March, 2013

Midwifery Across the Pond

Sunday, March 24th, 2013

by Geraldine Beaubien, midwifery student from Ireland who visited The Birth House in February, 2013

The short time that I spent in The Birth House was enough to show me a model of care that seems to work. It works for the women, their families and for the midwives attending them throughout their pregnancies, births and in the post-partum period. The midwives approach was very much an open one that gave the women a chance to express what exactly their needs were. The small details such as the offering of tea on their arrival to the centre and the comfortable chairs in the sitting room really said a lot to me. This reminded me that pregnancy is not an illness and birth is not a medical emergency.  It is a miracle. It is our foundation as humans and we should treat it that way.

Many midwives have written many books about the sacred art of midwifery. It is sort of an ideal I hold some place in my head and hope that one day, I can work in a place that gives me the space to practice in such a way. This sacred art is being performed in The Birth House. Women and their families that I met during my stay appeared to have very strong connections with the midwives. They really knew each other. The consultations weren’t spent flipping through charts but through conversation. This, I thought, is real midwifery.

In Ireland, midwifery has a very strong history. Midwives have been the main care-givers for women throughout their pregnancies and birth and in the post-partum period. This is something that we value immensely. Midwives attended home births throughout history. It was the only way for years. Although, the role of the midwife in the tertiary hospitals in Ireland may have changed over the years. Women in Ireland in the 21st century choose hospital births. Currently, the rate of home births is just under 1%. I work in a busy maternity hospital in Dublin, Ireland. In 2012, there were well over 9,000 births. We expect more in 2013. This puts a great pressure on the midwives to give the care that they want to give.

Thankfully, our community midwifery programmes are becoming more and more popular. Women can book in to have their babies in the hospital but they can be seen in satellite locations within a certain distance from the hospital. This alleviates pressure in the massively busy antenatal clinics that run Monday-Friday. The community midwifery programme also allows low risk women to be discharged after 12 hours of the birth for their care to be followed up at home. It may seem small, but it is a step in the right direction.

There is also a DOMINO (Domicile in and out) scheme that has been set up. This is where low-risk women will be seen by the same group of midwives throughout their pregnanacy, birth and in the post-partum period. I have met a few women that have booked in and birthed their babies under this scheme and they have been extremely happy with their care. It has only been set up in the last year and we hope to see more women partake in the scheme.

Women are asked to draw up a birth plan early in the antenatal period and this is honoured as much as the midwives possibly can in the delivery suite. We don’t accommodate water births in the Republic of Ireland due to a neonatal mortality that occurred in a midwifery-led unit in years past. This is going to change in the coming months.