We are writing in response to the article, ‘Fewer than 1% of women had ‘practically perfect births’ in a two-year study’, which appeared online (www.irishexaminer.com, May 10).
While any paper reporting on the Irish maternity services is welcome in terms of gathering data to inform practice, the tone of the paper entitled ‘How would Mary Poppins fare in labour? Practically Perfect? Unlikely’ (Bolger, L, Sweeney, R, Foley, M, & Mahony R. IMJ 2018) is very concerning for women.
In the first instance, reports of this study are misleading as it only sought to look back at crude birth outcomes, over two years.
The most important people involved in birth, the women, were not consulted or surveyed.
Rather it was the authors who decided what a “practically perfect birth” should be.
The results, are not surprising, we know that fewer and fewer women are having spontaneous, vaginal births.
The more important questions to be addressed are why is this actually happening?
Why are the rates of induction of labour, instrumental birth, caesarean section, pelvic floor trauma, and postnatal depression in Ireland all increasing?
Rather than ‘managing women’s expectations about birth’, we suggest that a health-focused approach to maternity care, with practitioners working in partnership with women to facilitate what women want.
We know too from research that women want to be involved in decision-making about their own bodies and to have informed decisions during the birth process.
There is robust evidence that this can be best achieved through continuity of maternity carer.
Women aren’t demanding and awkward, they simply expect a positive birth experience in which they are cared for in a holistic manner that leaves them intact, physically, psychologically and emotionally.
It’s quite simple and maternity services should strive to achieve this.
We respectfully suggest that women in Ireland should not have to lower the bar, for their expectations of birth rather, the Irish maternity services should strive to reduce the level of unnecessary intervention and aim to fully implement the Department of Health’s National Maternity Strategy as a matter of urgency.