March 14, 2004

Scandals in Ireland

This weekend I am facilitating an active Birth Workshop in Dublin for the Irish Childbirth Trust. I have altered the emphasis of this program slightly, at their request, to spend more time on activities and presentations for prenatal programs and have omitted some of the more midwifery orientated materials.

There are midwives in this group, and their concerns very much echo those I heard in Drogheda over the last two days. The power of the obstetricians is still affecting women and midwives in a major way, although things are changing very slowly. I’ve heard many stories during these past few days of midwives being censured for speaking out, being subjected to unreasonable protocols that are clearly not evidence based, being forced to subject women to procedures they feel are unjustified and at times even dangerous, all because a doctor demands they be done. In many ways this is not unusual - it is the same story in many countries. However, in a developed, first world country, which has a thriving economy and a prosperous lifestyle, it is strange that women are still haven’t found an equal place in this society.

The High Court last year ruled that women were not entitled to a home birth in Ireland, supporting the medical case that said it was dangerous. Home births are available, but are hard to arrange due to very few midwives being willing to offer this service in the face of stiff opposition. Holles Street (as the National Maternity Hospital is known) has been offering a domiciliary service for the past 5 years (the only service of its kind in the country), and women using it can opt for a home birth, should they want this and meet the stringent criteria. About 10% of the women in the program are now having home births - a major development, if somewhat limited.

Recently, an obstetrician working in Drogheda was struck off the Medical Register for misconduct. He had removed the uterus from over a hundred women, during caesarean births, when there was no medical indication and no consent from the women concerned. It appeared that he was exercising an extreme form of contraception on unwilling women, and it took years for this to be exposed, Many of his colleagues knew what he was doing but colluded and failed to act. Just before the announcement of his “retirement”, and the inevitable publicity as his terrible practises became public, obstetricians mounted a very active campaign against home birth, trumpeting that midwives were killing babies by carrying out births at home. It was seen as a cynical attempt to force the spotlight onto midwives so that one of their colleagues, who was deliberately butchering women’s bodies would receive lesser publicity. It appears to have been a fairly successful ploy, because there has been no general community outrage over this doctor’s shocking mutilations, and homebirths (and midwives) are still fair game and receive little support.

It was a scandal of similar proportions involving an obstetrician’s lack of treatment for women who had cervical cancer that tipped the scales in New Zealand in the late 1980s and enabled midwifery to achieve its deserved recognition. This was achieved because the community were outraged and demanded that the health system be changed - women lost confidence in obstetricians and the Ministry of Health were forced to act. They agreed to support the midwives, changing laws to make sure that they had the opportunity to work alongside their medical colleagues, with equal rights, pay and conditions. The changes to the laws that resulted, have transformed childbirth in new Zealand and created the best midwifery service in the world, with outstanding results and true chocie and freedom for women. It would be wonderful if the women in Ireland could achieve similar results. Right now, the culture surrounding women’s place in the community and general attitudes don’t seem yet ripe for such a change to occur. Perhaps in time.....

Posted by andrea at March 14, 2004 07:00 AM

Comments

Hi Andrea, Sandra from the weekend in Dublin here. Would you mind if I cut and pasted some of the very insightful comments on the www.EUMOM.ie bulletin board. I have already posted somewhat tamer stuff on there, but I don't have the same "weight" as you, if you'll excuse the expression. Anyhow, thanks for the great workshop for the weekend....I loved it!!
xx
Sandra

Posted by: Sandra Callaghan on March 19, 2004 04:32 AM