While the exact events preceding Savita Halappanavar's death are unclear, the heart-wrenching account her husband has given raises urgent questions about the medical management of her case.
According to reports, on the Tuesday morning, she asked to terminate her pregnancy, given her own worsening health and that the 17-week-old foetus was unviable because she was miscarrying, a fact that her husband Praveen said became clear soon after she arrived at the hospital.
But the request was apparently refused, the couple were told that it was against the abortion laws and that "this is a Catholic country".
"That evening [the Tuesday] she developed shakes and shivering and she was vomiting … a doctor took blood and started her on antibiotics," said Praveen. She later died of an infection.
Sepsis – blood poisoning – is now the leading cause of direct maternal death in the UK, according to the Royal College of Obstetricians and Gynaecologists.
"Infection can come out of nowhere and kill you very quickly," said one senior NHS doctor and specialist in this area the Guardian spoke to.
The growing number of deaths from sepsis – 13 in 2003-05, 29 in 2006-08 – prompted the RCOG to send a safety alert to its members in April, warning them to be aware of the signs and act quickly when they appeared, as failure to recognise its signs had featured in "many" deaths related to it.
The inquiries now under way will have to establish when doctors should have realised Savita had an infection and decided that there was a risk to her life, not just her health. The distinction is vital because Ireland supposedly allows abortion only when the mother's life is at risk.
Any woman in labour, whether her labour is proving straightforward or not, is at risk of infection once her waters break, as the waters protect both her and the baby from infection.
Savita appeared to be in trouble as early as Sunday. The apparent failure to recognise that risk then, and to start her on antibiotics until the Tuesday night, will be the most urgent question for those investigating.
