Eamon Ryan (Dublin Bay South, Green Party) | Oireachtas source

It is important to stand with and support those women, particularly those who have not got anyex gratiapayments. For them this problem continues. We have not given what we should have given, an upfront apology, a recognition that what went on was wrong and recompense for the huge damage, loss and pain that occurred over their lives. I listened to the Minister for Education and Skills, Deputy Bruton, ask how we could have done that if Judge Harding Clark did not deliver that for those women. While we did not want to go into an adversarial, inquisitorial system, was it not possible to listen to those women in a humane way rather than merely stating they did not have the records? That would have been an appropriate response to what had gone on. I regret that we are not getting that today but we are getting a similar defence of the system that was indefensible. That is a terrible missed opportunity and that is why this debate today is important.

The way our medical system deals with births remains an issue today. Let us hope the new national maternity strategy published last year will lead to a genuine change and shift in the system. The statistics show we have not learned the lessons we would have learned had we stepped back, apologised and said our approach is wrong. The doctors and consultants say the statistics show we have the safest and best system but we could refer to other statistics. The level of inductions in birth in Irish hospitals at 31% is approximately three times what the World Health Organization, WHO, recommends. That has real consequences today for mothers and babies. I have seen oxytocin used as part of this active management of labour. Symphysiotomy was also part of that system. The Minister for Health said certain labours went on for 50 hours. We have created a managed system which tells a woman that if her chart is not going the right way within 12 hours, the doctors will intervene and apply oxytocin which has real medical consequences for the child, particularly some in crisis pregnancies, and mother. This is done, as I have seen, without really consulting, preparing or offering choices to the woman. It is the same interventionist approach in which doctor knows best and one should not listen to the mother that still happens today.

According to the statistics from the National Maternity Hospital approximately 27% of women have an episiotomy. That has real consequences. Our level of caesarean births is high at 30% and in some hospitals it is as high as 38%. In some instances that is no doubt the right medical procedure. We have to stand up for our doctors because there are certain acute cases where they provide lifesaving, important interventions but that level of intervention has knock-on consequences, making the average mother's recovery period at least two or three times what it would be with an alternative approach. Today, 60,000 women are suffering the consequences of that excessively interventionist, medicalised, doctor-knows-best approach. It is against all the recommendations of the WHO and other international scientific best practice. We say we are the best in the world but the statistics say otherwise. Our approach fits women into the consultant's or active management timetable, rather than trusting and working with them to make their deliveries the best they could be.

Breastfeeding is connected to this and is a cultural problem within our medicalised interventionist system. Why are our levels of breastfeeding the worst in the world? Only 6% of mothers here breastfeed after six months. I do not want to send them on a guilt trip and far be it from me as a man to talk about it but we cannot ignore the statistics. We spend only €100,000 a year on supporting breastfeeding but we spend €15 million a year on the acute infections in infants which could be addressed by higher levels of breastfeeding because it is the healthiest alternative. All the evidence is clear on how we raise our babies but we do not do it because we are still stuck in this consultant-led system.

Today we should be celebrating the work of Máiréad Enright and Dr. Jacqueline Morrissey and the Association for Improvements in the Maternity Services, AIMS, who have done a fantastic job, as well as the women themselves but it should not be up to those women to fight their case. It should have been for the State to acknowledge the facts, admit we were wrong and to listen but not in an adversarial way. Had the doctors really listened to Savita Halappanavar, her tragic case might not have happened. Our Lady of Lourdes Hospital was mentioned several times. Michael Neary should have listened to the midwife who was having her baby there and screamed at him not to do a hysterectomy. She was not listened to. We should be listening to those women today. We should be responding, as Deputy Bruton said, not in an adversarial or inquisitorial way but a listening way and responding accordingly to admit we need to change. More than anything else that comes out of this debate let us respect, honour and apologise to those women. Let us give them due recompense.

More than anything else, we should use this opportunity to admit that the delivery of medical services in the obstetric health system is still not right and is still not mother-centred in nature. We have chased after midwives who have tried to provide alternatives such as home births, which should be available. We have hounded them out. I have seen it personally. They have been demonised and hounded out. I understand that just 5% of deliveries are led by midwives, even though such deliveries are just as safe as doctor-led deliveries. I am speaking from personal experience when I say that this completely different cultural and medical approach is fit for purpose in many pregnancies. It should be commonplace. To my mind, we should have a completely midwife-led system. I appreciate that in cases of acute medical emergency, consultants and others have to be brought in to save the lives of babies and mothers. We have allowed doctors to control the system. I am afraid they need to learn the lesson that they are not gods. We need to have a system that is led by midwives and mothers. We need to apply the lessons of the symphysiotomy experience to all mothers today.

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