Whose Body Is It Anyway?

at

kerryKerry General Hospital

Last week in the High Court, Judge Sean Ryan ruled against Ciara Hamilton, who was taking a case against the HSE. She now faces a six-figure legal bill.

Ms Hamilton claimed that a midwife at Kerry General Hospital artificially broke her waters on June 11, 2011, through a procedure called ARM.

She alleged this rupture of her waters led her to have an emergency C-section due to a cord prolapse – where the umbilical cord drops into the birth canal in front of the baby’s head during delivery.

Cord prolapse can cause stillbirth unless the baby is delivered quickly.

The court heard Ms Hamilton’s baby boy, Jacob, was born safe and well.

However, Ms Hamilton claimed she suffered personal injuries, loss and damage because of the C-section.

Following Judge Ryan’s decision last week, the Irish Examiner reported:

Mr Justice Ryan found that it was reasonable for the midwife involved to seek reassurance with an artificial rupture of the membranes. The midwife was the person entitled, authorised and qualified to make the decision, the judge said.

When the midwife broke the waters, the judge said she immediately appreciated the cord had prolapsed and responded appropriately by raising the alarm while protecting the baby from injury.

On May 14, the Irish Times reported:

The claims are denied and the High Court heard the midwife in the case will say she discussed the artificial rupture of the membranes with Ms Hamilton and that her rationale was a concern for the health of the child.

However, yesterday afternoon, AIMSI (Association for Improvement in the Maternity Services in Ireland)  claimed it has been told that Ms Hamilton was unaware the midwife was going to break her waters.

In a blog post, updated yesterday evening, AIMSI wrote:

AIMSI has received confirmation that the woman in this case was unaware the midwife was going to break her waters. An ARM was performed during a routine exam with no discussion or opportunity for the woman to consent or refuse treatment.

It’s also been claimed that Ms Hamilton was a carrier of Group B Strep, a common streptococcus bacteria, which apparently is more likely to be passed to a baby if the mother’s waters are broken prematurely (before 37 weeks). The amniotic fluid acts as a protective barrier for babies.  

Meanwhile, Mind The Baby blog  yesterday wrote:

“So the intervention was performed without the woman’s knowledge. Justice Ryan has judged that performing an intervention that is not based on evidence or best international practice, without the knowledge or consent of a labouring woman, is acceptable and appropriate. Even in this case where the intervention itself caused an obstetric emergency and had long-term negative consequences for both mother and baby. Where does the average woman who has an intervention during labour without her permission or knowledge, but doesn’t have such serious long-term effects, stand? If the action in this case has been deemed appropriate in the High Court, God help us all.”

Anyone?

Mother who sued over care at Kerry General Hospital faces massive legal bill (Irish Examiner)

The High Court Says We Can’t Say No (Mind The Baby)

Not a consent issue (No Country For Pregnant Women)

Related: Midwife unnecessarily broke woman’s waters, court hears (Irish Times, May 14, 2014) 

Woman sues after alleged inappropriate interference during birth of her baby (Irish Independent, May 14, 2014)

Thanks Deborah

87 thoughts on “Whose Body Is It Anyway?

  1. George Loved Pies

    Am I reading this wrong ?

    Medical professional sees something wrong, takes action, mother & baby both fine.

    I know there seems to be some confusion over whether the patient was told or not, but surely thats a she said / she said situation between the midwife and patient and not something that the whole nation needs to be involved in.

    Or am I missing something ?

      1. Rob

        Basically it was a she said / she didn’t say situation.

        Then the judge got involved and made a finding of fact that said she (the nurse) did say.

        Then the woman went to some crowd who published her claims as fact.

        Then Broadsheet published a load of things that seem to, but don’t actually, confuse the matter.

        They then asked the question “Anyone?”, the answer to which is of course Mr Justice Sean Ryan.

        1. Li

          Regardless of ‘he said/ she said’, ARM is outlined as a DO NOT DO in the NICE guidelines- the judge was way off with his call on it being reasonable for the midwife to seek reassurance by carrying out ARM. It provides no reassurance, especially once baby is full term- it only increases risk of harm to mother and baby.

    1. Hosanna in the Hiace

      Basically Broadsheet will take the side of any crank when comes to childbirth. See head-the-Ball homebirth woman. Something something, Catholic, something, abortion, , women’s rights

    2. D

      I’ve a very hard time believing that the mid-wife did the ARM without asking. That’s the only real contention here. Everything else is noise.

      1. Orla

        Which is fair enough fact based point. However, If Ryan said what he is reported to have said in relation to the midwife bring the right person to make the decision it sets a horrific precedent in respect of autonomy and medical treatment in general that could be applied in all circumstances. Unsettling.

        1. bruce01

          I disagree with the contention that the ruling could be ‘applied in all circumstances’. Pregnancy is a very specific circumstance. It is a medical circumstance, distinct from say emergency medicine where time is very short, where there is a reasonable amount of time to inform herself as to the decisions she will need to make. If she has not made those decisions then why is it ‘an horrific precedent’ that a health professional should make those decisions with her best interests in mind?

          1. big_g

            Agreed, Bruce01. The principle of informed consent in some ways is a difficult one to apply. With respect to previous judgements, a patient should be informed of every risk, no matter how small or seemingly irrelevant when any procedure is to be undertaken. This simply isn’t practical. Some concepts require significant amount of tertiary education to understand, hence (partly) the need for educated professionals in the first place. Nowhere in principlism does it state that one of the principles of medical ethics should outweigh the others, therefore autonomy cannot outweigh beneficence or non-maleficence. The aim is to strike balance. I find it hard to believe that the patient wasn’t informed that her waters were going to be deliberately broken but the devil is in the details.

          2. big_g

            I should also say the other reason for not defining every possible risk, no matter how small, is matters of time.

          3. orla

            Bruce01 and Big_G, you’ve raise informed consent which is a red herring here.
            the principle is that a procedure cannot be carried out without patient consent- period. agreed that in principalism there can be a balancing exercise but there is no balance where there has been no attempt to inform a patient at all. patient should be informed of options and consequences. what Ryan J found, ie that only midwife has a say in treatment and no chance for patient to know what will happen, goes against the most thinking in medical ethics. it’s a simple not nuanced or impractical big_g. also it goes against legal precedent ( In Re ward of Court) which held that a competent patient/ person has final say over their bodily intergrity EVEN if their choice goes against their best interests. That Ryan J appears to have ignored this Supreme Court decision is astonishing. Further, there appears to be no issue here that the baby was going to die otherwise, so competing life interests do not arise.

            I also dont agree that it could not be applied in other cases; (maybe not all cases, that was a typo) even though High Court decisions are only of persuasive value to other High Court matters. I can envisage the case being cited in legal opinion to other medical personal. and therfore perhaps followed.

    3. Lisa Healy

      Where does it say medical professional sees something wrong? Yes you are reading it wrong. The correct reading is: Medical professional performs an allegedly unwarranted procedure allegedly without permission that inadvertently causes a medical emergency situation. Whether or not she responded correctly to the emergency caused is not really relevant is it?

      1. Jene

        In many instances in maternity services, a procedure or intervention is based on routine admissions or management policies. Have you read the policy for Active Management of Labour? In which women all women are routinely managed by policy of the hospital – including routine artificial of membranes on admission with a clear management for progression based on time limitations?

      2. Rob

        These things were all alleged.

        Now the correct reading is:

        Medical professional performs an reasonable procedure allegedly with permission, A medical emergency situation arose. It was dealt with properly (which is clearly very relevant)..

        1. Li

          ARM is not a reasonable procedure. It is strongly advised against as routine by all evidence based guidelines

          1. dd

            unless of course there is a reason to expedite labour. Perhaps there were some signficant ctg findings.

          2. Jene

            The evidence does not show that ARM shortens labour in normal nor prolonged labour. And in all cases, consent should be obtained.

    1. Helen

      Its disgusting that this family have received hate mail. What have they done, except complain about sub standard care? Surely that benefits us all.

  2. Richard

    Whoever advised the Mother that she had a case is a numpty. Even if she won the damages would have been tiny, as an earlier poster said, Mother and baby are well. The amount of damages you could get in this case is limited, certainly not in six figures.

    Hope the Taxing Master cuts the legal fees for her side to zero. Not sure from the report if costs were decided.

  3. Mau

    Stories like this make you think…. On the one hand yes we all have a right to be treated competently and to be involved in the decision-making process where our bodies are concerned (where we have the competency to do so). On the other hand it seems that sometimes we almost expect too much from medical staff. They are only human and most of the time they administer treatment with the best of intentions. Speaking as someone who has delivered two children with the help of midwives, I can only commend these people for the care they administer in hospitals that are bursting at the seams.
    It seems a shame to dissuade them/punish them for trying to help you. I know they don’t do this for free but lets face it, its not the easist job in the world…

  4. Lara

    “‘She now faces a six-figure legal bill’ which she has no-one to blame for except herself and a harebrained lawyer. But hopefully she will find some comfort in the fact that both herself, and her baby, are fine.” This child is now three years old. Move on. A victory for common sense.

      1. Jaggie Thistle

        perhaps so – but in this instance the child is not OK as you put it , this child has global developmental delay , no speech causing significant difficulty in communicating , he has difficulty in walking anything more that short distances and at three is still in nappy’s and will be for the foreseeable future.
        Moreover the care required for children with special needs – such as speech and language, physiotherapy occupational therapy , special needs pre-schools and indeed special needs schooling have been significantly cut and is particularly scarce in rural areas. parent with children with special needs have to fight tooth and nail for even one afternoon a week at a special needs playschool.
        so yes I’m sure both parents would have been overjoyed if their child was “OK”

  5. bruce01

    “It’s also been claimed that Ms Hamilton was a carrier of Group B Strep, a common streptococcus bacteria, which apparently is more likely to be passed to a baby if the mother’s waters are broken prematurely (before 37 weeks). The amniotic fluid acts as a protective barrier for babies.”

    Link? Where does it say when the ARM was conducted? If pre-term that would be unusual. And was GBS infection recorded in this case?

    1. scottser

      group B strep is very common and is usually flagged pretty early on in a pregnancy. it just involves iv antibiotics during the birth. i thought breaking the waters by the midwife was also quite safe when under supervision but i’m open to correction on that. as mentioned above by serveral commentators, the shyster involved who led this woman down the garden path should be struck off.

      1. Jene

        We don’t know the exact number of women who carry GBS as we do not routinely test for it in Ireland and the UK. Ireland currently does not routinely test for GBS as it follows a ‘risk approach’ model – if a woman demonstrates risk factors in her pregnancy (urine testing positive for GBS) or in labour, or has previously tested positive for GBS or had a baby that presented with symptoms for GBS, she is treated with antibiotics. Other issues, with routine testing is GBS status can be different at different points in a woman’s pregnancy. Routine testing at 37 weeks does not necessarily mean the woman is or is not GBS positive in labour. 2/3 of early onset GBS infection cases were false negatives (woman tested negative in late pregnancy) and Testing positive for GBS (Colonisation) does not necessarily mean that GBS infection or transfer to the baby will occur. There are limitations with the routine use of antibiotics. Antibiotics are not shown to be effective in all cases/ is not effective in late onset cases – antibiotics also introduces new risk factors. Overuse of antibiotics & early introduction to antibiotics in babies leads to resistance of antibiotics and other effects. Antibiotics are recommended every 4 hours starting at least 4 hours before the woman gives birth – this is not possible with all labours. Some women, with a history of fast labours, may be induced to ensure that she receives the full course. Again, this introduces new risk factors. Just keep the waters intact!

        1. Jaggie Thistle

          Group B Strep Support are actively petitioning the UK government calling for better prevention of group B Strep infection in newborn babies. I found their web site to be very informative.

          http://gbss.org.uk/ – Offer information and support to families affected by group B Streptococcus; Inform health professionals and individuals how most group B Strep infections in newborn babies can be prevented; and Generate continued support for research into preventing group B Strep infections in newborn babies.

  6. jeanclaudetrichet

    Allegedly litigious persons seek out libel cases online allegedly.
    On an entirely separate note and nothing to do with this whatsoever – I’m glad to see the state has changed from FF era settle, settle, settle policy.

  7. Conor

    This sums up Broadsheet (and more specifically, Bodger’s contributions to Broadsheet) perfectly. A High Court judgement and sworn testimony is disregarded in favour of blog posts from the website of a special-interest group.

    The “Mind the baby” blog extract says that “the intervention itself caused an obstetric emergency and had long-term negative consequences for both mother and baby” – what negative consequences, exactly?

    I have two young kids; both times when my wife was in labour, the staff were reluctant to do anything other than let it proceed normally, so I can’t imagine this midwife did what she did without good reason, i.e. she was doing her job. You have to trust the professional in these situations.

    1. Anne

      I don’t see how you came to the conclusion that the high court judgement was disregarded.
      There are numerous links given and the a summary of the judgement.

      I have two young kids; both times when my wife was in labour, the staff were reluctant to do anything other than let it proceed normally, so I can’t imagine..

      How about your stop imaging, based off of your own experience?

      1. Conor

        Imaging?

        Yes, the High Court judgement was mentioned, but a lot more weight is given to the random blog post, that’s my point.

    2. Li

      The negative consequences being long term health risks associated with being born by cesarean… Only recently a study was published on this can affect a persons genetics.
      The negative impact this may have on the mothers futures pregnancies and births- the maternity services will (unlike many other countries) automatically class her as high risk having had a previous section.

  8. Marie

    So let me get this straight, it doesn’t matter if a woman consents or not, or what happens to her, as long as the baby is healthy?

    Symphysiotomy anyone?

    1. orla

      + all the unpaid compensation
      that thought process should actually terrify all right thinking women

        1. Nessy

          I was thinking the exact same thing Marie! Symphysiotomy was still carried out up until the 80’s – sickening – Those poor women!

          What’s worse is the current state of our hospitals, at no point should the church be involved in the dealings of our healthcare service (example: Mater Hospital and Fr Doran etc) – the current farce which is The Protection of Life During Pregnancy Act (still ongoing) whereby a men/priests who’ll never give birth and the crazy pro life campaigners can dictate that an unborn foetus’ well-being is more important that the person carrying it. This country is a f*cking joke when it comes to women’s health. It’s something that we as a nation should be wholeheartedly ashamed of! How many more women need to be maimed/die before there are laws in place to protect them?!

          1. dearmg

            Christ, I’m glad someone else finally gets it. This is not a comment on the incident or the case, but on the the fact that the judge has deemed pregnant/labouring women unfit to decide on what is best for them. ‘Vessels’ indeed.
            Why are women treated so poorly in Ireland? its very sad just how belittled 50% of the population are in an everyday way. I hope the Human Right people continue to drag the governments arses over hot coals.

  9. Smoo

    And people wonder why there weren’t enough applicants to fill places on the first round of the obstetrics training programme for doctors last year?? Horrible work environment where staff are massively overburdened and the media have made patients excessively suspicious and litigious. Stats show Ireland still one of the safest in the world.

    The HSE usually settle cases but I’m glad to see someone who was proven to have absolutely no case will have to pay the price for putting people who were just trying their job through the stress of a court case, probable suspensions from work during the case and everything else that goes with it. The poor midwife.

    1. Marie

      Depends on the stats. CSO stats are not correlated properly & leave us with inaccurate figures. The Maternal Death Enquiry stats are more accurate and place us higher. And really, is surviving childbirth in the Western world really how we want to measure our maternity services? Pretty low standards. Perinatal and maternal morbidity are more accurate measures – physical and mental morbidities. There are some fantastic midwives and obstetricians in Ireland but there is also a lot that needs to be improved on. Having used the services myself, I saw a decline in care over the decade I birthed in. As hospitals are under more pressure, the standards have fallen. There is more intervention, women being accellerated to get beds clear. Consent is an issue – get a group of women together sharing birth stories and its always bound to crop up in conversation. The problem is – how do you prove it? its the woman’s word against the health care provider. There are a lot of women who carry deep wounds following childbirth and their care/treatment. Its deeply offensive and dismissive to imply that the health of the baby is all that matters. Women matter too.

      1. Ciara

        Most cogent comment I’ve read so far. ‘Sure the baby was fine’ is totally beside the point and just underlines the view that the woman is an unsentient vessel for the production of the child.

  10. Jene

    And as commenters on here condemn this woman and her case, women all over social media are sharing their stories of how they experienced medical procedures without consent in childbirth. Is it any wonder these stories are told in secret when this is the response you expect to get.

  11. Father of the normal baby

    I have been trying to ignore all these negative comments but now i’ve just had enough. Alot of the facts of the case were not mentioned in the papers. People keep saying we should be grateful for having a normal baby. Our son became seriously ill within hours of being born. He spent 11 days in the special care unit fighting an infection, which we were told by the paedicitrian he was presenting as a group strep b baby. He is now 3 years old and requires alot of early intervention care because he has special needs. He does not talk and has very little communication skills whatsoever.
    So for all those people that are saying we should be thankfull we had a healthy baby i wonder if you would let it go if it had been your own child. Had my wife and son not had any long term effects we certainly would not have taken the case. Thanks to some ill informed people like some of the people here we have been recieving hate mail. It’s pretty pathetic to go to the bother of writing a letter, buying a stamp and sending us abuse and not having the guts to put your name to it.
    For those who have been supporting us i thank you for all your kind words.

    1. eeef

      For every negative comment here, there are plenty of us shaking our heads in despair at the arrogance and ignorance ripe in society when it comes to birthing and women’s rights in Ireland.
      I’m sure you know there are a huge amount of people behind you and you are a brave family to take on the HSE.
      I am so so sad that this happened, so sad about the outcome for your son and absolutely terrified at the judges ruling.

      1. orla

        To Father of the normal baby, I hope you find some comfort knowing that there are people who support the action you took. I really am horrified by the deference the Irish courts take to the medical profession. in other countries this would be considered assault, if action was taken wihtout obtaining consent, even if action was “in best intersts”, ie blood transfusions against wishes.
        I am not surprised but am disheartened by the decision, as reported.
        is there a copy of the judgment?

    2. Drogg

      Thanks for your comment i was reading some of the comments here last night and i was sickened by a lot of them. Thanks for sharing the info on what happened and i hope you know a lot of people stand behind you.

      Another concerned father.

    3. Kate

      I am terribly sorry to hear about what your family went through & are still going through. Please know that there are a huge amount of people out there who support you & your brave stance.

      People who voice vile abuse on sites such as this, may have problems of their own. Often problems around having their voice heard in their own lives. That is not to excuse it. It is just so you realise that generally it isn’t about you. It is about them.

      Can I say as a woman who has experienced maternity care, that ARM without consent does happen, I exprrienced it & it happens way too often. In some hospitals routine ARM is policy dispite that fact that internationally it is regcognoised as bad practice.

      I hope to God that you have the best outcome possible both for your son & with this court case.

    4. George Loved Pies

      Firstly sorry to hear about your troubles since the birth.

      Secondly sending hate mail is abhorrent.

      My intial comments were based on what Broadsheet posted originally, if they knew more of the facts they should have published them too instead of looking for clicks.

      You had / have every right to seek answers to what happened and good luck with your case.

          1. Anne

            You didn’t offened me George.

            Might I suggest that you shut the pie-hole now and then if you think you mightn’t have all the facts?

    5. Jene

      Thank you so much for your brave post. With every case, there are facts that are not made public, something many people do not bother themselves to consider before commenting. You have so much support and there are many families who are quietly nodding reading your story, having also experienced care in the Irish maternity services which has led to devastating consequences. These comments raise a new issue, how as a culture, a society, we are so quick to side with the ‘experts’ regardless of the care or practices they provide; in many cases un-evidenced and contradicting best practice. Thank you for taking your case and for sharing your story.

    6. Casey

      I am so sorry to read what you and your family have been through and really sorry that the dickish behaviour of know it all internet boors and real life coawards continue to make it worse by presuming they know the hell you are going through.

      My regards to you and your family. Not all Irish people are dicks even if the minority would cause you to despair sometimes.

      I admire you for standing up, I admire you for causing a fuss, I admire you for coming into the lair of the beast and telling your side of the story. I admire you for perhaps contributing towards a debate whereby women in this country may one day have a bit more control over their own bodies. I hope you take them back to court and get everything you need to make your life easier.

      All the best

  12. Helen

    Anyone saying that she should be thankful for a healthy baby is missing the point. Several of the maternity hospitals in Ireland have a policy of carrying out unnecessary interventions that are not based on best evidence based practice. In fact, a number of these interventions, including artificial rupture of membranes which happened to this lady against her will, are on the UK’s guidelines for clinical excellence’s list of things “not to do”. Cord prolapse which also happened to this lady and is an obstetric emergency is a rare but accepted risk of this procedure that is carried out as routine in many Irish hospitals.

    In any other branch of medicine, in a non emergency situation (which is what this case was until the midwife intervened) carrying out a procedure on a person without discussing it or gaining consent can be considered assault. Would a man passing a kidney stone (for example) just be told to shut up if a nurse stuck an instrument up his penis without prior agreement?

    This attitude that the medics know best and that they don’t need our informed consent just sickens me and is indicative of the attitude towards women in this country. It seems we have learnt nothing from the horrors of the past.

    1. Randy Ewing

      Too right Helen , Damn know it all medics ! as i said / will say in a second…..sack the lot of them, we’d be better off fending for ourselves

      1. Kate

        Randy I am aware you are being provocative, but to be honest there are many we would be better off without. Simple comments such as yours show our country’s mentaliy especially towards women. Is your point that we need health care thetefore we should put up with inferior practice? Now Randy that is funny

        1. Randy Ewing

          I think your comment shows alot about the mentaliy of the country too Kate, looking for offence in anything, shaping any situation to suit your own bandwagon, complaining with out giving solutions.

          Maybe I was just trolling Helen because most of what she posts is idiotic.

          1. Kate

            I don’t take any offence. Howevrr it is clear that the father of this child left to deal with the outcome out come of medical arrogrance is. I would hope that anyone would be able to consider that before getting a thrill out of trolling. But sure whatevrr floats your boat

  13. Amanda Farrelly

    Complete disgrace this country is now. We are not living in the dark ages. Nobody has the right to make any decision for any woman in labour. It’s a complete breach of human rights and it’s not acceptable. No one has the right to make judgement either. My heart goes out to this woman and her family.

  14. Clodagh

    I am appalled a) by the actions of the mid-wife, b) the ruling of the judge and c) the reaction by a number of people who do not understand the case, the woman’s rights or the best practise for mother & child.

    First off, let’s be very clear that ARM happens OFTEN in this country as part of a woman’s birthing experience and way too often, without consent. It is a medical procedure and should only ever be done with the consent of the patient or in the necessary event, next of kin. The midwife in this case was incorrect not to ask for permission and should NEVER have performed the procedure. The patient was entirely right to bring a case against her & the hospital.

    The ruling by the judge has now very clearly removed some of a woman’s very basic rights. Worse, it is stating that while giving birth, we are not entitled to any say over our own bodies and what is domes to them. We are to remain at the mercy of the professionals. I would ask that anyone who believes this read extensively on the disadvantages of ARM for both mother and child. This judge has stripped us of our rights to request the best possible care for ourselves & our babies.

    The people who have the audacity and the ignorance (and lack of education on this subject) to taunt the woman who was trying to set precedent for other women to be able to avoid what she went through are appalling. To be so ignorant to assume that this woman has done something wrong in trying to fight for her & her baby’s rights, and in that case the right of all other mothers and unborn babies in this country, is just unimaginable. You have made it quite clear that you have no knowledge on the subject and therefore are not entitled to an opinion on it. Maybe at some point in time where you find yourself or a family member in a similar situation, you will require yourself to become educated on the subject. Just remember that by then, it’s too late – the precedent has already been set, by a judge with a lack of understanding, in a country with outdated guidelines and a idrastically inferior health system to the rest of the developed world.

    Ciara, you have my support & my best wishes. Thank you for bringing your case & for fighting to keep women and their babies safe at the most vulnerable times of their lives.

  15. Beebop

    I think that this case will resonate with many women who have received maternity care in Ireland. The point is this c-section appears to have been completely avoidable and that it is in the interests of women and their babies to avoid unnecessary interventions and major surgery (which is what it is!) if possible. Sure some interventions do become necessary for medical reasons of course, but the majority of healthy women presenting at hospitals in labour (or often just slightly overdue!) should not feel the kind of pressure they do to complete a task within 12 hours which nature has dictated often takes a few days. The problem starts when you arrive in the ward and are told to take Pethidine to relax, this often has the opposite effect of making women very sick and can cause hallucinations and unable to labour actively as slumped into a wheelchair, a shocking start to the labouring process and you have already started down the well trodden route of unncessary interventions ending in c-section or episiotomy and foreceps etc. Essentially the HSE appears to have stopped trusting women (if it ever did) to know their own bodies and labour naturally. Women need to be enabled to feel calm, awake and in control throughout the process, a process which is natural and for the majority of people should not require any medical procedures. I agree that in a non emergency situation like this, there is no way such questionable practices should be carried out without consent, but i would go further and say that it needs to be an informed consent and that we need to halt these policies of 12 hours to labour and emphasis on interventions and getting women in and out of the ward whatever the human cost. It is desperately sad and the rates of c-sections in this country are a direct result.

    1. scottser

      ‘The problem starts when you arrive in the ward and are told to take Pethidine to relax’

      sorry bebop, this wasn’t our experience a few months ago when our first was born. my partner had to plead to get her shot of pethadine even though the contractions were coming really strongly and she wasn’t dialated enough to get it. we both thought the nursing staff were amazing during the contraction stage and were on hand to reassure us and give me massage tips for her. she also had ARM done by the midwife and everything was fully explained to her all the way through. the only gripe i had was when the anaesthetist turned herself while in the middle of a contraction and i let a bit of a roar at him to be careful. he shot the midwife a glance as if to say ‘any more of that and he’s out of here’. i thought he was a d1ck but everyone’s experience is different i guess..

      1. antoinette

        You do know that ARM can cause the hard and fast contractions that leads to you begging for pain relief?
        If there’s no medical reason not to, women should be let labour at their own pace. Babies come in their own time.
        This is speaking from experience of induction with gel, arm and delivery by forceps under threat of “if he’s not out in 30 minutes, will deliver you by section”. Yes that was a threat that led to me accepting interventions I wouldn’t have otherwise. I was given drugs I didn’t want without even being informed (Syntometrine for stage 3) let alone asked, yet I had to scrawl a signature when I could hardly good a pen for an epidural I was begging for.

        I’m fine, my baby is fine, but I won’t be going back to that hospital if I can avoid it! If I do, I’ll have a doula to be my voice when I can’t speak and my brain when I can’t think.

        I find this article particularly crap, it’s not clear why the midwife performed the arm if the baby’s head wasn’t engaged (which it must not have been if there was space for the cord to fall down in the way). I’m not an expert on childbirth, but I’d consider myself relatively informed on what happens and why.

  16. teal

    Instead of ‘sacking the lot of them’, why not work on better, evidence-based training and following guidelines (such as the NICE ones)? When women are saying they want changes in their health care, to make things safe and equitable, why is there always an outpouring of vitriol?

    It is incredible to see people arguing that ‘the medics know better’ when they haven’t any understanding of what it’s like to be a pregnant woman in Ireland. For those arguing that everyone has the right to consent, take a look at the HSE National Consent Policy where pregnant women are equated with those who are incapicitated or seriously mentally ill.

    This couple were incredibly brave to argue their distressing case in the High Court. In another jurisdiction, this would be considered medical negligence. In Ireland, legislation supports removing consent from pregnant women, hence, the law protects medics whether they know better or not.

  17. Scump

    So this is how a woman is treated for actually standing up and taking action against the awful injustice experienced by her and her family. Is this how it is to stay in this country? Women are to remain in the dark, ask no questions, and give up consent for what happens to their own bodies or suffer the consequences on top of the already existing terrible consequences suffered. It was brave to come forward and speak out in a country that clearly still hasn’t learned for any of its brutal past mistakes!

  18. Helen

    I think the problem sometimes is that the medics do “know better” but are constrained by the hospital policies that go against evidence based best practice. Particularly in NMH where women are put on a clock when they present in labour, all for the benefit of the hospital and not for the benefit of the woman or baby’s health. Look at the statistics for interventions such as episiotomy and ask yourself why are they so high.. Anecdotally it has been carried out as a “training practice” on women unnecessarily in a particular hospital in the past.

    Why on earth would anyone believe a woman shouldn’t be able to discuss or make decisions with regards to her health while giving birth, when she is considered capable of making such a decision and giving informed consent when not pregnant. Oh yes, I know, women as soon as impregnated become nothing more than a vessel.

  19. Conor

    A lot of people have made the point that no-one should be allowed to make decisions for the woman as to her medical care. In general I’d agree with that, informed patient consent is absolutely critical.

    But this is slightly different, in that the hospital also has a duty of care to the baby. Imagine a hypothetical (nb; hypothetical, as we have very few established facts on this case) situation in which a baby is in distress but the mother insists on a natural, unassisted delivery. What should the midwife or obstetrician do then? Does the mother’s right to consent override their duty of care to the baby?

    It’s a horrible situation to be in but it is far from black and white. Probably not very appropriate of Broadsheet to have posted this in the first place, given the lack of information, but that’s their style.

    1. Kate

      Well in most other countries a woman right to refuse treatment.is respected. How do they manage. In many other countries they practice evidenced based maternitu care. Can.you imagine how horrible

  20. Buzz

    Well done to this couple for taking the case. Medics in this country are a law unto themselves, and seem to think nothing of carrying out unnecessary medical procedures that can have negative consequences.

    For example, patients who present in most other countries with cervical dysplasia are told to take Folic acid – price €4 a bottle – and it resolves naturally. In Ireland, more often than not, a Lletz treatment – price €4,000 to the taxpayer – is carried out (burning off cells) and the patient is told it is harmless, which it is not. It’s a total racket that negatively affects women’s health.

    This couple should be applauded for refusing to submit to damaging health care.

Comments are closed.