Madam, – We celebrate Minister for Health Mary Harney’s publicly declared intention to support women choosing home birth. However we wish to highlight the unintended consequences of the inclusion of “adequate clinical indemnity insurance” in the Nurses and Midwives Bill 2010 (Home News, November 5th).
The inclusion of “adequate indemnity insurance” in the forthcoming legislation will not protect women. If anything, it will leave women choosing homebirth more vulnerable than they are currently. Insurance does not protect, it only compensates and even then, only if negligence or malpractice is proven. Explicit and unilateral requirement for indemnification in the legislation will severely inhibit women’s choice.
Some women would be forced to birth alone because a registered midwife’s attendance outside the HSE’s narrow terms for indemnification would be unlawful. A midwife must be enabled to support all women regardless of their choice of place of birth. We ask therefore that indemnification (which midwives want) be supported through some mechanism that recognises their full professional scope of practise.
We women and professionals, would welcome midwifery supervision as a mechanism that would protect women, enhance professional standards and improve services. The Dr Neary case in Our Lady of Lourdes Hospital Drogheda, is a particularly illustrative example of where indemnification was unable to protect women. Supportive professional supervision, which creates transparency and facilitates clinical audit, would undoubtedly have limited the damage done to so many women. We urge the Minister and Health Committee to reconsider the inclusion of supervision in the forthcoming Nurses and Midwives Act.
Literature indicates that countries that have robust and supportive midwifery legislation, are better able to demonstrate safe, effective and high quality midwifery care, than countries without such legislation. We request that the proposed legislation be strengthened for the good of Ireland’s women and babies. While we are signing in our individual capacities, it can be seen this concern is shared by women and midwives from a wide variety of birth groups and midwifery organisations. – Yours etc,
Dr COLM O’BOYLE, TCD,
Community Midwives
Association (CMA) DEIRDRE
DALY, TCD and (INMO
Midwives); Dr JOAN LALOR,
TCD; GERALDINE CAHILL,
President, Cuidiu; Dr KRYSIA
LYNCH, Association for
Improvement in Maternity
Services, Ireland and Home
Birth Association of Ireland;
ARMELLA CARAS-DOYLE
and SINEAD Ni GAIRBHITH,
Clare Birth Choice; JOHANNA
RILEY CUSACK (CBC) and
International Board Certified
Lactation Consultant; RHONA
O’CONNELL, UCC and
Midwives Association of Ireland
(MAI); AGNES PHELAN, UCC;
MARGARET CARROLL, TCD
(INMO Midwives); MARY
HIGGINS (INMO Midwives);
LINDA BIESTY, TCD;
KATHRYN MULDOON, TCD;
JANINE STOCKDALE, TCD;
DEIRDRE van der PUTTEN
and DECLAN DEVANE, NUIG;
Dr MICHELLE BUTLER,
MARIA HEALY JOANNE
O’HARE, UCD; Dr PATRICIA
LARKIN, DKIT, MAEBH
BARRY UL; Dr ANNE
MATHEWS, DCU
PHILOMENA CANNING,
Self-employed Community
Midwife (SECM),
C/o D’Olier Street,
Dublin 2.