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Irish medical scandal enquiry report released

Irish maternity (or should I say Obstetric) services are under the microscope at the moment. For many women in Ireland, having a private obstetrician’s care for pregnancy and birth has been regarded as synonymous with status, prestige and excellent medical care. That may be under challenge now that a report into the shameful behaviour of one obstetrician has been released.

The story began some years ago, when a consultant at the Our Lady of Lourdes Hospital in Drogheda began exercising his own form of retribution on young, unmarried women giving birth. He began performing hysterectomies on these women following caesarean sections, without their consent. These unfortunate women would wake up from their anaesthetic to be told that they had lost their uterus and, in often patronising and demeaning terms, be told they should now go home and care for their baby as it would be the only one they would ever bear. The ultimate irony was that these women were primarily his private clients - those women in the public system but under his care, largely escaped his sadistic surgery, because hospital staff, who knew what was going on, were better able to protect the women from harm.

The whistle was finally blown by a midwife, who could not in all conscience, stand by and watch him remove another uterus without consent, just because the young unmarried woman had become pregnant. The complaint reached the Medical Council, who eventually struck him from the medical register and the doctor, having re-organised his finances so that he would be protected from potential lawsuits, escaped to Spain where he now lives.

The Government set up a public enquiry, headed by a Judge and it is his report that was released last week. The fallout has been inevitable: the case has attracted considerable media attention and the Department of Health is under pressure to make sure that policies and procedures are changed to protect women from such assault in the future.

All maternity hospitals have been sent a document that sets out a number of changes to be immediately implemented. Practice audits of are to be carried out on a regular basis; policies are to be reviewed and updated, and collaboration between doctors and midwives on all committees etc is to become standard. Outcomes will have to be justified and rigorous checks made to ensure that some transparency will finally enter the system as a whole.

These changes have been sorely needed in Ireland for a long time. For too long the midwives and women have been ruled by a tight knit obstetric fraternity, led by “the Masters” of the main maternity hospitals in Dublin. Just the existence of a person who is referred to only as “The Master” says it all really - such a situation would not be tolerated in any place outside Ireland. Perhaps a change of title will be one change that will result form the sweeping overviews that is now being demanded by the Government.

Meanwhile, the women of Ireland are getting a wake-up call. In the past, I suspect that Irish women would have tended to protect and defend their obstetricians when a scandal such as this one broke. Modern women may not be so inclined to be charitable, given that they are more worldly wise and more demanding of value for money.

It will be interesting to see how the ripple effects of the shocking revelations play out. Will midwives seize the day and demand support and recognition so they can protect women from unnecessary surgery and medical meddling? Will the women rise up and demand more choice in maternity services? Will the Government set in place genuine reforms that guarantee some transparency of the services the taxpayers are underwriting, so that, for example, all birth outcomes are published and freely available for public scrutiny? Will midwives et up their own College, breaking away from the Nurses Association to create their own autonomous professional organisation? Will the doctors start treating midwives as professional equals and work happily in collaborative ways to ensure clinical excellence for women and babies?

None of these issues are being discussed amongst midwives on their Irish Midwifery Mailing list, so it seems they have either not been registered on midwives’s radar (which I would find hard to believe), or else the topic is too “hot” to handle or broach publicly. This could be the greatest rallying point that midwives in Ireland have ever had. I hope they see the potential and get their acts together. Midwifery in Ireland could finally come of age as a result of this terrible tragedy where dozens of women’s reproductive lives were sacrificed for one doctor’s desire to play God. It would be some small consolation for their terrible losses.

Posted by andrea at March 16, 2006 02:42 PM