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Delivering her verdict on childbirth

Dr Juliet Bressan, Irish Medical Times, 20th January 2011

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.

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“In all of us there is a hunger, marrow-deep, to know our heritage, to know who we are and where we have come from. Without this enriching knowledge, there is a hollow yearning . . . and the most disquieting loneliness." 

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