A leading obstetrician has said that Savita Halappanavar could have survived if she had been allowed a termination at University Hospital Galway during the two days after she was admitted on Sunday October 21 last.

However, Dr Peter Boylan, former Master of the National Maternity Hospital, today told the coroner's inquiry into Savita's death that the current legal position in Ireland meant that a termination could not have been undertaken on October 22 or 23 as there was no 'real and substantial risk' to the life of the mother at that stage.

Dr Boylan said had the termination been carried out on those days, on the balance of probability, Savita's life could have been saved. Savita had requested a termination on those days.

He felt that by the morning of Wednesday, October 23 her condition had deteriorated sufficiently to warrant a termination, and at that stage such a termination would have been allowed under the current law, but at that stage he did not believe a termination would have saved her life.

Dr Boylan said said that there had been deficiencies in the care provided at to Savita, who died of sepsis on Sunday October 28 last. While none of these individually resulted in Ms Halappanavar's death, together they led to delays in her treatment.

He said doctors were currently working in a 'legal vacuum' on termination in terms of calculating the level of real and substantial risk to the life of the mother to justify such a procedure.

Savita's consultant, Dr Katherine Astbury, told the inquest in Galway last week that she decided she could not allow for a termination onOctober 22 or 23 as there was still a fetal heartbeat and at that stage on the balance of probabilities there did not appear to be a serious risk to the life of the mother.

The consultant denied using the phrase 'this is a Catholic country' but said she had told Savita after she had asked for a termination on the Tuesday morning: "in this country, it is not legal to terminate a pregnancy on grounds of poor prognosis for the foetus."

She said her understanding was that that unless there was a real and substantive risk to the life of the mother, abortion was not permitted in this country.

Dr Astbury said Savita has asked her about her termination once, but Praveen Halappanavar said his wife asked for a termination three times over two days and was told by the consultant this couldn't be done because Ireland was a Catholic country.

Last week, a midwife, Ann Maria Burke, admitted telling Savita that this was a Catholic country but stressed that she did not mention this in a hurtful context.

Dr Astbury said after Savita's condition had deteriorated she decided a termination was necessary around lunchtime on the Wednesday. She said if she had known earlier about a foul-smelling discharge discovered in early morning by one of her junior doctors, indicating serious infection, she would have carried out a termination sooner that day.

Savita spontaneously delivered a dead baby girl later that afternoon. Her condition continued to deteriorate and she died on Sunday October 28.

Dr Boylan told the inquest today that from 6.30 onwards on the Wednesday Ms Halappanavar was ill enough to justify a termination. However, he said that any termination from 9.30am on that day would have been unlikely to make a difference to the outcome.

Differences remain between a midwife and a doctor from the Galway hospital in their accounts about an apparent delay the transmission of information about a deterioration in Mrs Halappanavar's condition on the evening of Tuesday October 23.

The midwife, Anne Maria Burke, and Dr Ikechkwu Uzockwu both returned to the inquest today. Ms Burke said the she informed the doctor of an elevated pulse reading from Savita at around 7.35 on the Tuesday evening, but Dr Uzockwu said he recalled getting a call between 9pm and 11pm, and said that no reference was made to an elevated pulse rate at that time.

A verdict is expected to be reached in the inquest on Friday.

Lessons from Savita inquest