March 11, 2003

Reflections onthe Irish midwifery scene

Today I am back in the UK, and reflecting on my recent experiences in the Republic of Ireland. It is important to recognise that the Irish Republic is a very different country from Northern Ireland, even though they are so close togther and have many things in common (starting with that lovely Irish lilt in their speech!).

The contrast between the two Irelands is very noticeable in the field f midwifery, for example. Thirty years ago, I suspect that midwives in both countries worked in much the same ways, but the advent of O’Driscoll and his “active management of labour” protocol changed all that in the 70's. Midwives became subservient to obstetricians, who dictated exactly how labour would proceed and ensured that everyone fell into line with their thinking. Midwifery lost its status as a separate profession as well, and became a branch of nursing. An email list has now been set up to enable midwives to network as a group more effectively, but there is still no separate no College of Midwifery to provide a focal point for midwives.

I was astounded to learn that in the Republic, midwives are still using sterile drapes, swabbing down perineums (“must have a sterile field for birth”), performing routine V.E.’s every 2 hours and of course, rupturing membranes on admission. These things were accepted without question and I was surprised that there was general ignorance of the literature, research, education and standards of practice elsewhere. Some of the experienced midwives in the group knew of other ways of working, but seemed to have succumbed to applying these kinds of outdated practices to labouring women rather than risking challenging their appropriateness.

Irish women it seems, on the whole, are used to being told what to do and rarely step outside the boundaries established by their male-dominated society. They are hesitant and inhibited, and seem very compliant and malleable. I am sure they are not all like this, but it is as if feminism has passed Ireland by, in many respects.

It was therefore refreshing (and useful), to have midwives from Northern Ireland participating in the group I have just concluded. The Craigavon Maternity Unit in Northern Ireland is a model for midwifery led units everywhere, and if the rest of the group doubted what I was suggesting, the midwives from this unit quickly confirmed that these were ideas well known and practised in the North.

I love Ireland and the Irish people, but it some ways going there is like stepping back into a time warp. I feel sure they will catch up, and I hope rapidly, because there is a whole new world of midwifery awaiting women and their caregivers that I know they will find enormously rewarding.

Posted by andrea at March 11, 2003 12:24 AM

Comments

Hi again ANdrea! Long time no seeeeee!
It came as a bit of a surprise for me to find out how arcaic the relations between women and health care givers are dealt in Ireland. Considering we live in this day and age I would have thought that only in countries like Brazil women are told what to do by doctors and avoid listening to their own inner power of giving birth naturally and spontaneously.
Live and learn....
Enjoy your stay in the UK
*hugs*
Jackie

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