Just like in Tennessee, the Republic of Ireland has had intense debates about abortion access. In the 1980s, voters there put a ban on abortion into their constitution. But 10 years ago this week, one woman’s death caused an uproar that eventually led to the country legalizing abortion several years later.

The public outrage was precipitated by a news story — and specifically, the front page of The Irish Times in mid-November. Above the fold was a smiling portrait of Savita Halappanavar, a 31-year-old dentist from India who’d been living in Galway. And the headline: “Woman ‘denied a termination’ dies in hospital.”

“It had all the makings of just an explosion of passions,” Kitty Holland, the lead reporter on the story, said in a recent interview.

Her piece detailed how several weeks earlier, in October 2012, Halappanavar had gone to the hospital at 17 weeks pregnant with back pain. Doctors said her cervix was opening and that she was going to have a miscarriage. But when she asked if they could terminate the pregnancy to speed up the process, they said they couldn’t, because the fetus still had a heartbeat.

At the time, abortion was only allowed in very limited circumstances when the mother’s life was deemed at risk, similar to the current law in Tennessee. Doctors noted that Halappanavar seemed healthy and opted to let her miscarry naturally. According to her husband Praveen, the medical staff explained it by saying, “This is a Catholic country.”

“‘I’m sorry, I can’t help you, because it’s a Catholic country,’ and Savita said that she’s not Catholic, she’s a Hindu, so why impose the law on her?” Praveen Halappanavar said in an interview with Holland.

Savita Halappanavar did eventually deliver a stillborn fetus. But she also ended up developing sepsis, and she died on Oct. 28, 2012.

A reckoning over the treatment of women

Her friends and family wondered: If she’d gotten an abortion when she asked for it, would she still be alive? They got in touch with an abortion rights group in Galway, who tipped off Holland. And the story exploded around the world, especially in India, where the Halappanavars were from, and in Ireland, where the death happened.

“There was just huge, huge anger,” says Sinead Kennedy, a longtime abortion rights activist who helped organize a massive protest a few days after the story broke.

On one hand, the anger, the protesting — it was nothing new. Over the previous decades, several cases had tested the limits of Ireland’s abortion ban. Teenage girls who’d been raped. Women who were told their babies wouldn’t survive. About every five years, someone would go to court under a pseudonym, and abortion rights activists would protest … and that would usually be it.

But the Savita case was different. A woman had died. And Kennedy says Ireland was already in a state of reckoning:

“Namely the uncovering of revelations of physical and sexual abuse by the [Catholic] Church, the incarceration of women in Magdelene Laundries, the enforced adoption and selling of babies overseas — all of these kind of revelations had been pouring out.”

At the same time, many Irish people were eager to build a new reputation as a modern European country, one where religion had less influence and where people from other countries wanted to move. And here was Praveen Halappanavar — an Indian man who had moved to Ireland to work at a biotech company — implying that Catholicism had played a role in his wife’s death.

“I think in that sense, there was a kind of connection, that people could connect with what this actually meant. This wasn’t an abstract,” Kennedy said.

Skepticism but undeniable impact

Immediately, there were calls for the government to pass legislation defining when exactly doctors could terminate a pregnancy. But the backlash to the story started just as quickly.

“My immediate reaction was to just — I just couldn’t believe it, really,” says Michael Kelly, the editor of the Irish Catholic newspaper. “My second reaction was: I’d be surprised if everything was as it seems here.”

He believes The Irish Times was irresponsible in how it focused so clearly on the role of abortion in Halappanavar’s death by putting “termination” in the headline, “particularly when, in the immediate aftermath, there were so few facts available,” he says.

In the following months, the government would produce hundreds of pages of details about the days leading up to her death. Those against abortion, like Kelly, point to evidence that the hospital staff missed multiple opportunities to identify her infection sooner. To him, it’s a case of medical mismanagement: If they had been able to tell that sepsis was setting in, they could have treated her more effectively and even legally terminated her pregnancy earlier.

But on the abortion rights side, activists like Dr. Peter Boylan maintained that a termination when she asked for it also would have saved her life. In a televised debate about abortion law in 2018, he noted: “Her treating consultant was asked, ‘Did you feel that the law interfered with your ability to treat Savita Halappanavar appropriately?’ And she answered yes.”

(His statement was countered by an audience member, who said Boylan was telling “continuous lies.”)

Zooming out

But one thing is clear: The fight over the narrative of Savita’s death did not stop the impact. In 2018, 35 years after Irish voters banned abortion in their constitution, they voted overwhelmingly to legalize it.

Is her death and legacy an indication of what might happen in other jurisdictions where abortion is banned, like Tennessee? The prediction depends on who you ask. Sinead Kennedy, the abortion rights activists, thinks a death is inevitable.

“Part of the problem with these anti-abortion laws is that it creates a chilling effect on medical practitioners,” she says.

But she doesn’t know if one tragedy would create the same kind of societal reckoning over abortion.

Ireland was in a unique cultural moment, for one thing. Plus, activists had laid the groundwork with decades of resistance to the abortion ban — resistance that hasn’t existed as much in the U.S., where abortion had been technically legal since the 1970s.

And, Kennedy notes, in response to sustained public pressure after Halappanavar’s death, politicians from across political parties came out in support of legalizing abortion.

“It’s not like we knew that back in 2012,” she says. “It’s very difficult to pinpoint what is it that is going to ignite change.”