Dr Juliet Bressan - Delivering her verdict on childbirth in Ireland

SanFran07

http://www.imt.ie/opinion/2011/01/delivering-her-verdict-on-childbirth.html/comment-page-1#comment-22874

Cat Melodeon

Dr Juliet Bressan wants to dispel what she sees as the myth that Ireland is the safest place in the world to have a baby.



On December 16 in the Grand Chamber of the European Court of Human Rights (ECHR), a unanimous judgment was made against a number of Irish doctors that there had been a human rights violation in respect of their patient.
This patient was a woman in remission from cancer and unaware that she was pregnant who had a series of check-ups contraindicated during pregnancy. On discovering her pregnancy, she became afraid that her cancer would relapse. And, she was also concerned about a risk to the foetus if she continued to term.
She asked her doctors what she should do – but they refused to give her clear advice. Unable to cope without medical advice and support here, she decided to have an abortion in England. She then went on to receive €15,000 in compensation for her suffering from the ECHR in a judgment against the Irish State.
The response of the anti-abortion movement in Ireland through its medical advisors is that Ireland is the safest place in the world to have a baby. End of. Ireland is probably a relatively safe place to have a baby – unless you happen to have been a patient of Dr Neary, of any of the symphysiotomy-friendly Catholic hospitals, to have had Rhesus-negative blood and have been in receipt of a Hep C contaminated blood product, or if you want a home delivery or a natural child birth… or indeed you want simple basic medical advice. Our Caesarean section rate is over twice the WHO recommended rate for a developed country.
Ireland, in other words, is probably the lousiest place in the world in which to be expecting a baby.
I had my own babies here in the late 1980s. Thanks to my obstetrician who was unwilling to give me a blood transfusion when my (unmonitored in ante-natal care) haemoglobin dropped to 7 after a post-partum haemorrhage, I don’t have liver cirrhosis today.
At university in the 1980s we were taught that although the Anti-D products were known to be slightly contaminated, the risk of transmission was low enough that the women probably wouldn’t really notice by the time they got the yellow jaundice, but that it was a happy price to pay in the long term for a series of healthy babies. Many of those women, of course, have since died.
Ireland is the country that pioneered the active management of labour. My own first labour lasted for over 24 hours because my obstetrician was on holidays and so my private patient chart was left under a pile while other more sensible women were managed actively by the State-employed midwives. Bitter? Not at all. A third-degree tear is but a scratch when you think that they could have given me liver cancer if they’d been arsed.
I don’t know many women who talk fondly of their happy days in the labour wards of Ireland. I’ve worked in many of them myself, and I’d love to have been able to replicate the experience I had of working in labour wards in Scotland and Australia.
I’d love to have worked, in Ireland, in an atmosphere where women in labour were deeply respected as the creators of life. Where women were offered comfort, freedom to move, to birth in a position of choice, to birth underwater, to enjoy acupuncture or homeopathy or whatever snake oil tickled their fancy, because their power of giving new life to the world was being honoured for the amazing gift that it is.
I would love to be able to say that in Ireland, a country which entitles women in the Constitution and which declares that the unborn child is worthy of just the same rights as any other citizen, that pregnant women are respected, honoured, and elevated. And I would love to be able to say, as a physician who trained in Ireland, that women in labour are always treated with admiration, dignity and grace. And if you aren’t laughing by now, you’re probably in tears.
I’d love to be able to say that, far from actively campaigning against the rights of children of foreign women who arrived in late pregnancy, that the obstetricians of Ireland have always honoured and respected the rights of the unborn children and have welcomed them into our citizenship. I’d love to be able to say that, far from refusing to consult with women whose babies will not survive their own delivery, that doctors in the maternity hospitals of Ireland have been a rock of compassion and support to these women.
I would love to be able to say that no woman is ever shown the door, shunned and forced to leave the country when she feels she must end a pregnancy. I’d love to be able to tell any of the journalists who are currently asking me, well, is it true what they say, that Ireland is the safest place in the world in which to be pregnant? That yes, we love babies in Ireland. We honour and respect pregnant women. We give power to women in labour and in childbirth.
But I cannot lie. And so I cannot push aside the truth about childbirth in Ireland. Dr Neary. Hepatitis C. Sheila Hogers. Anne Lovett. Joanna Hayes. The Magdalene Laundries. The X Case. The Y Case. The C Case. The D Case. Baby O. I could go on. We all know the truth.
And so the truth is this: and let’s be very clear about it. Ireland is not the safest place in the world to have a baby.
Sadly, this country is probably the lousiest place you can possibly imagine. The point is now to change it.

I know all this is true, but I wish more attention could be given to the places and people in Ireland that do get it right. My midwives were brilliant. I was allowed to get on with my baby's birth. I felt respected and empowered.Why can't that be the case for every woman?

bakedbean

I think all systems have their ups and downs and your own experience of them will really fashion your opinion.

I'm Irish but I live in the Caribbean. Through my medical insurer I have the choice of giving birth here, in the US or in Ireland. I've been weighing up the pros and cons of each and have decided that - on balance - Ireland offers the best and safest care.

My friend had her first child in the local hospital here last month. A healthy little boy but one that arrived without any notable pain relief. They don't do epidurals or gas and air here. If you need a CS, you're knocked out under a GA. It's very 1950s - the stern midwife tells you what length of nighty to wear and you must wear a black slip under so that you are "not letting the menfolk see your joujou"

As for the USA, my American friends tell me it's a good system if you have insurance which - at around $15,000 a year - is not cheap. However, if you're looking for freedom to birth in the way that you want, this is not the ideal place either. Another friend went through the US system in September was bedbound for her whole labour. She had an iv line, two heart monitors and various other bits and pieces - the staff wouldn't let her go to the loo.

She also found that her baby had had tests done and vaccines carried out all against her wishes. Five months later the bills are still coming in for items that she never knew were carried out and aren't covered by insurance.

I've scores of friends that have been through the Irish sytem and have heard good and bad stories but nothing that would scare me away completely. (OK, there is ONE hospital in Louth that I wouldn't go near;))

The author of this article may well be right but when compared to other countries, Ireland has huge advantages.

SanFran07

Yes there are always going to be better/worse off places than Ireland but you'll often see in discussions about Irish maternity care this same line pops up over and over again....that Ireland is one of the safest places in the world to have your baby....so that's supposed to make everything else that's wrong with our maternity services ok then....

The Caribbean sounds like a nice place to be today!

bakedbean

Yeah, I have to say that line has become a mantra and I suppose it all comes down to the research that it's based on. Is it flawed? Is it out-of-date? It's probably a 'statistic' that politicians love to throw out there as well.

I agree, there are improvements that can be made - I spent a lot of time on the Aims site before I made my own personal decision.

And yes, the Caribbean is a great place to be in February. Not somewhere I ever expected to live but an amazing place!