Joyce Fegan: Will we ever respect women in this country?

It beggars belief that we could turn all private hospitals into public hospitals virtually overnight, but when it comes to pregnant women getting adequate support there are issues still ongoing
Joyce Fegan: Will we ever respect women in this country?

Vikki Cullen, Mogeely, East Cork, with her seven-month-old daughter Daisy at an AIMS Ireland distanced protest against maternity restrictions outside Cork University Maternity Hospital earlier this week. Picture: Dan Linehan

Three years on from Repeal, who would have expected this?

This time three years ago, as 66.4% of the country geared up to vote yes to repeal the Eighth Amendment, it is highly unlikely that we could imagine pregnant women having to protest outside maternity hospitals in 2021.

It was widely thought that the landslide vote was a vote to respect women.

But instead, this week, as the uncertainty continued around restrictions in maternity hospitals, because of Covid-19, with power-holding figures stating publicly that there was no medical evidence for the restrictions to remain in place, women were still protesting, while pregnant, outside our maternity hospitals.

These are women with pelvic girdle pain, where your daily movement can be restricted to a short stroll, women who are about to undergo embryo transfer alone, the final leg of their IVF journey, and they're having to resort to standing with placards outside our maternity hospitals.

While we may be well used to this in Ireland, if we step back for a moment, it surely says something very profound about our treatment of pregnant people when they have to stand outside a maternity hospital with a placard asking for support.

One professor commented this week that the restrictions in place at maternity units were for the protection of the mother, in fact, they were "dedicated to the mother".

How about we ask women what protection might feel like to them, how might we best support them in labour?

The week was peppered by various public comments from various medical professionals and politicians stating that there was no case for these restrictions. To the non-pregnant person or to Joe Bloggs it looked like all was sorted in the land of maternity care.

The HSE’s chief clinical officer, Dr Colm Henry, had written to all maternity units to instruct an easing of restrictions.

But why then were women still protesting outside of hospitals? Letters and public comments are different to change in policy and by the end of the week it appeared that four maternity units were still not compliant with the easing of restrictions: Tipperary University Hospital (it has an issue with its daily visiting), Waterford University Hospital (it also has an issue with its daily visiting), St Luke’s in Kilkenny ("it has an issue specifically around the scan"), and Wexford General Hospital ("as well on daily visiting”) — this is all according to Health Minister Stephen Donnelly.

It beggars belief that we could turn all private hospitals into public hospitals virtually overnight, but when it comes to pregnant women getting adequate support there are issues still ongoing.

But these four units aside, there was further confusion this week about the latest guidelines and what parts of labour could partners attend or not.

Apparently being present for labour meant from "induction onwards". But how many women are actually induced? So when a labour is not induced, which is a sizable number, at what point can a birth partner join?

This week, a public talk took place online with various groups, including Women Ascend, which has been campaigning for better maternity care these last 14 months.

One midwife spoke in plain terms about the mechanics of labour these last 14 months.

During the pandemic, women were "allowed to" have their partner present once they reached active labour. The public just heard that and went about their business. But what is active labour? Depending on the hospital, it's determined by the number of centimetres by which your cervix is dilated. But how do you determine that? By carrying out a vaginal exam — something which many women are reluctant to undergo, especially in case a contraction occurs during one.

The restrictions had forced women into this situation of having to undergo a vaginal exam, or several, in order to receive the support of their chosen birth partner. It's like having to pass a test, but a test that you aren't actively consenting to, a test that you know you have to do in order to get the support you need.

How is that a show of respect to the people giving birth to our next generation? How was that dedicated to the care of mothers? How was that protecting mothers?

There is now anecdotal evidence emerging that inductions increased in the last 14 months, as knowing when you would go into labour, despite the physical effect of experience of an induction, gave women some hand in the game that is their body and their labour.

And it was doctors and nurses, care staff, and porters who had to navigate these restrictions and the impact of and fall-out from them, with people giving birth. These professionals should have just been doing their medical job, but instead they were having to navigate restrictions that caused upset to many.

Meanwhile, our pubs and restaurants and sports clubs and airlines were busy jostling for, and getting, their needs met. We see now that our society and economy has more or less reopened, because apparently it is safe enough to do so, safe enough even to possibly dine indoors from July.

How was maternity care not a priority for this Government from the get-go? It's not like it's a small issue. According to the Central Statistics Office, there were 61,022 live births in Ireland in 2018.

When it comes to women's health we have fallen down time and time again in this country. We allowed a quarter of a million women to travel to the UK for abortion care for decades. We heard all their stories, in order for minds and hearts to be changed, we had to be privy to the private lives and tragedies of women. And we vowed to respect women.

We, finally, thanks to much activism and protest, addressed that situation, although access to our services remains an issue, and the legislation is now up for review. Will women's rights be rowed back on, or not? That depends on how TDs vote in Dáil Éireann on the issue.

It always seems to fall down to that, doesn't it, when it comes to women's health? How the TDs vote — those generally without the experience of pregnancy, pregnancy loss, or labour.

This time three years ago we chanted "respect women" on the streets of this country, we repeated the phrase on the "doorsteps" of Ireland, and we heard it on the airwaves and live TV debate. But here we are three years later, in a whole other situation, where women's health got left to last and we are having to say it all over again: "respect women".

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Wednesday, September 28, 2022

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