Finding a posher place to push

Word reaching expectant mothers that hospitals, under pressure from lack of staff and an increase in custom, are discharging women earlier than ever is driving some to consider drastic action. Kathryn Holmquist reports

A friend enceinte rang me last week to ask about the Four Seasons Hotel in Ballsbridge, Dublin. Is it true, she wondered, that after giving birth, instead of braving the vagaries of the communal shower in "semi-private" in the National Maternity Hospital, Holles Street, she should go straight from the birthing chamber to the Four Seasons where she could recover in the lap of luxury?

Ten centimetres dilated? Push that baby out and call a taxi! Have the pleasant, people-centred staff at the Four Seasons waiting with a warm room, clean bed, satellite TV and room service. And the surroundings will look so much more attractive in your new baby pictures.

Are there special rates at the Four Seasons, my friend wanted to know? (May I add here, that my friend is no bimbo. She excels in her field and has the international awards to show for it. So excuse her, she's just pregnant.) She wants to know: Is it true what she has heard that a special floor with nursing staff has been set aside at the hotel for new mothers? And does the VHI cover it? And don't I agree that a private room in the Four Seasons with bathroom en suite and room service, is better than hanging around in "semi-private" while waiting for your name to reach the top of the list for a room in the Merrion Wing? And isn't it certainly better than going straight home to your five other children who expect you to cook beans on toast while you're still in shock from the delivery? The Four Seasons? Humph. Why not the Merrion Hotel? I countered. It's nearer to Holles Street, it has food by Patrick Guillbaud, who will provide post-natal truffles if you want them and certainly a sustaining cup of broth. And, once you're on your feet, Mothercare and the designer babies section of Brown Thomas are within a stone's throw.

Forgive me, I am being tongue in cheek. My friend, who is indeed extremely pregnant, has very good reasons for nearly begging Visa to raise her limit so she can book herself in to a hotel. She has heard that at the National Maternity Hospital (NMH), the current policy is that women who have given birth for the first time can stay 48 hours; women who have given birth for the second and subsequent times can stay 24 hours. My friend has given birth five times and has very little faith that she'll be allowed to as much as blow her nose before they have her out of the place.

This indeed, has been pretty much the case. Staying in maternity hospital any longer than you have to is no longer considered de rigueur. The hospital can hardly cope with you and you can hardly cope with the overcrowding.

Many women today are doing what their grandmothers did two generations before, and they are booking in to the 2002 version of the nursing home, which is the four or five-star hotel.

The NMH tell me that a new batch of student midwives will graduate mid-October and that from then on, new mothers will be able to stay at the hospital for as long as their doctors recommend. The standard line is five days for a first baby and three days for a second, although the health of mother and baby actually decrees the time scale. Nobody gets thrown out if they really need to be in hospital, in other words.

Moreover, the NMH is very quiet at the moment and the Merrion Wing has plenty of available beds, according to the NMH. The baby boom that had women grappling for shower space is over. So don't believe everything you hear.

The assistant matron in the NMH, with whom I spoke, had never heard of the Four Seasons philosophy.

So here's the reality: women, these days, are expected to give birth while replying to urgent e-mails, to have the shortest possible time of recovery and then to get back to work asap. Yes there's a little thing called maternity benefit, which lasts 18 weeks and is fine if you're an employee. High-flying women these days are more likely to be self-employed. Unless you've saved up for it, there is no maternity leave.

The reality, also, is that women do not have families to back them up any more. As midwives in the Coombe Hospital told me recently, many women have no support of any kind when they return home with their new babies.

Their husbands are working, their own families live far away or are working, their incomes don't stretch to hiring maternity nurses. For this reason, the Coombe tries to give women as much rest and support as possible. Three to five days on a first baby and three days on a second are the least women deserve, the Coombe believes.

But maybe you don't want to be in hospital at all, after you've given birth and are healthy with no complications. You can hire a maternity nurse, which will cost you about €360 in each 24-hour period, Nurse On Call in Ranelagh tell me. There's not a huge demand for their service. Most people cannot afford it and those who can, are foreign nationals on high incomes.

The NMH has a "domino" scheme, where throughout your pregnancy you deal with a midwife and your own GP, you go to hospital to have your baby, then you return home again where the midwife/GP team provide your care. The Coombe also has a community midwife programme, where you can plan to be cared for by a midwife, going to hospital only for the messy bits (it's called labour, and it's not so bad), then returning home within hours to be cared for by the loving midwife who has kept you together for the previous several months.

All of this smacks of a return of tradition: hi-tech care is for at-risk pregnancies. What most women really need, during pregnancy, labour and the aftermath, is TLC (tender loving care) They need advice on breast-feeding, somebody to bring a cup of tea and a sandwich, somebody to look after the younger children underfoot. It's not such a big deal.

In today's world, where your family live far away and your friends are all out working, any pregnant woman will find that nurturing is in short supply. Get it from the Four Seasons if you want to. And no, the Four Seasons is not covered by the VHI. But the food's quite good.

There is a deeper issue here. Having babies is the easy part. Irish women work an average of 115 hours per week on childcare, preparation of meals, laundry and shopping, according to a a new survey on women in Ireland and their working patterns both at home and in the workplace on behalf of Ark Life Assurance, AIB's Life and Pensions Company.

The survey revealed that women's work in the home and in the workplace is dramatically undervalued by both employers and women themselves - leading to a huge gap in terms of life assurance cover. The average woman's work in the home is actually worth €37,000 a year.

We women are undervaluing ourselves. We are putting up with not being nurtured and cared for because we have convinced ourselves that we have to be Super-Moms. We're not. So let's start thinking differently. Let's start demanding proper nurture and support when we have babies, and at all the other times in our child-rearing lives. Let's stop thinking that the Four Seasons and a credit card will bail us out.