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Monday 4 December 2023 Dublin: 2°C

'Ireland over-medicalises birth - and it is terrifying mothers-to-be'

Dil Wickremasinghe, since she has become pregnant, has found the maternity system is fraught with fear and discourages women from making decisions about the birthing process.

GIVING BIRTH FOR a woman is the most significant, meaningful and empowering event in her life. Not only does she heroically introduce a new life into this world but she emerges from the experience triumphant and forever transformed into a strong, nurturing and self-assured mother.

I believe that birth should not only be the making of a child but also the making of a woman.

Sadly, most women in Ireland would not view birth as a positive and empowering experience in fact many would describe it as traumatic, disempowering and fearful.

A quote that encapsulates the reason why birth in Ireland – instead of being embraced – is viewed with trepidation and an event that can only be survived if one is numbed or rushed through it:

“If a woman doesn’t look like a goddess during labor, then someone isn’t treating her right.” – Ina May Gaskin

The “Fear”

Since I became pregnant like all expectant mothers I have done my best to make sure I have a healthy pregnancy. I’ve made the necessary lifestyle and dietary changes, used mindfulness to stay calm and attended my local maternity hospital and GP. I did what most women do; follow the instructions of the medical professionals.

I was disappointed that because of my age and the fact that mine is an IVF pregnancy I was immediately classed as a “high risk” pregnancy and didn’t qualify for the Domino scheme. I was also told on my very first appointment to be prepared that baby could come early. The “fear” of childbirth had begun.

Having a birth plan

Then a couple of months ago when I was at a social event an expectant midwife asked me, “So have you decided on a birth plan yet?” I was confused so she asked me again, “What kind of birth would you like for you and your baby?”

I was speechless as the thought of a birth plan had never been suggested but even more alarmingly I was unaware that we even had a choice when it came to our birth experience. The next day I started researching the area and I couldn’t believe what I found – a social justice issue relating to our maternity services that I had never been aware of before.

The last two months have been quite remarkable as after much research I have come to the realisation that most pregnant women don’t play an active part in their care but instead completely surrender their birth experience to the medical professionals.

I find this incredibly worrying as the women I spoke to were assertive, educated, driven and working in decision-making roles. These women are the kind of women who would ‘go through you for a shortcut’ if they felt you were trying to take advantage of them.

It was perplexing that these women would probably put a great deal of effort into informing themselves before getting a mortgage or buying a car and yet were willing to surrender the most intimate part of their body and the life of their child to a group of strangers just because they were medical professionals.

Power imbalance

I believe that there are a two reasons for this – firstly our perception of childbirth. Most women fear the entire experience and choose to take the “less I know the better I’ll be” approach as they view birth as something they need to be saved from. The other reason why mums-to-be don’t take a more active part is sadly due to how our maternity services are set up.

Just like our mental health services our Irish maternity services follow a medical model that at times does more harm than good as they tend to over-complicate, over-medicate and even over-think the process of childbirth.

The recent ‘What Matters to You?’ survey released by AIMS Ireland, the Association for Improvements in the Maternity Services Ireland, highlighted that “52% of those surveyed did not receive information on potential implications to have or not have tests, procedures, treatments to assist with their decisions, and only 50% able to make an informed refusal during their labour and baby’s birth”.

The power imbalance between women accessing the maternity services and the medical service providers is still shockingly high and remains unchanged despite symphysiotomy victims sharing their experience of having their pelvis broken during childbirth without their knowledge or consent.

Reversing the medicalisation of childbirth

Did someone ever have to teach you to sneeze or cough? Childbirth is a natural part of life and a women’s body, if trusted to do its job, would naturally give birth to their baby. Of course things can go wrong in childbirth and that’s when the midwife or the obstetrician can step in, but why not include the woman in the decision-making process right from the beginning? Shouldn’t she be regarded as an expert on her own body and trust her natural instincts and judgment?

Surely the act of giving birth should be a team effort between the mother, baby and medical professionals?

To have a positive birth the woman must feel a sense of control, she must feel empowered and supported by those around her. I believe if this is done the woman will emerge from child birth healthier, happier and triumphant and most importantly deeply connected to her child.

As a result of my conversation with a stranger and my introduction to Ireland’s birth movement my partner and I have decided that a home birth, with the aid of an experienced midwife from Neighbourhood Midwives through the UK Birth Centres, and the support of our local maternity hospital is the best way to go for us.

However this option was never offered or even mentioned by the maternity services, a situation which – in this pregnant woman’s view – must change.

  • Dil is a social justice and mental health campaigner, broadcaster of Global Village on Newstalk 106-108fm, Saturdays 7-9pm and Training Director with Insight Matters

Read more of Dil’s columns for here>

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