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Effecting change in Ireland

How to sum up my recent trips to Ireland? Such a mixture of wonderful women, struggling midwives, pockets of hope, fields of despair....

The workshop in Limerick ended well, on a positive note and was well received from the feedback on the evaluations. As I pointed out to the group, I appreciate that implementing the ideas we had explored would not be easy, but that there was much they could do despite the limitations of the system and the restrictions imposed by rigid policies and protocols. After all, each midwife is responsible for her own practice and can make a huge difference to each individual woman that she cares for, even in small ways. Caring about each other is the basis for a compassionate society and this can begin with women in labour: treating them as though you were in her shoes is a good way to start.

Two lasting impressions stand out in my mind: the lack of a “midwifery community” across Ireland and the legacy of years of general repression of Irish women.

By “midwifery community” I mean a sense that midwives are a separate professional group from nurses, with specialised skills and a strong sense of identity. I have met many Irish midwives who would fit this description as individuals, but I also sense that they feel unsupported in many ways, that they work more on their own than as part of a collective team. There seems to be a lack of co-ordination and sense of “belonging” in the wider scheme of health care provision.

It takes a collective sense of midwifery to develop strong networks that can effectively lobby and promote both midwifery and women’s needs to Government bodies, the media and within society. What I felt, and what was also stated in several ways during my two recent visits to Ireland, was that midwives fear putting their heads above the parapet, either individually or as a group, because they fear retribution and censure from their colleagues and also from other health professionals. Yes, it does take courage to make a stand on an issue, but stepping forward and stating a case, wearing the fallout and re-grouping for the next charge offers valuable learning experiences. These are skills that are worth cultivating.

I was alarmed, but not really surprised, by the fears of a backlash from other midwives, if an individual challenged an aspect of maternity care. This kind of behaviour is classic amongst the repressed, and is well documented. Groups under pressure find it easier to fight amongst themselves than collaborate to defeat the opposition, and midwives have adopted this victim mentality in many countries, not just Ireland.

The repression of Irish women seems to have been both systematic and comprehensive in many areas of daily life, but especially with birth services. The one area where women excel (giving birth to babies) has been so regimented and controlled by others that women have lost faith and trust in their abilities to an extraordinary degree. Maternity care is inflexible, discriminatory and decidedly unhealthy for most mothers and babies. Women are routinely being denied choice, subjected to procedures without consent and brainwashed into believing that the “care” they are being given is necessary because they are “weak” and “incapable” of achieving safe births without help. It is not only the women who believe this, many midwives also subscribe to this view, a sad reflection on the widespread nature of the problem.

Achieving change in Ireland will require determination, organisation and a strong alliance between midwives and the women they serve. Links need to be forged between the childbirth educators, doulas, the Irish Childbirth Trust, midwives, pregnant women, home birth mothers, in fact anyone who has an interest, either personal or professional, in the way babies are bon in Ireland. Can this be achieved? I hope so, and I will do what I can to help, because the fate of women and babies in Ireland is too precious to be brushed aside by those whose main interest is in the exploitation, control and repression of birthing women.

Posted by andrea at May 01, 2005 06:55 PM