources to say how abortion will or will not affect people and what people experience. I cannot point to research that has been carried out.

Ms McDermott might have misunderstood my question. She is in touch with these people as part of her organisation's work. Will she relate to us their experiences when they reported the directive counselling, which is clearly outside of the legal framework within this jurisdiction? It was clear, when I read the stories, that people were telling Ms McDermott and the organisation that they were in receipt of this directive counselling, which is not legal. What was the experience when that was reported and how that was treated?

Ms Liz McDermott

We do not keep a dossier. We do not take this information to construct a dossier to use against hospitals. If the Deputy is curious to know and investigate the fact that people hear this counselling, that would have to be done as an investigative process. People make contact with us either online or after they get a leaflet or a care box from the hospital. They tell us their stories and in the course of their stories, they say what they were told, what they went through and that they do not know what to do. We are not there to start castigating hospitals. It is a point we make but we are there to support people going through this traumatic journey. We are not there to file a dossier but people's experiences suggest that medical guidelines and protocol are not being followed. While we are told that all supports will be given to pregnant women should they wish to continue with their pregnancy, that is not what women seem to experience, to our understanding, but we are not collecting data on this as such.

So they are not telling One Day More that they are reporting it?

Ms Liz McDermott

They are not reporting it. They are just saying at that time-----

They are not reporting it. I am conscious of the time. I thank Ms McDermott.

Ms Liz McDermott

We would advise medics please not to do this in hospitals. I hope the committee would take that into account.

I welcome Ms McDermott. I had to step out to speak in the Dáil but I was here when she making her opening statement. Like others, I know it is difficult to come here and talk about a very personal story. From the word go, in order that Ms McDermott knows where I am coming from, I believe in the right to choose, including the right to choose to continue with a pregnancy and be supported with that pregnancy. I have to say that the language and sensitivity Ms McDermott talked about and her experience and the experience of others within the maternity services should be of concern to us all. It is interesting that when we had people in from the group Terminations for Medical Reasons, they made the point that one cannot change a diagnosis but one can change how people are treated. They would make different arguments from Ms McDermott but we need to say something with regard to how the experience in maternity hospitals has to change in order that people feel supported in the decisions they make. It would be very useful for us to hear what those changes would be. Our report will be intended to respond to a range of different things. I see this as an issue that should be very much something that is provided within our health system. What does Ms McDermott have to say about changes she would specifically seek in maternal services? I take the point about perinatal care. Most of that is funded by charity rather than the health service.

Ms Liz McDermott

That is a big question. Changes I would like to see include having a whole system put in place at the point of delivery of bad news to a pregnant woman so as to deal with it and provide support. That would require a big investment and considerable research. Consultation with families who have gone through this would be really useful, as would reaching out with an open mind and open views to everybody to contribute truthfully and honestly. I have tried to outline the negative experiences people have reported to groups like One Day More. My own experience was that when one is in the medical process and dealing with feelings about one's baby, one is also interacting with doctors. A person is just another patient number to them, part of a clinical process. It is not quite a conveyor belt but there is a slight element of that. One feels like one is in the way and causing trouble. All of that requires psychological and emotional support and another care pathway in order that one does not sit in waiting rooms with all the healthy pregnant women. There should be another system that would kick in.

Considering the American model would be a good starting point for the committee. It would be great if that could be recommended to the Government and perinatal hospice care highlighted as an urgent requirement in order that women find out at the beginning what is going to happen and what the path ahead for them will look like. If that does not happen, women do not know what the road ahead will be for them but are looking down a very uncertain and scary path that they have to walk on their own. Going for an abortion can seem not like a choice but, rather, the only option one can take at that point, which is the point of decision. If the perinatal hospice and antenatal support care package was put in place, it would hopefully render redundant the situation of having to abort one's baby. My desire is for women to have an option not to have to abort their babies because the country provides a world-class, very progressive modern and supportive system of care for them.

I thank Ms McDermott for coming in. It is much appreciated by all members and I know how difficult it must be for her.

There has been much discussion of crisis pregnancies at the committee but there is no doubt that a diagnosis in the latter part of a wanted pregnancy that reveals a condition that will limit the life of the baby is utterly devastating. Ms McDermott presented very well that in those circumstances help and support are absolutely critical and there is no doubt that the State has failed people in that regard. People who have had such a diagnosis and chosen to continue with the pregnancy, as Ms McDermott did, may have received great solace from that and felt it was the right decision for them. All members have met such people and it is very useful that they give their testimony. We have met others who chose a different ending and felt the best solution for them, factoring in all considerations, was to terminate the pregnancy. Many of them told of getting solace from the experiences they had in Liverpool Women's Hospital or whatever place it may have been. There is no right answer to the issue but there is a right answer for each individual pregnancy. Is it not the case that the only way of respecting that is by allowing people to make the latter choice in Ireland, surrounded by supports and family? A change in the constitutional position will not affect the decision making of those who decide to continue with the pregnancy and will only alter the position for those who decide to end it.

Ms Liz McDermott

There is no right answer. To say that people want to make the right decision for themselves is to completely ignore the baby in all of this. It is a separate human life and it is very difficult to airbrush that life out of the narrative. Nobody can say with any real certainty what way things will go for a baby who is sick or results from a crisis pregnancy or whose mother feels very unsupported or cannot face having a baby at that time. Our legal system cannot provide for every eventuality and individualise our laws for that but it is incumbent upon us to support every woman. If we affirm the right to life of children in the womb, the pre-born, we are also supporting their mothers, fathers and families and it is incumbent on us to invest in that in a meaningful way. Ending a pregnancy is ending a life and that is an uncomfortable reality we try to skirt around. We do not like coming up against it but it is a reality. Sometimes I think about what would have happened if I had chosen to have an abortion, gone down that road and listened to the advice around me. A woman at a baptism party asked me had I not had a scan, by which she meant to ask why on earth I had the baby. A dehumanising language is applied to disabled people. We uphold equality and welcome disable people and support the Paralympics and Special Olympics but we do not support women who are facing into a lifetime of caring for those children. I sometimes think about what it would have meant if I had chosen to have an abortion and get rid of John. I would not have had to move house or look for a special car and it would have made life far easier in many ways but I would have missed out on him rolling over at four months and smiling at me and his getting up at nearly two years of age and starting to walk across the floor, which I never expected. It was a complete surprise to me that he could do that. It is not just my family and I who would have missed out but also the wider community. I have brought with me a poem John's sixth class teacher wrote for him when he was leaving. It is called "Ode to John". The teacher is not a man who usually writes poetry. It is an astonishing testament to the life of John McDermott. He is not mine to do anything with and I cannot get past that. Many people in this country think the same way.

Nobody would seek to delegitimise the decision Ms McDermott made and the person who implied that to her was completely wrong. Does Ms McDermott not recognise the very tragic testimony of people who made a different decision and felt it was the best decision for them? Many of the points she is making are about women feeling pressure to abort. I have been involved in this issue for a long time and have never met anybody who felt pressurised into having an abortion but I have met plenty of people who decided to have an abortion, most of whom were satisfied it was the best decision for them. Some have regrets. I have met people who put their children up for adoption and had regrets about that but it was their decision. The only way of respecting everybody's decision and supporting them is to change the legislative position.

Ms Liz McDermott

I understand why some women opt for abortion and why it would seem the best thing for them to do at the time. I am trying to say that one cannot make that call at that time. I could not have known how John would impact on me, my family and many others in many ways. It is not possible to say it was the best thing because one cannot know that. One has bracketed out any other outcome. Having a baby is a good and positive thing. Women have possibly become a bit afraid of it because it interferes with our careers and there are issues in terms of a lack of supports for women going back to work. All those things can come crowding into one's mind when one is pregnant. We have to face up to the fact that people decide to have abortions and there is such a thing as abortion regret and some people have experienced serious amounts of emotional trauma that they did not expect after an abortion.

The clinical evidence that has been presented to the committee does not support that view. In most instances, women are satisfied it was the right decision for them. The committee has heard evidence of that from Professor-----

Ms Liz McDermott

I do not disagree but there is other evidence out there. Perhaps the studies that have been done are slightly slanted.

All present would agree that the lack of perinatal care and the problems in our maternity services are issues that come up quite a lot.

However, the shortcomings Ms McDermott has highlighted exist in Ireland now in the context of the eighth amendment being part of the Constitution. The situation is bad now, when we do not provide for abortion in Ireland. Why does the witness think that if we provided for abortion things would get worse or that there is any link between the two things at all?

The reality is that 170,000 Irish women travelled for abortions, mainly to Britain, since the eighth amendment became law. If we acknowledge that that reality exists, and those people do not have a right to determine their own pregnancy, what is the solution? Should we compel them to continue with the pregnancy? How do we deal with that when many of them say that it was the right decision for them? If we recognise that that was genuinely their decision, do we say they should be compelled to continue the pregnancy? I would like to grapple with that question. I sincerely thank Ms McDermott.

I can understand why you ask the question, but it is a difficult one for the witness to answer.

Ms Liz McDermott

We come at the problem from different perspectives, philosophically. Deputy Daly, in principle, supports abortion as a procedure and a solution to a crisis pregnancy or problem pregnancy. I do not see it as a solution to anything, because when someone is pregnant, she is pregnant. One cannot turn the clock back. It does not make her un-pregnant, and it is certainly a harrowing event for her baby, who is still her baby. I know that there can be all sorts of circumstances and I am not trying to judge anybody in this.

However, I would say that abortion becomes an industry. There are people who have vested interests in making abortion available. There is profit in all of this too, and that can lead to a certain amount of pressure on women. I do not want to get into an ideological debate with members on this, because I am not qualified to answer all of these questions. We either uphold the right to life and apply it to all our citizens, regardless of whether they are at the beginning of life, at the end of life or sick during life, or we start to qualify it. We bracket out certain cohorts, or we say that it is not for us to say who has the right to life. I say this with all sensitivity. I understand the difficulties women in particular are in.

I wish to clarify that I do not expect Ms McDermott to have the evidence. I know she is not medically or legally qualified, and that is not undermining her. However, we do have to take evidence into account. Ms McDermott said that abortion was a violent procedure, that it was a harrowing experience for the baby and that if people knew what it was they would not choose that option. We must be careful. The evidence would contradict that view. The medical evidence is that a foetus does not feel pain until after 24 weeks. We heard testimony of many instances of fatal foetal diagnosis where people who went to Liverpool had the baby delivered and were able to hold it, and they got solace from that. Of course, in the early stages, an abortion is just like a heavy period. That is uncomfortable, but it is not violent.

I thank the Deputy. We will leave it there, because we have heard a lot of that evidence in the committee and the witness is not here as a medical expert.

I thank Ms McDermott for her evidence, and I would like to thank the parents in the seven moving case histories that were presented to us. I would like to move straight from the personal onto wider questions about Ms McDermott's charity. One Day More is a charity properly registered with the Charities Regulator, is it not? Does the group engage in fundraising?

Ms Liz McDermott

Yes.

I am astounded that in her testimony Ms McDermott spoke about some of the parents being told that their pregnancy was futile, that the foetus was like the Michelin man, or that in the case of a baby who had Down's syndrome, the parents were constantly contacted after each hospital appointment, to try to make them change their mind and have an abortion. Has Ms McDermott never dealt with a parent who would make a complaint to the Irish Medical Organisation, the management of the hospital or the Garda about this sort of harassment? If she has not, does she think that encouraging these people to complain, so that this type of treatment is dealt with, would be a good role for her charity? Everybody would find it quite shocking that any parent would be treated in this manner. That is one question.

Moreover, Ms McDermott spoke about the abortion industry, and how its for-profit nature puts another pressure on people to have an abortion. I know she does not want to get into a big philosophical discussion about it, but would that logic not tell her that abortion should therefore be free, safe and legal, so that there is no profit attached to it? The corollary of what Ms McDermott is arguing is that abortion should become a maternity or reproductive service that women can avail of.

I would like Ms McDermott to comment on the fact that her group is angry about the way hospitals have treated these parents, and the discussion about how badly they were treated is what brought them together, yet they do not seem to complain about it.

I would also imagine that Ms McDermott is very angry that this Government and other Governments have not signed up to the United Nations Convention for the Rights of Persons with Disabilities, that they continue to cut special needs services for children in schools, and that we have over 3,000 homeless children. I wonder if her charity is engaged in fighting those kinds of things, and in trying to improve those aspects of society for the children that are actually born. I am really interested as to why they do not complain about the treatment that is meted out to them as parents.

Ms Liz McDermott

We are there to support parents in their pregnancy. Lots of people asked why I did not write a letter to complain about the hospital and the treatment and tell the whole story. I have to say, whenever it happens to a woman, she just wants to be away from it. She just does not want to go back there. One is too upset at the time to even say the words. This happened to me in 2002 and 2003, and I am finally able to talk about it without getting upset. That is a real reason people would not want to jump up and down and make an official complaint about it. They are very vulnerable. However, it is important for there to be somewhere for people to go with that experience. I agree that if it can be collated into some kind of submission to hospitals to clean up their act and desist from this kind of pressure, that would be important. However, on the Deputy's point that we should make abortion safe, legal and free, it will be very expensive. In the UK, where abortion is supplied on the National Health Service, over £750 million of taxpayers' money has been paid to private sector abortion clinics since abortion was legalised. The boss of Marie Stopes received £420,000 as a salary in one recent year alone. That is four times the UK Prime Minister's salary.

I am sorry for interrupting the witness, but they are private clinics. When I say free, safe and legal-----

Ms Liz McDermott

This is taxpayers' money being used to-----

Ms McDermott is missing my point. When I say free, safe and legal, I mean provided for, the way it is under the NHS.

Ms Liz McDermott

Ireland is not as rich a country as the UK, and if the UK is not fully funding free abortions to women, I do not see how Ireland is going to be able to provide-----

They are fully funding it. The problem is that they use private operators, but that is not my point. What I am actually asking Ms McDermott is this. She complains about the abortion industry because it is for-profit. Would the logic of that complaint not mean that it should not be for-profit, that abortion should be provided as a service?

Ms Liz McDermott

The Deputy mentions a not-for-profit basis, but very lucrative salaries are paid to the people who work in the sector. We are not going to be able to provide it for free. When I say profit, I mean that it is very profitable, and it is incentivised. Marie Stopes was criticised for looking for employees to be paid bonuses. That inevitably brings pressure to bear on women.

Ms McDermott is making my point for me.

Ms Liz McDermott

The answer is not therefore to make it free to everyone because there is no possibility of making anything free. Everything has a cost.

No - to the woman who is looking for the abortion, it is free. My-----

Ms Liz McDermott

It still has to be taxpayer funded.

Absolutely. But so-----

Ms Liz McDermott

If it is taxpayer funded and the salaries are hefty, then it is going to be a big burden on the taxpayer, is it not?

That does not make sense because the consultant who saw Ms McDermott when she was pregnant would also be paid a hefty salary.

Ms Liz McDermott

Yes, and he was paid by me as well, not to attend the birth.

And paid by Ms McDermott as well. And he treated her so badly he should be complained about to the medical organisations that look after these things. My point is, given that One Day More is set up with charitable status, I assume it is registered with the Charities Regulator.

Ms Liz McDermott

But to support women - we are not out to get doctors or attack hospitals. What we are there to do is to provide emotional support to women who are going through a pregnancy and who need to get through the system. We do not-----

I absolutely get that but what-----

Ms Liz McDermott

I am not going to be quizzed on "why don't you do this or that". That is for other people to take up. We do what we can and we fit it in around our own lives.

I absolutely get that but I just really would like Ms McDermott to address the question. Would it not be a big help to the women she comes across if consultants who behave in this manner were reported for doing so? Would that not be a big help?

Ms Liz McDermott

Yes. All we can do is suggest that they might do so; what I was saying is that when it is happening to you, you just want to be - you cannot deal with that kind of thing. It is just impossible.

I welcome Ms Liz McDermott. We are two thirds into the process of the committee and today is the first time somebody who is in favour of the eighth amendment had a platform alone, so to speak, with a session devoted to them. What she has had to say is just so radically different from everything that has gone before. It is so noteworthy.

To correct one thing, Deputy Daly was picking Ms McDermott up on issues around pain and the question of whether abortion is violence. Actually, we have had very scant discussion about the question of foetal pain and I think no discussion about the question of the different types of procedures used. We have certainly had nothing diagrammatic or that would allow us to quiz for ourselves how violent or not abortion is at different stages. That is one of the many things that this committee has turned a blind eye to so far. Perhaps before the end there will be some discussion.

The reason I picked up the fact that Ms McDermott was interrupted - and I think that was also a first - is that while it may not have distracted the witness, I find that type of thing extremely disruptive and I lost what she was saying about Dr. John Parsons. I would be grateful if she would repeat for us what he had to say.

While Ms McDermott is looking for that, I might also ask her another question. There has been some talk about directive counselling and whether people in One Day More should report it. I am not so clear, to be honest, about what is illegal in these situations. For example, a doctor might say, "I feel obliged to tell you that it would be legal if you were to have an abortion in England." I understand Ms McDermott is a lawyer. I am not sure there is such a legal obligation but that would be interesting if there was. We have a Constitution that actually protects the unborn.

Ms Liz McDermott

I think it was the provision of information, back then, about the availability of abortion.

Everybody here seems to agree that it would be wrong to suggest a decision to go to Britain. I think Deputy O'Sullivan talked about "necessary non-directive". Even that is very undefined. I did not succeed in getting the HSE crisis pregnancy programme representatives last week to define directive counselling. We have a Constitution that protects the unborn. Ms McDermott has been very eloquent about how she could not have foreseen how she could cope. That is one big plank of her argument about why abortion should not be provided. I think I am not misrepresenting her when I say she also believes that John, in her case, had rights irrespective of how she felt. Is that correct?

Ms Liz McDermott

Very much so, yes.

If that is the case, then, that there is another human being who has rights in this situation, does Ms McDermott think that the whole area of directive counselling needs to be re-imagined? If we have a Constitution that protects the unborn, ought doctors not to be encouraging people, instead of leaving a cold choice and saying, "It is up to you; we are going to wash our hands of that particular decision."? That is not the way doctors act in other areas. They act to try and protect people's health and promote their wellbeing. I do not want to lead the witness. She must tell me if this is not her view. Is it her view that doctors ought to be suggesting or at least encouraging people to go with the life of the baby, even in very difficult situations?

Ms Liz McDermott

I think there is certainly an experience of dehumanising which can happen. Phrases like "anomaly" and "fatal foetal abnormality" - to describe human beings in that way is insulting. I think what the Senator is asking is if there genuinely can be non-directive counselling if we are putting abortion on the table and if we have a Constitution that forbids abortion and upholds the right to life of the unborn, should our counselling therefore be directed towards that. Yes, I would agree. I think doctors are in a difficult position. The provision for the availability of information about abortion is a fine line for them to walk, perhaps. They would know experientially that women do travel to England and they do not want to appear to be judgmental or, in other words, to tell a woman what to do. That is the dilemma we are in.

I heard it said that we have an abortion service and we outsource it to the UK. We do not provide abortions other than on the very limited grounds of the 2013 Act. I would love for more women not to feel they need to make that choice. Deputy Daly said that most women are happy to make that choice. I have to say I have encountered women, and groups that I have worked with have encountered women who say: "I do not want to do this but I have no choice." That might be because they have no practical supports, they have nothing ahead of them, the boyfriend is not interested or whatever. There can be myriad things. In terms of directive counselling I think doctors should be encouraged and they need to be almost given permission to be more definite in the encouragement that they give.

It meant a lot to me to have the scan doctor actually come back from Arklow - I think he was doing a clinic there - to see me in the hospital. He said he had just been up in the baby unit and had seen John and that John was lovely. It was a humanising and compassionate interaction and it meant so much to me. He was the only one in the whole structure of that hospital. It was like the rest of them just felt they just could not go near this. I think there is an awkwardness that exists.

Supposing Ms McDermott's vision and mine, as it happens, does not prevail, and the State withdraws legal and social support for these very sick babies in these situations, would that lead to more people having abortions or terminating the pregnancy? Does Ms McDermott think it would impact on the culture? Does she foresee any other consequences?

Ms Liz McDermott

Very definitely. The data would show that when abortion is legalised it is very difficult. The committee has heard the medical experts saying that they want really rather flexible legislation because it is very hard to put women within certain categories if the State legalises abortion in situations A, B and C-----

Is Ms McDermott talking about anomalies?

Ms Liz McDermott

Well, anomalies or rape and incest, these kinds of things. If we introduce a flexible or wide-ranging abortion service, in other countries where that is the case I think the abortion rate settles at something like one in five, generally. That is not just in the UK but in most other countries. We have about one in 20 currently. It does not take a mathematical genius to see that one in five is an awful lot more than one in 20. I think it is inevitable that there would be more abortions and that certainly women would, perhaps as a knee-jerk reaction - I can understand why they make that decision - but they would opt for abortion because the supports are not there to continue on. It is not just during pregnancy but throughout life. If a woman has a child with a disability, there must be a proper level of support and care provided.

However, that is costly. There must be buy-in from the whole country. It is not a vote winner. It is not a politically attractive thing to do.

Will Ms McDermott read out Dr. Parsons's comment for us?

Ms Liz McDermott

Yes. The Senator asked me for that. The discussion is titled, "Don't mention the "A"-Word". This is what Dr. Parsons said. I think I was halfway through when I was interrupted.

When you are doing termination procedures... you are exposed to a rather gross, destructive process dealing with bits and pieces of fetuses, which are not very nice... This is why we are not keen on people observing abortions. I was recently asked if I would have a journalist join me at work, who wanted to write [about this] for the Daily Telegraph. After discussing with other people we decided this was probably not a terribly good idea because it does not really help women who have got to make this decision to hear how unpleasant it is.

My point is that we are keeping the truth from women.

I am very sorry to interrupt, but there is a vote in the Dáil so we will have to suspend the meeting. I hope members will come back. I do not think there is any point in starting another contribution now.

Sitting suspended at 6.11 p.m. and resumed at 6.30 p.m.