Intervening in childbirth
Sir, – I am a midwife working in one of the Dublin maternity hospitals and I have never seen a woman subjected to either an instrumental delivery or an episiotomy against her will (Jacky Jones, Health+Family, December 4th). Furthermore, Jacky Jones inaccurately compares a midwifery-led unit in Cavan to obstetric-led units in other parts of the country.
It is impossible to compare induction rates or instrumental rates between these two types of units. Midwifery-led units deal only with low risk women whereas obstetric units also care for high risk pregnancies. Women for example with pre- eclampsia or gestational diabetes. Therefore it may be necessary to induce labour at an earlier stage to protect the lives and well-being of the women and their babies.
The high rates of instrumental deliveries in Ireland, as opposed to for example, Slovenia, can be at least partly explained by the high rate of uptake of epidural anaesthesia in Ireland. International studies have shown that one to one midwifery care reduces the need for epidurals and consequently improves outcomes.
In the current climate of recruitment embargo in the public service, Irish women are lucky if they have the continuous care of a single midwife. If we want to improve maternity services we need more midwives and more choices for models of care such as the midwifery led services offered in Cavan and Drogheda. – Yours, etc,