About the Choices in Childbirth Initiative
Choices in Childbirth brings together midwives and women who are working very hard to bring about a transformation in Irish maternity services. Like other countries, the structure of our maternity services since the 1950s has become increasingly centralized and the medicalisation of birth has become the norm. Within the last ten years, however, tender new shoots of change have emerged. Starting with Judge Mella Carroll’s landmark Report of the Commission on Nursing, midwifery and midwives came out of the shadows at a time when childbirth groups in Ireland were also urging change.
These recent developments are in line with the recommendations of the World Health Organisation, which acknowledges that the midwife is the expert in normal birth with extensive professional training and specialist skills to support birth. The World Health Organisation recognises the midwife as the most appropriate caregiver for women with healthy pregnancies who can anticipate uncomplicated births (WHO, 1997). This is where midwives come into their own as the key providers of care.
Midwives give sensitive support to women in pregnancy and birth, nurturing them in a way that fully acknowledges this profoundly life-changing experience. Working together, women and midwives have begun to explore a range of care options, some of which are new to Ireland, that afford women greater choice in their childbirth journey.
These include:
-Midwives’ Clinics
-DOMINO Schemes
-Home Birth Services
-Midwifery-led Units
-Early Discharge Home Services
Our population is expanding rapidly and maternity service provision in our major centres of care is often overcrowded and subject to problems such as understaffing of midwives, who remain the principal carers for women in hospital. Our maternity services should provide choice of how to access maternity services, choice of type of antenatal care, choice of place of birth and choice in postnatal care. Every woman in Ireland deserves a quality service that offers a real choice and opportunities and is free to all. This National Initiative seeks to help make this happen.
The purpose of the Choices in Childbirth leaflet is to raise awareness of the full range of midwifery services that should be available to all women within a comprehensive and open national maternity service. The leaflet may give women the impetus to ask for appropriate services. It tells of the options available to some women in Ireland and points out the patchy nature and the inequity of such variability across the country.
The website will offer a publicly accessible source for the evidence to support effectiveness of midwifery care and services. This evidence may further empower women, indeed all interested in good maternity services, to challenge the status quo, the inadequacies of the current restrictive, highly centralised, hospital focussed and coldly industrialised model of birth that has become the norm in Ireland.
Choice and women centred care is not a 'bells and whistles' extra, it is, we believe a minimum requirement for humane and responsible maternity care.