Maternity services - Cheque book system must be reformed
As is patently clear from the results, low income mothers are 12 times more likely than their better-off counterparts to be discharged from hospital within 24 hours of giving birth.
Further defining the skewed nature of this country’s health service, the research puts a spotlight on a scenario whereby well-off mothers, who can afford to pay for private maternity care, receive more ultrasound scans during pregnancy, have more Caesarean sections and are subject to fewer emergency interventions during delivery.
These are some of the intriguing findings of the first in-depth probe into the level of services available for pregnant mothers. Not surprisingly, this varies significantly up and down the country, depending on where people live, what social class they come from and, in particular, how well off they are. In an intriguing result, it appears that expectant mothers right across the social spectrum are increasingly likely to opt for a Caesarean birth, purely for non-medical reasons.
Confirming a widely held perception, this trend suggests that more Irish women are becoming ‘too posh to push’ because they regard a Caesarian as more convenient for a variety of reasons than the prospect of having to go through a vaginal birth.
Nonetheless, the right of women to choose whatever form of delivery they want is strongly defended by leading expert Professor Fergal Malone of the Royal College of Surgeons of Ireland. As he points out in a revealing interview, today’s woman is informed, educated and well able to make up her own mind.
Among other insights into trends, we learn that women in Leinster, outside of Dublin, travel the farthest to hospital, while those living in the capital have the shortest hospitals stays.
Women in the Connacht-Ulster area have the most C-sections, while those in Munster are most likely to opt for private care. The reasons for these regional differences have yet to emerge.
Interestingly, a marked divergence was found between Irish and non-national women in their use of maternity services. In the same hospital, for instance, non-nationals are twice as likely as Irish women to go through childbirth without seeking pain relief. Further contrasting with Irish women, they generally opt for a midwife rather than a consultant during labour and delivery.
The seminal importance of the Irish Examiner/Lansdowne survey, is in raising deeply significant questions about inequality of maternity services from one region to the next. Peeling back the layers of Ireland’s cheque book health regime, it highlights profound difference between the quality of private and public maternity services.
Above all, it highlights the need for reform of a health service riddled by social and economic divisions where the level of care fluctuates steeply according to a person’s financial status.
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