A healthy labouring woman, fully dilated, is ready to start pushing. She has taken the responsibility of informing herself of the pros and cons of hospital and home-birth and has chosen the best and safest option for herself and her family; a home-birth. She is eagerly awaiting the birth of this child – her fourth – and is happy that her labour is progressing smoothly. She feels powerful and energised. Confident of her body’s ability to birth, this woman is surrounded by carefully chosen birth attendants: Chief among them is her midwife, who has cared for this woman since the 8th week of her pregnancy.
This midwife has met with this woman and her family a dozen times during the pregnancy. She has nurtured her and her family throughout. Her kindness, care and experience have helped create an atmosphere of calm. She has met with the family in the comfort, safety and privacy of their own home and answered all their questions. She has worked hard and diligently with the family to achieve the optimum birth. She has earned their trust.
Just as the pregnant woman is about to start pushing her baby into the world, there is a loud rapping at the door (in spite of the note pinned to it asking callers to return later, as a birth is in progress). When the bewildered father-to-be answers the door, he is confronted by uniformed Gardaí. They have come to arrest the midwife. The HSE has decided that her attendance at this birth is illegal because the woman’s last baby (her third) was over 9lbs in weight.
This midwife faces up to 10 years in prison and a €160,000 fine for exercising her profession to the best of her ability.
Sounds crazy, right? Well, that’s exactly the scenario that could be enacted up and down the country if the HSE has its way. The Department of Health is currently preparing to put a Bill before the Dáil which would virtually outlaw homebirth in Ireland and leave self-employed midwives at the risk of being vilified, arrested, fined and imprisoned.
The proposed Bill would strip midwives, who attend women outside the criteria dreamt up by the HSE, of insurance. Most of the criteria currently proposed by the HSE are not evidence-based and violate a woman’s right to make an informed choice with regard to where she births.
These guidelines and sections form an architecture of coercion. Mothers who fall outside the draconian and prejudicial terms laid down by the State may be forcibly hospitalised. Midwives who, like other professionals, seek to exercise their autonomy may face a jail sentence of up to 10 years. Draft HSE guidelines recently circulated go so far as to define the Garda Siochána as ‘relevant stakeholders’ in home birth.
‘Section 40 of the Bill, in effect, undermines women’s rights by withdrawing access to midwifery care in childbirth. Women have the right to appropriate health care, to bodily integrity and to self-determination. They also have the right to decline medical intervention. This Bill effectively denies women the freedom to give birth as they wish’, said Dr Krysia Lynch of the Home Birth Association.
Self-employed midwife Philomena Canning puts it most succinctly: ‘The Bill, as it stands, threatens the future of midwifery, criminalises autonomous midwifery practice, conflicts with a midwife’s duty of care and denies midwives the right to run their own profession, a right enjoyed by all other health professionals in law.’
‘The Bill places the midwife in an intolerable dilemma,’ she continues. ‘She must decide whether to assist the mother under circumstances where she is no longer indemnified––and possibly be jailed for doing so – or stand idly by. Withdrawing care from a mother who suddenly ceases to conform to insurance criteria in mid-labour is an appalling vista.’
I sit here and wonder how I have ended up raising daughters in a country where women’s and children’s rights can be systematically trampled over by its own government. This is a witch-hunt against midwives who want to practice their profession. It is another attempt by the government of Ireland to violate women’s human rights. It is another example of the Irish government telling Irish women that they must do what they are told – that they must conform and be ‘good girls’. It is another example of the Irish government deciding it knows what is best – even if international research and evidence does not support their stance.
I am shocked and saddened that Irish society has progressed so little. This treatment of women, by the Irish government, is not a million miles from what they did to women in the infamous ‘laundries’. I am disgusted at the lack of respect this proposed Bill shows for women and children.
This issue is not about home birth versus hospital birth. It is not about hippy women ‘refusing to listen’ to doctors. It is not about ‘stupid’ women refusing medical care. It is not about women who ‘just want to be different’. It is about the proposed violation of the rights and integrity of the women and children in this society. Peace on earth begins with peace at birth. Women must feel respected and at peace with their decisions when they give birth. They must be allowed to make informed decisions based on their own histories and their own research.
Let us not forget that this proposed Bill is also unconstitutional: Article 40.3.1 of Bunreacht na hEireann and Article 3 of the European Convention of Human Rights state that ‘free and informed consent is the cornerstone of medical treatment.’ For consent to be free and informed, it must be based on information and choice, neither of which feature in the proposed legislation. Thousands of Irish men and Irish women stood by and allowed the government – aided and abetted them, even – to treat Irish women and children despicably in ‘homes’ and ‘laundries’ and ‘under State care’ until the 1980s. Are you going to stand by and allow them to repeat their contemptuous treatment of women and children?
If not, you can voice your opposition by signing the petition to have the Bill amended: http://www.gopetition.com/petition/39693.html
Hazel Katherine Larkin is a mother, journalist, writer and doula who spent 10 years in Asia working in the media before returning to Ireland six years ago. She is currently working on a memoir and looking forward to returning to Asia in 2011 – chiefly because she believes Ireland is no place for young women.