Comment & Analysis
Jun 18, 2015

The Need for A Better Maternity System

Problems faced by Trinity's midwifery students echo national and international hindrances to securing women's rights.

Fatimah Alaya-KennyContributing Writer

It’s 2015 and it’s never been a better time to be born female. Twenty years ago it was prohibited for a Tanzanian woman to own or inherit property. In Nepal, the chance of a mother and baby dying during childbirth was staggering. This is no longer the case. A young girl growing up in Rwanda, which was once plagued with genocide and rape, can now stand proud that the women of her country paved the path in rebuilding their society with more women serving in their parliament than any other country in the world. So far so good, right?

Despite these global improvements, major fundamental matters still require bridging. While many countries have laws prohibiting domestic violence, more than half of them still have no legislation about it – leading to 1 in 3 women experiencing such violence. While the rate drops whilst a women is pregnant, 30 per cent of women experience domestic violence for the first time whilst pregnant, according to Women’s Aid. Female genital mutilation, be it the act or travel associated to facilitate it, is now illegal in most countries. Yet 90 per cent of North Sudan and Somalia’s young girls are forced into this traditional right of passage. Despite it being prohibited in Egypt since 2008, the country still has one of the highest prevalence rates in the world. The maternal mortality rate has halved across the globe – yet many women are still denied safe, good quality reproductive health and pregnancy care.

Ireland supposedly being “the safest place in the world to have a baby” is definitely no longer applicable


But Ireland doesn’t remain untouched by these wordily challenges and maternal mortality has become pertinent in and Irish context. Ireland has had at least four maternal deaths in the last ten years alone: Tania McCabe in 2007, Savita Halappanavar in 2012, Bimbo Onanuga in 2013 and Dhara Kivlehan in 2014. Ireland supposedly being “the safest place in the world to have a baby” is definitely no longer applicable and these cases are only the tipping point – the proof that there is a bigger issue under the surface. Ranking just 26th in Europe, the UN Population Fund found that Ireland had nine deaths per 100,000 live births. Belarus, which is regarded as a third-world repressed country, tops all nations with only one death per 100,000 live births.

So why is there such mayhem within the Irish maternity system?

Irish pregnant women are jointly cared for by obstetricians and midwives. Maternity is no different to many other pressurised health environments in Ireland: there is a major shortage of midwives, who work long, unhealthy and unsociable hours in highly pressurised environments. Medical journals have logged how midwives burn out young and quick in their profession, feeling drained and unsupported. This is also applies to the doctors – with hectic 24-hour shifts, countless night calls and jammed clinics. Yet, midwives are at the bottom of the pecking order.

Should midwives, the experts in what most of us consider a major life event – childbirth – not be respected, embraced and empowered? The recent report conducted by Trinity College Dublin Students’ Union regarding the School of Midwifery proves and student placements in the hospitals says otherwise. 63 per cent of students agreed that they had felt victimised or bullied while on placement. 80 per cent revealed that the demands and pressures of their course affected their mental health negatively. The report further highlighted the financial pressure placed on midwifery students: 26 per cent spend €250 or more in expenses related to their course – with no bursary for travel expenses like nursing students. For many midwifery students, their reality is juggling part-time work so they can fund their a non-paying degree that requires so much hands-on, real-life work – all in the name of gaining experience.

There is a major shortage of midwives, who work long, unhealthy and unsociable hours in highly pressurised environments

This is on top of the usual student pressures – family commitments, college lectures, deadlines and being on placement in hospital wards. Since the report emerged, many have taken to social media to express their support, horror and shock at the findings. The reality is that even though one may not have fully known what the course entailed, after the first three years, it becomes pretty clear. And, night shifts and weekends are an integral part of the job. A woman’s hormones peak at night, resulting in a higher number of babies being born in the early hours of the morning and late at night. Unfortunately, if student midwives were placed in 9–5pm jobs, then they’d struggle to get the hands-on experience – something that’s already hard to get.

Even though Irish maternity hospitals are teaching hospitals, those tasked with the education of students in the hospitals need to be better trained. If students are bullied by those who they’re meant to learn from and look up to, the care provided to patients is bound to be affected.

The report’s conclusion identified the importance of setting up a working group which will be now know will be headed by Declan Devane – someone who has already said he has zero tolerance for many of the report’s findings.

When we withdraw and stand back, we see that the world and women’s rights have come a long way. As well as Rwanda’s women showing they do in fact run their world, Ireland also paved the way a month ago – granting equal rights to lesbian women, acknowledging their status, relationships and desire to wed.

Global issues regarding women’s rights are important in defining progress. Nonetheless, we need to retract the telescope and zoom into what the Irish contribution is to improving all of women’s rights. Even if you’re not spiritual or religious, giving birth is one of the cornerstones of live. When a woman is strong, so is the family, society and the future. Women’s rights are human rights. Would you tolerate the report’s results if your mother or sister was at the receiving end of problems caused by the issues raised?

Ensuring that these issues are identified and out in the open, and that we progress to a point where the actual learning process occurs in an open and egoless manner, is the task ahead.

We need to do it for midwives, and not just for the women who we help to go from mothers to be, to mothers, but all women.

Correction: 23:26, June 18, 2015
An earlier version of this article incorrectly said that the rate of domestic violence rockets amongst pregnant women. In fact, the rate drops from a risk of 1 in 3 to around 1 in 10, according to Women’s Aid. However, 30 per cent of women experience domestic violence for the first time whilst pregnant.

Correction: June 19, 2015
An earlier version of this article incorrectly referred to the head of the working group. He is Declan Devane, not Declan De Van.

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