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Are Irish women wimps?

I made a day trip to Dublin today, to showcase The Essential Educator to a group of midwives and educators from across the country. They were very keen on this teaching package and no doubt many will want to use it in their work.

After my presentation, we had a general discussion about childbirth education and some fascinating points were raised. One educator (from Holles St - the National Maternity Hospital) pointed out that at her hospital (the “home” of The Active Management of Labour) the epidural rate was now 70% and that this had not produce poor outcomes. The caesarean section rate was 15% and they also had a low rate of forceps/vacuum (not specified). She felt that if there were no poor outcomes then there was no way she could encourage women to consider alternatives to epidurals, especially if women demanded them and the hospital was to “keep up” with the services offered in other Dublin maternity hospitals.

What is going on here? It was apparent that Irish women are being denied information about the adverse effects of epidural on their babies, which is a primary motivator for women in other countries to manage their labours without drugs. When I demonstrated the role play from The Essential Educator that enables women to understand exactly what is involved in an epidural, I was told that this might “frighten” women. Eductors felt they should censor the information they gave in case women might be upset by some of the possible side effects or potential outcomes.

Irish women are, of course, used to being given information that someone else has deemed “allowable”. Feminism has not really surfaced in this country, where for generations, women’s lives have been ruled first by the Church and now by the doctors. All kinds of limitations are imposed on women in Ireland that would be completely unacceptable in other western countries: the freedom to speak out (lots of whispering behind hands goes on); the freedom to voice opposition or even question policies of all kinds (lots of undercurrents of threats to jobs and plenty of backstabbing); restrictions on who can be involved at births (no extra support people, be they friends, family or a doula); domination of midwifery by obstetricians (ridiculous policies and protocols); restricted services (closing small maternity units, denying the right of women to have home births); and various political manoeuvres that protect vested interests at the expense of women’s rights.

The one shining example of modern maternity care - the Birth Centre in Drogheda, which was established as a pilot project, is apparently under threat, from internal bullying of staff and restrictions that are so onerous that its availability is restricted to very few women. Other small maternity units are being closed and there seems little political will to fulfill the promise of rolling out maternity services modelled on this pilot projects, across the country.

Of course, none of this will be discussed in the open, although I will gets some personal emails. The maternity care system in Ireland is being used to keep women in their place - flat on their backs, unable to help themselves and under the direct control of the doctors. The epidural is a modern form of subjugation that robs women of their dignity as it ties them up with tubes, monitors and catheters. Anaesthetised, unable to even manage their own bodily functions, women have their babies pulled from their bodies or are bullied to push them out according to instructions from their “caregivers”. It is a modern, ritualised form of torture.

When looking for a counter argument to present against the epidural for labour, one has only to look at the baby, and the psychological impact this form of treatment has on the mother. One of the most insidious effects of anaesthetising women and babies during labour is the disruption that occurs to the nurturing hormones (oxytocin and endorphins) which are vital for forging a close bond between mother and baby at birth. Artificial oxytocin does not produce the caring and nurturing behaviours associated with naturally produced hormones. The baby, full of drugs, will not breastfeed well, and is at risk of being fed formula as a result - not the best nutrition for babies.

What is happening in Ireland is an example of what can occur when medical dominance of women is allowed to flourish unchecked. Women don’t find their own power and strength through giving birth unaided; babies are not bonded to their mothers at birth through the natural flow of hormones; breastfeeding rates are low, leaving babies to survive on less than ideal formula foods, and women’s voices are stifled through systematic subjugation by powerful, vested interests. Fear is rampant, women are afraid to speak out and leaders who are willing to take up the challenges are ostracised or even punished. For this to happen in poor oppressed nations struggling to provide the basics for human survival might be almost understandable, but to see it in a wealthy first world country which claims to be affluent and progressive is unacceptable.

One measure of how well a country is doing is to examine their health care system. Until options are in place that freely offer women choices for childbirth, births that don’t compromise the baby’s health through the use of obstetric medications, professional practice based on evidence, home births, water births and other non-invasive comfort measures for labour - in other words mother and baby friendly services - no country or hospital can claim to be civilised.

Posted by andrea at September 20, 2006 06:20 PM