Joyce Fegan: When will we see the emergency legislation for pregnant women?

Hospitality lobbyists are listened to — but if you're about to give birth, you'll just have to make do with a few ad hoc guidelines

Siobhán O'Donoghue, Linda Kelly, Holly de Burgh, Julie Coakley and councillor John Maher with members of Uplift delivering a petition signed by 52,250 people to CUMH last December calling for partners to be allowed attend scans, labour, and postnatal visits. See link to 'protest' story below. Picture Denis Minihane

Where there’s a will there’s a way. Indoor dining? No problem, let’s draft emergency legislation and have it before both the Dáil and the Seanad next week.

All-party agreement? You got it. Fancy a pint under the roof of your favourite pub? Say no more, we’ll get vaccine passes for that.

In need of some time in the sun? Don’t worry — we’re sorting digital certificates to circumnavigate that one.

Need to give birth? I’m sorry, the will and the solutions stop there.

As profound an experience as you can get

No woman, no matter how old or how many great-grandchildren she has, will ever forget giving birth. It is about as profound a physical, emotional, and mental experience as you can get. And even if we haven’t experienced it for ourselves, you are here because someone went through it for you.

Since the pandemic began, about 69,000 babies have been born in this State. In the final three quarters of 2020, April to December, exactly 41,858 babies were born. About 13,000 or 14,000 are born each quarter, so that’s approximately 28,000 so far in 2021. Of those 69,000 babies, about 2% account for multiples — twins or more — so maybe 1,400 births.

So we are looking at about 67,600 people who gave birth under severe restrictions in 2020, 2021, and now, beyond.

No plan to ease restrictions on childbirth

Because this week we learned that, while there is no date set for the reopening of pubs, indoor dining, and the return of air travel, there are concrete plans in place — but the same is not the case for the easing of restrictions in the country’s 19 maternity units.

Lobbyists for sectors such as the hospitality and travel industries were listened to, but pregnant women and their partners are treated as the passive subjects of ad hoc guidelines. 

Taoiseach Micheál Martin said a “short piece of legislation” would give a “solid legal framework” to vaccine passes that would allow for men and women, and friends and neighbours, colleagues and family, whoever really, to wine and dine indoors. In fact, Mr Martin said a plan would be ready by July 19. And Tánaiste Leo Varadkar said the reopening of the hospitality sector would happen “in advance” of the August bank holiday weekend.

Some lobbyists were listened to...

It’s still all to play for, but the lobby groups, the stakeholders, the business owners, the various associations have banded together and stuck at it, and have had their voices heard and their needs listened to by the politicians of Ireland.

The same cannot be said for the 67,000 or so people who have given birth since the pandemic began, and the thousands of women who are pregnant right now, and are none the wiser as to whether they can have a partner with them and at what stage.

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Much has been said on the Dáil floor about the maternity restrictions, the HSE has issued guidelines, and pregnant women have even resorted to protesting outside hospitals. 

These are not people looking for a bit of sun or a pint with a friend — these are people who are about to go through the most profound experience of their life in giving birth to a member of the next generation.

...but not pregnant women

Where exactly are we with the maternity restrictions? Isn’t that more or less sorted out now?

The HSE has issued guidelines around allowing birth partners to attend the 20-week anomaly scan, labour, and after the birth. These guidelines were sent to all 19 maternity units in Ireland.

Sounds good, doesn’t it? But it’s not. This is how it’s playing out in reality. These guidelines are just that. Think of them as suggestions. They are not binding. 

We give the pubs legislation, we give pregnant women guidelines.

The implementation of these guidelines is at the discretion of each individual hospital.

And that’s where we are now, an ad hoc system where partners are allowed into some parts of labour, but not others, depending on where in the country they are.

For example, from this week, Galway University Hospital is allowing birthing partners to attend all scans, visit the wards between 8am and 9pm, and be present during labour and for caesarean sections. The hospital, which practises all varieties of medicine, is essentially going back to pre-Covid arrangements for its maternity unit.

What’s happening elsewhere?

In some hospitals, your cervix needs to be 3cm dilated before you are allowed the invaluable support of your chosen birth partner. In other hospitals, your cervix needs to be 4cm dilated before you get a loving hand to hold.

'An indicator of how women are valued' 

An internal vaginal exam by a stranger will dictate whether you get support or not — that’s what it has come down to.

“The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honoured,” says renowned American midwife Ina May Gaskin.

In Ireland, women’s reproductive health has historically been neglected, abused, and ignored, be that through the brutal practice of symphysiotomy, forcing mothers to access medical care in England having received the most awful of news, and now this, how we’ve treated pregnancy in a pandemic.

When the dust has settled on Covid-19 and we look back at the damage done, we will once again hang our heads in shame at how pregnant women were treated by the State.

Before you get to delivery there are partners leaving their loved ones to walk through the sliding door of a hospital alone because of bleeding or cramping that has nothing to do with labour. Their loved ones wait in an emergency department — worried sick, crying, distraught — as the worst-case scenario sits in their mind, and they wait outside in car parks, phones glued to the palm of their hands, Whatsapp open only.

This week, the HSE was asked by Social Democrats co-leader Catherine Murphy if fully vaccinated partners of expectant mothers would be given additional access to maternity units.

The answer was no.

Instead, the HSE is surveying hospitals and maternity units on the level of restrictions in place.

Sometimes it comes down to wording and framing, doesn’t it? In terms of pubs and restaurants, we use the word “reopening”. For air travel, we use the word “return”. But in maternity care, we’ve been using the term “easing of restrictions”.

Can we now start talking about the reopening of maternity care?

“At what point to reverse this if we don’t reverse it when people have been vaccinated?” Ms Murphy said. “It’s difficult to see how you get back to where we were prior to the pandemic.”

That’s precisely the point.

In 12 months’ time, will it no longer be de rigueur for partners to attend the 12-week scan or to walk across the threshold of the hospital carrying their loved one’s bag in early labour?

It might be too late for the 67,000 people who have already given birth during this pandemic, but for the thousands of women who are pregnant now and facing into the mammoth task of labour with such uncertainty, we need to be as stern with dates and as swift with emergency legislation for them, as we are for pubs, food, and holidays.

Where is the legislation for pregnant women? And where are their partners’ passes and certificates?