Just over half of patients 'fully involved' in decisions about giving birth

Some 25% of respondents to a University of Limerick-led survey, and who had either a C-section or an instrument-assisted birth, said they were not provided with enough information about the procedures.

Almost half of patients surveyed about birth experiences did not realise consent was needed before medics could carry out internal examinations.

Some 25% of those who completed the University of Limerick-led survey, and had either a C-section or an instrument-assisted birth, said they were not provided with enough information about both procedures.

When asked if they were involved in the decision about what kind of birth to have — spontaneous vaginal birth, instrumental birth, or C-section — just over half said they were fully involved.

That 53% cohort stated they were asked “every step of the way” what they wanted and that their decisions were accepted without question.

However, issues arose with the remaining 47% who referenced varying degrees of either consent or information being provided to them in advance of procedures.

"There is little support for less invasive, physiological births in the Irish maternity system,” said University of Limerick’s School of Medicine researcher Susann Huschke.

“Rates for routine interventions such as inductions, C-sections, and episiotomies are significantly too high.

“This is despite the fact that research evidence and international guidelines highlight the risks of these routine interventions and recommend lower rates. 

There are significant issues with informed consent. Routine interventions are frequently presented as the only option, making women feel like they cannot refuse.

“The information given about risks and alternatives is often not sufficient. Many do not feel they were respected as the decision-makers during labour,” said Dr Huschke.

The National Survey on Birth in Ireland, which is due to be formally launched on March 10, is part of a research project on birth. 

It is the result of a collaboration between the Birth Rights Alliance Ireland and the Participatory Health Research Unit in the University of Limerick’s School of Medicine.

“We created this survey in order to find out more about experiences of birth in Ireland," said Birth Rights Alliance’s Rachael Bermingham.

The vast majority of births take place in the medicalised settings of maternity hospitals where birth interventions such as inductions and C-sections are very common.

“The aim of the research is to find out more about the reasons for these rates of birth interventions.

“Why is this happening, and what information is given to make decisions about birth?” 

Anyone who gave birth in Ireland between 2018 and 2023 was invited via social media platforms to fill out the survey.

It was run on the online survey platform Qualtrics, and while 3,824 respondents started the survey, 2,522 completed it.

Service users from all 19 maternity units were represented in the survey, as well as people who had a home birth.