Will birth centres
be the choice of Irish women?
Irish Times Tuesday
11 May 2004
Birth options are very limited for Irish
women - hospital or home. Do women want an alternative? Susan
Calnan reports on a viability study into an 'Irish birth centre'.
A feasibility study, which aims to assess the level of support
for the setting-up of Ireland's first 'standalone' birth centre,
has been launched in Cork. The study, which began in January,
will measure the financial
viability of and level of public interest in a birth centre for
the west Cork town of Clonakilty.
The town has been earmarked for a birth centre because of its
distance from the nearest maternity hospital, which is in Cork
city, and also because of
the growing number of young families settling in the area.
At present, there are no standalone birth centres in Ireland.
Birth centres are a common feature throughout the world, however;
in the UK, for example,
there are over 90 centres throughout the country.
A birth centre is a 'home-like' facility, separate from a hospital,
where a woman can undergo a natural birth and receive maternity
care, provided by experienced midwives.
It offers an alternative to women who are not comfortable with
having a home birth but who would prefer not to give birth in
a hospital. The service is
suitable only for women who have a low-risk pregnancy and who
are likely to have a normal delivery.
If the woman needs to see a consultant obstetrician, the midwife
will refer her accordingly. In the event of an emergency, midwives
are highly trained to deal with the situation and can assess if
the woman needs to receive medical attention.
International studies indicate that birth centres have a number
of benefits: women can give birth in an intervention-free and
drug-free way, in a more
intimate and low-tech environment, where they will receive one-to-one
care from an experienced midwife. Birth centres also offer other
facilities that
are not usually available in hospitals, such as family accommodation,
water pools, complementary therapies and a generally more relaxed
environment.
Also, birth centres have a high standard of post-natal care; for
example, women are given greater support with breastfeeding and
they are encouraged to stay in the centre until they feel ready
to go home.
Independent midwife Bridget Sheeran, who is a member of the Birth
Centre for West Cork Committee, an independent group overseeing
the feasibility study,
says the primary aim of a birth centre is to give women greater
choice over where and how they want to have their baby. She also
stresses the benefits of having a natural birth in a more relaxed,
non-clinical environment.
"Natural birth is based on a social model, as opposed to
a medical model of birth, so the mothers are viewed as going through
a healthy physiological process," says Bridget. "Midwives
see birth as normal, whereas the obstetricians working in hospitals
only see birth as normal in retrospect. The advantage of a birth
centre and of natural birth is that, provided there are no risk
factors, there is a greater chance that a woman will give birth
without intervention and also she will be better equipped to deal
with the intensity of a
drug-free birth."
Professor John Higgins, head of the Department of Obstetrics and
Gynaecology at University College Cork, declined to comment on
the proposal to set up a new birth centre in Cork. However he
did stress that obstetricians do welcome and encourage greater
choice in maternity care for women within the hospital setting.
He says developments, such as the construction of a new state-of-the-art
Cork University Maternity Hospital (CUMH) would further strengthen
his department's commitment to providing the highest quality of
maternity care for women.
Bridget stresses the benefits of a natural birth for babies: "Because
there are no mechanical instruments or drugs used during the labour,
the birthing process is much more gentle. "As a result, babies
tend to be much more alert and less likely to get sick after they
are born and they are more likely to breastfeed well. Also, the
mother tends to recover more quickly after the birth because there
is less
intervention and trauma all round."
Although Bridget trained and worked as a nurse and then as a midwife
in hospitals in the UK, she has been working as an independent
midwife for the
past 15 years. For over two years, she has been contracted by
the Southern Health Board (SHB) to provide a home birth service
to mothers, as part of
the Domiciliary Midwifery Pilot Project for Cork City and County,
a two-year pilot project undertaken by the SHB to assess the viability
of a community
midwifery service in the area.
The service has been extended indefinitely, pending the evaluation
and recommendations of the National Domiciliary Births Group.
Since she moved back to Ireland more than 10 years ago, Bridget
says she has
been disappointed with the lack of recognition given in this country
to the midwifery profession. Although she stresses that she is
not knocking the obstetric profession, which she says provides
an essential service for women who require intervention or medical
pain-relief during labour, Bridget insists that obstetrics and
midwifery are separate professions and that
greater support should be provided for midwifery-led services
in this country.
"In the UK, for example, midwifery is strongly recognised
as a profession in itself and midwives are regarded as being the
experts in 'normal birth', as
opposed to 'complex birth' which is really the realm of the obstetricians,
who can provide intervention and medical pain-relief when it is
required," she says.
"What has happened in Ireland, however, is that the realm
for birth is in the hospitals only and, as a result, it is solely
obstetrician-led; there isn't a separate midwifery context in
this country, except for home births."
"I receive a significant number of calls from Irish midwives
working abroad, who want to come home but who don't want to work
in hospitals," adds Bridget.
As part of this latest study, the results of which will be published
later this year, Bridget hopes to assess the level of interest
that women in the Cork region have in a new birth centre being
set up in their area.
"In Ireland, most babies are born in hospital, although there
are a few hundred home births every year," Bridget says.
"There's still a lot of work that needs to be done in this
country to inform and educate people about what birth centres
are and about the benefits of having a natural birth in an alternative
setting to a hospital.
"From the women that I've come into contact with and also
from the results of the feasibility study so far, it is apparent,
however, that many women are looking for an alternative to the
medical model of birth; they still want to be cared for by professionals
but in a way that requires less medical intervention," she
adds.
For more information on the feasibility study, contact Bridget
Sheeran on bridget@bridgetsheeran.com or visit www.bridgetsheeran.com
Irish Times Tuesday 11 May 2004
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