Dublin management of labor, is this still true?

[sapphire_chan]

I've been reading through excerpts of Goer's Obstetric Myths versus Research Realities, and I was just reading the section on how they manage labor in Dublin.

Do they still do things like that? I mean, rectal exams, oxytocin drips adjusted to keep contractions at a set rate, oxytocin for 40% of women? "Midwives" that are basically non-electronic fetal monitors?

[theelfqueen]

I dunno but have you read Penny Armstrong's A Midwife's Story, she talks some about her training in the UK, also.

[Belle]

In the original Dublin management of labor women were also had continuous labor support.

Not saying that it was better to keep mom's on an arbitrary labor schedule though. But to answer your question, yes this still happens.

[sapphire_chan]

Yeah, after posting the question, I went on to read that it had been transported to the US without the accompanying continuous labor support.

Sometimes when I read things, I feel like if I ever talk to an OB I'm going to assume they're a moron. And then I read a bit more and I *know* I'm going to assume they're a moron.

[Peppamint]

Originally Posted by sapphire_chan

Yeah, after posting the question, I went on to read that it had been transported to the US without the accompanying continuous labor support.

Sometimes when I read things, I feel like if I ever talk to an OB I'm going to assume they're a moron. And then I read a bit more and I *know* I'm going to assume they're a moron.

I know it's bad... but I just have to assume that OBs are bad unless the prove otherwise. My experiences haven't been good, except one "okay" experience with the OB who backs up the local midwives (unofficially).

Sad, but true.

[sapphire_chan]

Offtopic: That made me decide to check out your siggie links. A yarn womb! Too cool.

[huggerwocky]

slightly off topic, if you want to sell that book drop me a line...

My library doesn't have it and doesn't buy it either despite me suggesting it several times...

[sapphire_chan]

I used the "search inside" feature on Amazon (and maxed it out, I think you only get to look at like 50 pages or so). I want to buy it sometime just because I'm so interested in birth, but with dh being on board for homebirthing I don't really need it.

Have you asked your librarians if they can do interlibrary loan? The annoying thing is my library only has Goer's "Thinking Woman's..." but they've got 2 copies of William's Obstetricians or whatever it's called that is basically the bible of the mythology of standardized care.

Also, Goer summarizes the conclusions in her other book and at least references the studies, she just doesn't include all the abstracts like she does in "...Reasearch Realities".

[TracyD]

Hello from Dublin, Ireland

I'm a doula in Dublin (one of about 4 in the entire country) If you want to read a really scary book get your hands on Active Management of Labour by O'Driscoll.

AML originated in a Dublin hosptial (National Maternity Hospital) and continues to this day - it's unbelievable. Just like the US most Irish hospitals follow these protocols. Dilate at 1cm per hour or else..... In this hospital 55% of all first time mums have their labour speeded up......They are told quiet casually in their antenatal classes that when they are at 3cm they will have their waters broken and get 'the drip'....like this is NORMAL !!


We have a shortage of midwives and the hospitals are dirty and overcrowded. So eventhough many of the hospitals tried to have one to one support with a midwife they just can't do it.....and then the midwives are 'enforcing' the protocols....it's really sad. They get to mother the machines instead of mothering the mother.

Even with the so called one to one care our section rate is not far behind the US (about 23%)

Women are bullied into pitocin and are afraid to speak up in case they are labeled a 'difficult' patient. I just wrote a book on the Irish birth experience called the Better Birth Book....so that Irish women see that they actually HAVE options and don't have to follow these archaic rules....

Doulas are very new to Irish maternity care and not exactly getting a warm reception from the hospitals.

Oh and the best of all - the Head Obstetrician is referred to as......the Master.....

Tracy

http://www.DoulaIreland.com

[sapphire_chan]

That sounds too scary for me.

Do you feel that the general culture in Dublin contributes to the hospital environment? Do you feel that AML was more likely to develop there first instead of say, another Irish city/region?

What an utterly frustrating situation for you as a doula. On the plus side, any change you make will be a change for the better.

"The Master?" Scary....

[willthiswork]

Is that true? I've never been pregnant but we're trying for the past 18 months (I'm on the 2ww after an IUI). I didn't know that they broke the waters etc for you. Does that happen on the domino scheme? Also, can you have waterbirths in Waterford? Sorry for all the questions, I'm kind of putting the cart before the horse here!

[sapphire_chan]

You might also check out the Ireland section of "Finding Your Tribe" to ask people questions about their birth experiences specifically in Ireland. Forum here.

: for you for your 2WW. Stop by the TTC forum and say 'Hi!'

[TracyD]

You can ask not to have your membranes ruptured routinely, you would just include it in your birth preferences. The Domino scheme is run by midwives - and most midwives are more supportive of normal birth (ie letting the natural process run without interference) At the moment Waterford Regional doesn't have a birth pool but you could labour in a pool at home until you decided to go to the hospital and Waterford are running a small homebirth scheme too.

Good luck with the TTCing !!

HTH

Tracy

[willthiswork]

Thanks! At the moment I'm really interested in having a home birth (haha I'm not even pregnant and I have my birth plan figured out!) but my husband and sister both think its crazy. I'll have to research it more if I get pregnant.

[erika978]

I gave birth in Dublin last August, specifically the Coombe hospital (I absolutely refuse to go to the NMH, especially since I don't qualify for the midwife-led scheme).

Luckily I had researched my birth options and knew I wanted a natural birth. The first thing I was asked when talking with my midwife - what pain meds do I want?

I told her to please not ask me if I wanted pain meds, but that I would ask for them if I wanted them. I got a quizzical look but to be fair, she was great about not asking again.

When I took a while to progress beyond 4cm, she told me that they have a progress chart and that if labour slows down, they need to start using artificial means to speed it up. I told her no. I didn't care if I was labelled a difficult patient but there was no way in hell I was going to start down that road. I had to convince her though to let me continue with the walking. BTW, I was the ONLY labouring mother walking the corridors that day (and there were a lot of us labouring on the floor).

I did get put on the monitor and LEFT on it for over an hour. After that labour was very fast. I did ask for entonox and my midwife was great about suggesting good positions to aid labour (such as on all fours, drapped over the bed, etc). She was also great about massaging my back.

As for the pushing part - well since I had so much back labour, lying on my back was the most comfortable positiong FOR ME. I honestly didn't think it would be and the midwives did encourage other positions first.

From my experience, I was lucky to have 2 midwives who, while they had to talk about progress charts and the like as per hospital protocol, did respect my wishes and after a while stopped fighting me on my wishes. One of them, the lovely Judy, even congratulated me on my birth saying it was quite rare to see a natural birth in the hospital anymore. That I found sad.

UNtil recently, I believe, waterbirths were suspended in Ireland. as for AROM, you don't have to have it done. Pressure is put on you to have it done but you can say no.

I'm also not sure about homebirth after fertility treatment or the domino scheme after such. There is so much liability that there are lots of women who should qualify but don't.

I had a very easy pregnancy and birth but I don't qualify because I have a clotting disorder and require injections during pregnancy. Eventhough it wasn't an issue at all for me and the injections practically cut all risks out, it would be hard for me to find a midwife who would take me on for homebirth or the domino scheme. And definately not homebirth now after my baby ended up in NICU. There would be too many worries that my next child would need to be in the neonatal unit, at least for some monitoring.

I remember about a year ago, the master () of Holles Street was on Ireland AM (morning TV show in Ireland) along with one of the top homebirth midwives (whose name unfortunately escapes me). I just couldn't get over the utter comtempt the master had for homebirths, waterbirths, basically any birth outside of a hospital based managed birth. That is what Irish women are up against.

[jessjgh1]

I'm still reeling over the fact there are only 4 (doulas) in all of Ireland.

I was lucky to visit for 2 weeks to take a course and do some travelling, just pre-pregnancy.

Jessica

[quarteralien]

Originally Posted by busybusymomma

I know it's bad... but I just have to assume that OBs are bad unless the prove otherwise. My experiences haven't been good, except one "okay" experience with the OB who backs up the local midwives (unofficially).

Sad, but true.

Sorry to jump in late like this, but this just reminded me of "Confessions of a Medical Heretic" by Robert Mendelsohn. He said

"When I meet a doctor, I generally figure I'm meeting a person who is narrow-minded, prejudiced, and fairly incapable of reasoning and deliberation."

[erika978]

Originally Posted by jessjgh1

I'm still reeling over the fact there are only 4 midwives in all of Ireland.

There are more than 4 midwives I think you meant there are only 4 doulas.
Honestly, most women over here have never heard of doulas and the other problem is most hospitals have a policy of only allowing one other person in with the mother on the labouring floor. My own mother wasn't allowed see me after I gave birth until I was down in the post-natal wards.