IT’S NO SECRET; our maternity services need an over-haul. The barrage of horrendous publicity and malpractice suits involving maternal and infant fatalities has made many of us question the reliability of the services.

As a migrant woman who recently accessed the public system and then opted for a home birth I believe I have gained some personal insight into what may be at the heart of the problem.

Why not a hospital birth?

Our decision for a home birth didn’t happen overnight it came about due to a number of reasons. Firstly, I am a victim of sexual abuse and find any gynaecological procedure extremely stressful. So I knew I required a degree of sensitivity from my care provider and most importantly needed to be an active participant in my birth experience.

Sadly from my first appointment in the Rotunda Hospital, I knew that this was not going to be possible. Before I continue I want to stress that all of the midwives I met were outstanding. They were kind, supportive and professional at all times.

At my booking appointment when I was being given my appointments I was told quite abruptly “we don’t work around you, you work around us” when I politely requested if the appointments could be at the beginning of the week due to my work schedule.

Too busy to care?

At 18 weeks I began bleeding profusely to the point that we were convinced I was having a miscarriage. It took two visits to A & E, a visit to our GP, an appointment with an obstetrician and a sonographer to be told that there was a second empty sack, a silent twin. It took the hospital a whole month to give us this diagnosis.

We had to push to get the hospital to investigate the cause of the bleeding by attending our GP who sent a letter requesting an appointment with an obstetrician. Surely the fact that I repeatedly told them that as part of my fertility treatment two embryos had been transferred, they could have moved to investigate this possibility sooner?

In one of those stressful appointments when I asked the doctor if it was possible to have a miscarriage without experiencing any cramps I was told “sure, the previous woman before you was carrying a dead baby around for weeks and didn’t know it”.

In our first antenatal class when we mentioned that we were having a home birth the instructor sarcastically remarked in front of the whole class “so what are you doing here then?” We found this rather rude but calmly replied that in the event of complications towards the end of the pregnancy or a possible transfer during labour, we wanted to be fully prepared and inform ourselves of the services the Rotunda provided.

Good Cop, Bad Cop!

The final straw came at week 37, five days before Phoenix was born. I was contacted by the management of the Rotunda as they wanted to meet with us to hear about our birth preferences. Initially I thought this was strange as surely this was not standard practice. We went along to what can only be described as a bizarre meeting.

Firstly, we met with a member of senior management and were ushered into the board room of the hospital, a very impressive Georgian room with high ceilings and stately oil paintings. We were told the hospital fully supported our decision to have a home birth but wanted to hear our birth preferences in the event we needed to have a hospital birth.

Then we were told that since we were there I should be examined by a consultant to make sure everything was alright. We were confused as this was not mentioned prior to our meeting and I had already been examined the previous week and was told my pregnancy was healthy.

We met with the consultant in an examination room and he started the conversation by saying “let me tell you my birth preferences for you Dil”. This got my back up as surely it should not be his birth preferences but mine! I smiled politely after he finished and said that as I was healthy and so was my baby we were going to go ahead with our plans for a home birth.

He then proceeded to warn us that home births were risky and I should have a hospital birth as complications could arise such as Shoulder Dystocia and Postpartum Haemorrhage. To demonstrate the gravity of the latter, the consultant stood up, went over to the sink, opened the tap fully and allowed the water to gush out for what seemed like an eternity and exclaimed “that’s the volume of blood that would gush out of you!” I understand that he probably had my best interest in mind but I found it strange that he had no basis for these worse case scenarios as he barely looked at my chart, never met me before and hadn’t yet examined me!

The tension in the consultation room was palpable as it was now obvious that the purpose of the meeting was not to hear about our birth preferences but instead to discourage us from having a home birth. I could feel the conversation was beginning to upset me so I requested for the examination to begin.

I popped up on the table and the consultant said something that really demonstrated to me the problem with our maternity services. He said “I’m going to put my hands on you”. It wasn’t a question, it was a statement. My home birth midwife always asked “can I put my hands on you?” prior to every check-up. The language used by the consultant made me feel powerless and voiceless whereas the language used by my midwife made me feel empowered and visible.

Voiceless and invisible 

The scan showed that all was well but I was told I should return next week for another scan despite everything being normal.

We walked out of the hospital in utter disbelief at what we had witnessed! We were furious that although my baby and I had a full clean bill of health, the consultant kept focusing on all the things that could go wrong.

We both felt that they were trying to scare us into having a hospital birth despite us telling them that we had engaged two professional midwives from Neighbourhood Midwives and felt very confident that a home birth would be our best option.

This unpleasant and distressing exchange crystalised for me why so many women don’t have a positive experience of our maternity services and why so many mistakes have been made to date. Even though it was my body, my baby, my birth experience – I didn’t feel my needs mattered and as a result I felt voiceless and at times even invisible.

“The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honored.”
― Ina May Gaskin,

Dil Wickremasinghe is the social justice and mental health broadcaster of Global Village, Newstalk 106-108 FM, Saturday 7-9pm and Training Director with Insight Matters – Inspiring change in self and society through personal development, psychotherapy and counselling. She also runs www.dilw.ie.