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21st March 2016, 15:52:14 UTC

Ms. Y is a young woman who travelled to Ireland seeking asylum after brutal persecution and violence in her country of origin. In February 2014, prior to arriving in Ireland, Ms. Y was kidnapped, held against her will, beaten and raped repeatedly by the head of a paramilitary organization. Her lawyer noted: “I understand he kept her for himself and raped her repeatedly. She was violently beaten and still bears the scars of those beatings, which are quite significant scars… not to mention the psychological trauma.”

She was violently beaten and still bears the scars of those beatings, which are quite significant scars... not to mention the psychological trauma

Eventually, she managed to escape. She was able to flee the country with a family member and arrived in Ireland at the end of March 2014. She and her family member were transferred to a Direct Provision Centre for accommodating asylum-seekers. Within days of arriving in Ireland, Ms. Y felt unwell. A nurse who saw her determined that she was pregnant. Ms. Y “was devastated and became very distressed upon hearing this news,” says her lawyer. She made it clear to the nurse and other officials who dealt with her that the pregnancy was as a result of rape, was unwanted and that she was feeling suicidal as a result. Giving her account of her ordeals was extremely difficult and traumatizing for Ms. Y. Her reporting of feeling suicidal continued and escalated. Ms. Y was told she would have to travel to the UK or Europe for an abortion – but that the obstacles to travelling abroad for such a purpose were many. Ms. Y was told she would need to complete complicated forms to obtain a visa and a temporary travel permit. The paperwork was extensive and in English, a language which Ms. Y does not speak. In addition, Ms. Y was told she would need at least €1,300 for the travel documents, flights and abortion costs. At the time, she was in receipt of €19.10 per week as an asylumseeker. Ms. Y was left feeling overwhelmed and abandoned. In June 2014, Ms. Y was referred to SPIRASI, a voluntary agency that works with asylum-seekers, refugees and survivors of torture and persecution. Ms. Y was sent for a medical assessment as part of her asylum.

Ms. Y’s name and country of origin have not been disclosed to protect her confidentiality and ensure her safety. All the information in this account about Ms. Y’s case is from an interview with her lawyer, Caoimhe Haughey, who narrated Ms. Y’s experience based on what Ms. Y told her and numerous written medical records, custody records and other documentation that she has obtained as part of her representation of Ms. Y. Interview with Caoimhe Haughey, Solicitor for Ms. Y, 28 January 2015. She is not a criminal The impact of Ireland’s abortion law Index: EUR 29/1597/2015 Amnesty International June 2015 41 application. The doctor who examined and assessed Ms. Y prepared a detailed medical report, which was submitted to the Reception and Integration Agency and other officials dealing with Ms. Y’s case at that time. The medical report submitted states Ms. Y was suffering from post-traumatic stress disorder; it states that Ms. Y expressed the desire to end her own life if the pregnancy continued. Ms. Y was noted to have a “strong death wish.” Further assessment and counselling was recommended; however, there was no follow up at all.

Further assessment and counselling was recommended; however, there was no follow up at all

Ms. Y was not referred for psychological or psychiatric support, intervention or treatment. Nor was she referred for ante-natal maternity care at this juncture. “The clock was ticking… she had no one to turn to,” her lawyer relates. “There were so many agencies involved and she was passed from pillar to post. They all knew of her pregnancy… they knew she was highly distressed and that she was seeking a termination. Nobody was listening to her and there was no intervention.” Communicating with those around her was very challenging, necessitating a translator to be available and physically present at all times. In July 2014, Ms. Y made a desperate, unsuccessful attempt to seek an abortion in the UK. A clinic was identified and arrangements were made. Upon arrival in the UK, Ms. Y was arrested and detained for up to eight hours. Her meagre personal belongings were taken from her, as were her clothes. The Custody Records note that she was deemed a risk to herself and that she was given a safety gown to wear. Ms. Y was monitored closely and medically assessed. The medical records state “suicidal since being pregnant as a result of rape.” Ms. Y was later returned to Ireland, as she was not legally permitted to enter the UK. A few weeks later, Ms. Y met with a general practitioner (GP). This GP’s medical notes record concern about Ms. Y being suicidal. She was referred to a psychiatric unit. It took a number of days before she was eventually admitted to a maternity hospital. Ultimately, Ms. Y was kept in hospital for several weeks during which time involuntary detention was mooted. Her medical records indicate that Ms. Y spoke of suicide on an almost daily basis, with increasing intensity.

Her lawyer related that Ms. Y told her health care providers “I will kill myself if I cannot get rid of this baby… I don’t want it inside me. I don’t want to discuss it. I don’t want to know about it. I want it out. I cannot continue with this pregnancy.” Ms. Y repeatedly threatened self-harm. Nonetheless, Ms. Y was not advised of her rights under the Protection of Life During Pregnancy Act. Her medical records reflect that she was instead told: “you cannot get an abortion in this country.” There was “huge emotional pressure inflicted upon this very young, vulnerable woman by health care providers to get her to continue with her pregnancy, even though she expressed the intention of ‘I am going to throw myself off the top of this building’ and ‘I am going to tie a rope around my neck,’” explains Ms. Y’s lawyer. Ms. Y had made an earlier suicide attempt, which was interrupted. As a desperate measure, Ms. Y went on a hunger strike, refusing all food and drink. Told by doctors that they would “terminate” her pregnancy, she resumed drinking and eating. However, “the termination” (as it was described) was postponed and postponed again amidst legal wrangling, resulting in an emergency application to the High Court. In early August 2014, the HSE obtained an order from the High Court to effectively force feed and hydrate Ms. Y; an order which was later abandoned. A number of days later, Ms. Y delivered Baby Y by caesarean section. This was the only option determined by the two psychiatrists and obstetrician, who certified She is not a criminal The impact of Ireland’s abortion law Amnesty International June 2015 Index: EUR 29/1597/2015 42 this procedure as meeting the requirements for a lawful abortion on suicide grounds under the PLDPA.

“In my opinion,” says her lawyer, Caoimhe Haughey, “Ms. Y was given no choice. I believe that she did not fully understand what was going on. How could she? I believe that she was unduly influenced into accepting the planned caesarean section, otherwise she would be kept in hospital in order to continue with the pregnancy, which was a life or death decision for my client. From what I have read, viability considerations and other legal implications were first and foremost in the minds of those involved.” After Ms. Y recovered from the surgery, she was discharged from the hospital and left to pick up the pieces of her life. She was granted refugee status and returned to her accommodation in the Direct Provision Centre. Her lawyer believes her after-care medical treatment and support was less than satisfactory in terms of follow-up. She stopped eating and lost a considerable amount of weight. She remained very vulnerable and fragile. Ms. Y bears many scars from her ordeals, physical and mental. Her caesarean section scar is a permanent reminder of being raped and her unwanted pregnancy. With the help of her legal team, Ms. Y now has a multi-disciplinary medical team in place to support her.