Maternity closures will result
in roadside births and roadside deaths
Talk given by © Marie O’Connor at
National Birth Alliance march 5th April '03


Yesterday a mother from the Beara Peninsula in West Cork rang me. She told me what it was like to do a round trip of 200 miles from Beara to Cork when you’re nine months pregnant, and exhausted. Her last child was born in an ambulance at the side of the road.

Having to drive 200 miles when you’re about to have a baby is not a maternity service, it’s a form of oppression. Birth is one of the most female areas of women’s lives. Centralised systems of maternity care discriminate against women.

Every year in Ireland up to 150 women give birth, generally without professional help, outside hospital. The death rate for such births is very high.

Ireland has a highly centralised system of maternity care. 30 years ago, there were 108 maternity units in this country. Today there are 22. If medical consultants plans go ahead, we could end up with ten units for the entire country. The Medical Manpower Forum plans to close up to 12 of the country’s 22 maternity units, as part of its agenda of centralisation.

Holles Street, the Rotunda and the Coombe are to move to acute hospital sites. Outside Dublin, consultants plan to close Ballinasloe, Castlebar, Kilkenny, Clonmel. Mullingar, Portlaoise, Tralee and Wexford.

These plans are part of a drive to rationalise hospital care. All services, including maternity, are to be centralised in regional hospitals catering for up to 500,000 people. All medical specialties will be under one roof.

Those who are driving the agenda of centralisation say this will mean more expertise in what they call centres of excellence. But things can go wrong in centres of excellence. Cerebral palsy babies have been born in these centres, babies damaged not by nature but by medicine.

These medical plans pit one hospital against another, one community against another. There will only be one hospital for each region. General hospitals around the country will be downgraded. Eleven hospitals have already been named as “losers’ in the battle to retain vital services.

Accident and emergency units are to close along with maternity units. Driving for two hours in labour is nothing compared with driving for two hours with a serious head injury.

Three out of four women in Ireland will have a child at some point in their lives. If these cuts are implemented, tens of thousands of women every year, not only in Beara, but all over Ireland, will have to drive further in pregnancy, to drive further in labour, to access their care.

Centralisation began in maternity care in 1976, when Comhairle na nOspideal, a medical consultant body, recommended that all women should give birth in large units under medical management. Each hospital had to have minimum production levels of 2, 000 births a year. The policy was based on a bed occupancy of three women per labour ward bed per 24 hours.

These cuts in maternity care threaten the lives of mothers and babies. Women will face more danger and more pain in childbirth. Intervention rates, already skyhigh, will rise. There will be more roadside births, and roadside deaths. More women will be obliged to have their labour induced to avoid a roadside birth. More women will be obliged to have their labour accelerated, as numbers rise in choked labour wards. There will be more Caesareans, more vacuum extractions and more forceps.

Irish stillbirth and first week-of-life death rates are already the highest in the EU. Caesarean rates are already almost one in four, More than half of all first babies are already Caesarean, vacuum or forceps babies.

Is birth to become an operation? Are women to be treated as machines that produce babies? Or can we treat birth as special and women as human beings?

We need safe, high-quality, local services for women in childbirth. Irish women have less choice in childbirth than in almost any other country in Western Europe. We need community care. We need a service that reflects a modern era, not a service that’s a product of 1970s thinking. We need midwives’ clinics in the community, so that women can have choice of midwife, as well as choice of doctor, during pregnancy and after birth. We need self-employed midwives so that women can have the choice of home birth. We need midwife-managed care in maternity units, so that women can have choice of midwife, as well as choice of doctor, in hospital. So that women can opt for a drug-free labour instead of being hooked up to a hormone drip, making labour faster, and more painful. So that women can decide to have a low-tech birth instead of a high tech one. So that women can have a water birth, instead of an epidural birth.

We need birth centres in the community and midwife-managed care in our hospitals, so that women are free to choose where, how and with whom, to give birth.

©Marie O’Connor
National Birth Alliance

© National Birth Alliance An Chomhghuallaiocht Naisiunta Breithe