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Apologies for cross-posting- I am attaching
the message I received from Marie O’connor
Dear Jenny and friends
Attached please find our press
release issued on Tuesday to every newspaper, radio and TV station in the
entire country!
Medical monoply has triumphed yet again in
Ireland's Supreme Court. Five judges unanimously rejected an appeal
by four home birth mothers against the South-Western Area Health Board's
decision to refuse them a home birth "grant", to which they were
entitled - until yesterday's ruling - under the 1970 Heath Act.
The point at issue was whether their
entitlement to free maternity care from the State extended to the provision of
midwifery services at home. The judges, in their ruling, pointed out that
there were different views about home birth within the medical profession, and
cited an affidavit from a health board manager, himself a member of
the
medical profession, who
claimed that home birth services could only be provided by a
doctor! Until now, home birth services were provided by independent
midwives, paid directly by mothers who received a grant of e1,200 from
health boards.
Although Dublin hospital doctors have now
launched an all-out media war against home birth, aimed at eliminating
their competitors, independent midwives, we have succeeded in making home birth
a national issue in the press, radio, and TV. We see the media as our
allies in
promoting the midwifery model of
care, and we realise that we will never get the legislative reform we seek
without media support.
This retrograde judgement is only a temporary
setback. With new health legislation expected in the near future, the hard
work of lobbying public representatives will now begin in earnest, with a view
to incorporating the relevant Aachen Declarations into national law.
The recent judgement of the European
Court of Justice outlaws state monopoly in law and regulation: medical monopoly
in maternity care is therefore unlawful in the Member States. We now
intend to use this judgement to apply to the Competition Authority to take
action to dismantle the legal and regulatory barriers which, for so long, have
restricted midwives in the practice of their profession, particularly those in
self-employment.
Already, we have applied to the Equality
Authority to look at the barriers to midwifery practice under equality
legislation: the Authority is now pursuing the matter, and we hope to persuade
them to take a case in the near future for a self-employed midwife under the
various equality laws that exist. We hope also that an employed midwife can be
found to bring an equal pay action: Irish midwives earn around 8 per cent of
what doctors earn for doing
most, if not all, of all their work in
private obstetrics (Caesareans, forceps and
vacuums excepted)!!
Finally, and most importantly, we intend to
examine existing human rights legislation, both nationally and
internationally, to see whether the right to self-determination extends to
women's right to determine how to give birth. Although this fundamental
aspect of women's rights was omitted from the Beijing Platform, we believe
that women's right to give birth based
on physiology, autonomy, dignity and bodily integrity forms part of
women's fundamental rights and
freedoms. Again, the Aachen Declarations are relevant in this
context: lobbying to get them incorporated into European law, possibly by way
of Directive, is one of our goals.
Best wishes
Marie O'Connor
Today’s Supreme Court decision may not be the
end of women’s entitlement to a free home birth service from the State. “Health
boards have discretion in this area, and we are appealing to them to use it for
the benefit of less well off women”, said Krysia Lynch Rybaczuk, PRO of the
Home Birth Association. “We have a Health Strategy that commits us to equity in
health. Why should home birth be a choice reserved for the rich?”
Marie O’Connor of the National Birth Alliance
blamed what she called “the medical empire in maternity care” for today’s
Supreme Court decision. “We live in such a deeply medicalised society that,
like fish who can’t see water, we
find it difficult to see the monopoly that consultant obstetricians exercise
over the services for birth”.
The market for private maternity services is a
highly lucrative one, worth an estimated e50m annually. ”Average obstetric
incomes are in the region of e500,000 yearly, and this is on top of a public
salary that starts, in the eastern region, at e114,000. Obstetrics is a
goldmine, and this goldmine is a huge barrier to reform”.
Independent midwife Philomena Canning says
that today’s judgement under lines the need for a complete overhaul of our
maternity care system. “Tomorrow sees the publication of a study showing that
Caesarean rates in Ireland have trebled in the last 20 years. Our system has
turned birth into an operation: two mothers in every five give birth by
Caesarean, forceps or vacuum extraction”.
These rates are not sustainable, O’Connor
points out. “The cost to the State of the present doctor-driven system is
astronomical. We are forcing women to have an excess of costly medical
treatment, while at the same time denying them access to the midwifery model of
care”.
Given the Government’s commitment to driving
the Hanly agenda, the need for local services will become acute. “Here again,
consultant obstetricians are blocking the development of the services. If they,
or their representative bodies, have decided to pull out of eight or nine
hospitals around the country, then they should move over and make way for
midwives, and allow them to manage the services that they have been providing
all along”.
Many women want a birth that is low-tech and
drug-free, options that in hospital are rarely open to them. Rybaczuk says that
in today’s overcrowded maternity units, active medical management is the rule.
“The more doctors intervene, the more adverse outcomes occur, the more parents
sue, the more doctors intervene. It is a vicious circle”.
Canning makes the point that we have opted for
a very expensive model of maternity care: “A normal hospital birth costs the
State e4-5000, while home birth only costs e2000”. Then there is the cost of
obstetric insurance, currently costing e400,000 per consultant: “The taxpayer
is picking up the tab for a model of care that is wasteful, expensive and unsustainable. Meanwhile midwives are
leaving the services in their hundreds, and mothers are suffering from the iron
rule of obstetrics in overcrowded labour wards”.
ENDS
For further details, please telephone:
Krysia Lynch Rybaczuk, Home Birth Assoc: 087
754 3751/ 01 6603 499
Marie O’Connor, National Birth Alliance: 087
918 2722/ 01 8388 168
Philomena Canning, independent midwife: 087
290 0017/ 01 295 1902
Jennifer Hall
Clinical Editor
The Practising Midwife
email [log in to unmask]
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