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43% of First Time Kilkenny Mums will have a Caesarean ..

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    #32
    Orion
    Closed Accounts Posts: 12,807 ✭✭✭✭Orion


    Nobody is suggesting that 43% is acceptable and if you want to discuss that then fine. But we will have no more insinuations that doctors and hospitals are performing sections for financial benefit.


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    #33
    metrovelvet
    Closed Accounts Posts: 9,376 ✭✭✭metrovelvet


    Orion wrote: »
    Nobody is suggesting that 43% is acceptable and if you want to discuss that then fine. But we will have no more insinuations that doctors and hospitals are performing sections for financial benefit.

    Can I ask why this is a taboo question?


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    #34
    Orion
    Closed Accounts Posts: 12,807 ✭✭✭✭Orion


    Because you are implying unethical behaviour and possibly illegal collusion and that can be construed as defamation. Besides that, there has been no implication, apart from you mentioning it in a throwaway remark, that this is a potential reason for the number of sections. This is not up for negotiation on thread. If you want to discuss this further pm me or take it to Conspiracy Theories.


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    #35
    Little My
    Registered Users Posts: 364 ✭✭Little My


    Just out of interest (and this might be better in its own thread - I don't want to derail this one) but why does UCH Galway have such a good record on breastfeeding within the first hour (59.9%) but such a low rate of exclusively breastfeeding on discharge (31.7%).

    Basically roughly half of all mothers who start breastfeeding are exclusively breastfeeding when leaving hospital?

    The thing that concerns me is that I am having my baby there in a few weeks - and have heard from friends who have just had babies that they really had to fight to continue breastfeeding.

    My friend specifically said that the nurses will try and force you to give your baby a bottle and you really have to be firm if its not what you want.

    She said she found it really hard as she was vulnerable, tired, her baby was crying and that she really felt backed into a corner over the whole thing. She went on to breastfeed for 6 weeks and then changed to bottle - and said that if she had of got more support to begin with she would probably still be breastfeeding.


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    #36
    Babyblessed
    Registered Users Posts: 229 ✭✭Babyblessed


    embee wrote: »
    Of course, liliq. Any procedure has to be done only after consent is given by the woman. If you say you don't want it, they can't do it.
    embee wrote: »
    SanFran,

    With the greatest of respect, please do not talk to me as though I haven't a clue what I'm on about. I'm a student midwife, there is little currency in helpfully directing me to AIMS Ireland. Do you seriously think I haven't read any of the AIMS reports or findings? My point about consent is that, in my experience, I have never seen a woman having a procedure carried out without her consent. It is always expressly stated that she needs to consent to it (or not). I don't believe that procedures being carried out without consent is a widely spread situation, not by a long shot.

    Of course, I'm only going on what I've seen. I'm a student midwife, not a qualified one, so I'm learning on the job. I would hope that in my practice I act as an advocate for womens wishes, no matter what my own beliefs are. We can all hold very strong views but as midwives we're there to be with the woman. Scaring women with all sorts of horror stories is not the sort of midwife that I want to be.

    Just realised I have 2 of embees comments on the multi-quote..... in answer....... I cant believe you havent seen women who have cried when ve's are done and said the doc is hurting?? Thats not informed consent, thats removed consent. How many women get synt/epidurals/etc and arent told the *bad* side effects? Or women that come in at 40 weeks and have ve's and are told, 'while I was there I did a sweep, hopefully it will get things going'...... I have felt I couldnt act as a proper advocate because I felt intimidated, God only knows what the women thought because they were convinced it was neccessary.
    Orion wrote: »
    Can someone point me in the direction of the number of births in Ireland in 2009? I think it was over 75000. Of that 75000, 367 people responded on a survey being held by a site which is already dissatisfied with maternity services. These basic premises already prejudice the independance and reliability of this survey and any other survey on that site. I do not doubt the sincerity of the operators of the site but their 'surveys' are compromised by this.

    I have some serious reservations about your approach to this topic. Can you point to a single, objectively reported, case in Ireland where consent was not sought for a medical procedure during pregnancy? The Kilkenny People article does not imply that. Without some actual proof (not tabloid articles) I will insist that you desist with your scaremongering on this issue and in this forum. This forum is here to support pregnant women - not to scare them.

    You may consider this a mod warning.

    The AIMS survey was only women who responded.
    The latest Cuidui information was from stats handed over by the hospitals about their own figures.
    The only questions might be how the hospitals collated their figures and why some declined to hand them over.........so much for freedom of information.
    Little My wrote: »
    Just out of interest (and this might be better in its own thread - I don't want to derail this one) but why does UCH Galway have such a good record on breastfeeding within the first hour (59.9%) but such a low rate of exclusively breastfeeding on discharge (31.7%).

    Basically roughly half of all mothers who start breastfeeding are exclusively breastfeeding when leaving hospital?

    The thing that concerns me is that I am having my baby there in a few weeks - and have heard from friends who have just had babies that they really had to fight to continue breastfeeding.

    My friend specifically said that the nurses will try and force you to give your baby a bottle and you really have to be firm if its not what you want.

    She said she found it really hard as she was vulnerable, tired, her baby was crying and that she really felt backed into a corner over the whole thing. She went on to breastfeed for 6 weeks and then changed to bottle - and said that if she had of got more support to begin with she would probably still be breastfeeding.

    Sadly this seems to be common. BF babies dont generally follow a 'routine' in the 1st few weeks. They feed on demand. This might mean they feed every 2 hours then go 6 hours. This doesnt go down to well in a hospital that likes to see 3-4hour feeding patterns. Be firm, demand skin-2-skin immediately after birth, then feed on LW. On the ward keep yourself well hydrated and feed as much as poss, go home as soon as you feel able and get in contact with LLL or another bf specialist to get support. Good luck, oh and ensure your birthing partner is supportive and will stand your ground so to speak!


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    #37
    embee
    Registered Users Posts: 2,890 ✭✭✭embee


    Look folks, don't start attacking me. I've only said what I've seen in my experience so far. Stop talking to me as though I'm an idiot - I'm far from it but will not be drawn into this any further.


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    #38
    Babyblessed
    Registered Users Posts: 229 ✭✭Babyblessed


    embee wrote: »
    Look folks, don't start attacking me. I've only said what I've seen in my experience so far. Stop talking to me as though I'm an idiot - I'm far from it but will not be drawn into this any further.

    embee, NO-ONE is suggesting you are an idiot. However your experience is not everyone elses. I am a tad jealous if what you have see thoughout your training is completely 'with woman' and family focused. For most of us its not.


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    #39
    Orion
    Closed Accounts Posts: 12,807 ✭✭✭✭Orion


    Mod response
    Babyblessed wrote: »
    Just realised I have 2 of embees comments on the multi-quote..... in answer....... I cant believe you havent seen women who have cried when ve's are done and said the doc is hurting??

    You should be able to make your point without drawing on anything embee has seen or not seen. Do not get personal with any poster, mod or otherwise, on this forum.
    Babyblessed wrote:
    ... How many women get synt/epidurals/etc and arent told the *bad* side effects? Or women that come in at 40 weeks and have ve's and are told, 'while I was there I did a sweep, hopefully it will get things ...
    Would you care to answer your own questions? How many? These type of comments actually reduce your argument rather than adding to it.


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    #40
    Babyblessed
    Registered Users Posts: 229 ✭✭Babyblessed


    Orion wrote: »
    Mod response


    You should be able to make your point without drawing on anything embee has seen or not seen. Do not get personal with any poster, mod or otherwise, on this forum.


    Would you care to answer your own questions? How many? These type of comments actually reduce your argument rather than adding to it.


    There was NO 'getting personal', it was an observation. Once I had chance to realise I had requoted someone twice, I simply stated it. Is embee a mod? Gotta say I look at the comments rather than the poster and I comment on the post rather than the poster.

    It was a rhetorical question. I have seen many such circumstances.

    The debate was over the massive level of CS at Kilkenny hospital, a fact not a speculation.


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    #41
    Orion
    Closed Accounts Posts: 12,807 ✭✭✭✭Orion


    Non-mod response
    Babyblessed wrote:
    Thats not informed consent, thats removed consent ... God only knows what the women thought because they were convinced it was neccessary.
    Certainly when we went through own experience certain things were not explained fully and looking back certain things would have been dealt with differently if we had some more knowledge but most prospective parents do not have the specialised knowledge that you seem to have.
    Babyblessed wrote: »
    The AIMS survey was only women who responded.
    The latest Cuidui information was from stats handed over by the hospitals about their own figures.
    The only questions might be how the hospitals collated their figures and why some declined to hand them over.........so much for freedom of information.
    The AIMS survey is invalid imo based on the premises I mentioned earlier. You cannot compare the two at all. They have different collection methods, different sources and different starting points. How was the information requested? I cannot find on the site what the requests for information were. It is possible that the hospitals did not have the information in the format requested. While there should be common recording structure for just this reason this is not the case and must be reflected in the report.
    Babyblessed wrote: »
    Sadly this seems to be common. BF babies dont generally follow a 'routine' in the 1st few weeks. They feed on demand. This might mean they feed every 2 hours then go 6 hours. This doesnt go down to well in a hospital that likes to see 3-4hour feeding patterns. Be firm, demand skin-2-skin immediately after birth, then feed on LW. On the ward keep yourself well hydrated and feed as much as poss, go home as soon as you feel able and get in contact with LLL or another bf specialist to get support. Good luck, oh and ensure your birthing partner is supportive and will stand your ground so to speak!
    We had the twins in Holles St and it was immediate skin-to-skin. They actively encouraged breast feeding also at whatever routine was necessary. I would hope that would be the norm. The health benefits gained from natural feeding is immense and I've never spoken to a nurse who would recommend anything but breastfeeding.

    [mod note - I might split this particular discussion out into it's own thread.]


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    #42
    Babyblessed
    Registered Users Posts: 229 ✭✭Babyblessed


    NB...........
    Orion, nowhere in your title it says your a 'mod'. Like I say I rarely look, I comment on the post not the poster.


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    #43
    Orion
    Closed Accounts Posts: 12,807 ✭✭✭✭Orion


    Babyblessed wrote: »
    Gotta say I look at the comments rather than the poster and I comment on the post rather than the poster.
    If that's the case then fine. It read differently but I'm happy with that clarification. :)


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    #44
    LegacyUser
    Registered Users Posts: 166,026 ✭✭✭✭LegacyUser


    It is great that AIMS give women who have had difficult experiences a voice. Also advancing MLU's is a very worthy cause. It's good to have someone advocating for more choice.

    But shouldn't AIMS be able to advance the issues on their own merit and choice, than questioning other perspectives like obs led care, section rates etc. Surely, the focus should be choice for mothers, and not setting one care setting against another?

    It would worry me that by being so negative about other methods that choice or access to these could be removed? Wouldn't it be terrible if women had reduced access to 'medicalised birth' such as epidurals, pain relief and sections because of a dominance of one perspective- isn't that what AIMS is fighting at the moment ironically?
    It may not be what is happening at the moment, but I am aware that there are more radical advocates who would move the whole system towards a natural birth centering than a choice based centre for everyone.


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    #45
    Hannibal Smith
    Closed Accounts Posts: 3,893 ✭✭✭Hannibal Smith


    Little My wrote: »
    Just out of interest (and this might be better in its own thread - I don't want to derail this one) but why does UCH Galway have such a good record on breastfeeding within the first hour (59.9%) but such a low rate of exclusively breastfeeding on discharge (31.7%).

    Basically roughly half of all mothers who start breastfeeding are exclusively breastfeeding when leaving hospital?

    The thing that concerns me is that I am having my baby there in a few weeks - and have heard from friends who have just had babies that they really had to fight to continue breastfeeding.

    My friend specifically said that the nurses will try and force you to give your baby a bottle and you really have to be firm if its not what you want.

    She said she found it really hard as she was vulnerable, tired, her baby was crying and that she really felt backed into a corner over the whole thing. She went on to breastfeed for 6 weeks and then changed to bottle - and said that if she had of got more support to begin with she would probably still be breastfeeding.

    Holles Street are almost intrusive with their breastfeeding policy :D If you have a normal birth you get skin to skin straight away, if you get a c section, as soon as you're brought out of recovery, you get skin to skin, and they're almost hopping on you trying to get the baby to latch on :D:D If the baby latches on and is fine, you continue as you are. If the baby isn't latching on and therefore isn't feeding, you can consider giving them preprepared stuff, though it's not advisable because apparently the different sucking actions required confuses them. Unfortunately my lad, never latched on and then was formula fed, topped up with expressed milk.

    The only thing I would say is (1) read up on breastfeeding and what is involved, it's not just a case of putting your baby up to you and away you go, it is tough to get started. (2) When you're in there, don't wait for the nurses to help you, especially if it doesn't work straight away, try try and try again with yourself and baby, until you get there.

    I hope there's something of assistance to you in all that waffle :D


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    #46
    Raybells
    Registered Users Posts: 2 ✭Raybells


    I had my baby in cumh and had decided to breastfeed, unfortunately I had not researchd enough and on the first night when DD was feeding constantly I was told she probably wasnt getting enough and was given a bottle of formula. I luckily received fantastic advice from a breastfeeding forum once I came home and dropped the formula and DD has been ebf since
    For many others though the introduction of formula in hospital is the beginning of the end for breastfeeding


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    #47
    SanFran07
    Registered Users Posts: 230 ✭✭SanFran07


    Happybirth wrote: »
    Wouldn't it be terrible if women had reduced access to 'medicalised birth' such as epidurals, pain relief and sections because of a dominance of one perspective- isn't that what AIMS is fighting at the moment ironically?

    It may not be what is happening at the moment, but I am aware that there are more radical advocates who would move the whole system towards a natural birth centering than a choice based centre for everyone.



    From another perspective...

    Isn't it terrible that women have reduced access to 'natural birth' such as baths, waterbirth, no time limits etc because of a dominance of one perspective?

    Medicalised birth is the norm in Ireland as the Cuidiu statistics have shown. As far as I can see AIMS are trying to level the playing field so that Mums who prefer not to have a medicalised birth (unless necessary) have more options - other than an epidural. Choice based maternity care is exactly what AIMS are lobbying for but at the moment depending on where you live many Mums have no choice but medicalised birth. There is no fear of anyone taking epidurals away from women they do have a place in maternity care as do caesarean sections. AIMS wants choices expanded not restricted.

    Orion - the only other studies I've come across around consent in maternity services was the 2010 Trinity College collaboration with the National Disability Association and National Womens' Council. It's available on the NDA.ie site as a fairly large Word doc.


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    #48
    taz70
    Registered Users Posts: 154 ✭✭taz70


    I had my son in Holles Street and was already planning to breastfeed so availed of the advice from the lactation consultant. My son however was premature and taken to NICU and two days later was moved to Special Care. So much for an "intrusive" breastfeeding policy - they shoved formula down his throat DESPITE my insistence that he only receive milk from me directly or expressed milk. This continued for several days and caused a huge amount of distress to me. Even when I did feed him, they immediately gave him a "top up". I was so upset and angry at this, as it was explicitly against my wishes. I was even asked to STOP breastfeeding so that the doctors could do their rounds. Seriously? You want me to stop feeding my little premmie baby? I was digusted.


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    #49
    Hannibal Smith
    Closed Accounts Posts: 3,893 ✭✭✭Hannibal Smith


    taz70 wrote: »
    I had my son in Holles Street and was already planning to breastfeed so availed of the advice from the lactation consultant. My son however was premature and taken to NICU and two days later was moved to Special Care. So much for an "intrusive" breastfeeding policy - they shoved formula down his throat DESPITE my insistence that he only receive milk from me directly or expressed milk. This continued for several days and caused a huge amount of distress to me. Even when I did feed him, they immediately gave him a "top up". I was so upset and angry at this, as it was explicitly against my wishes. I was even asked to STOP breastfeeding so that the doctors could do their rounds. Seriously? You want me to stop feeding my little premmie baby? I was digusted.

    I don't know much about how they treat premature babies, my boy was 4 weeks early, but was perfectly fine so needed no special care, other than he was cold so needed to be put in an incubator for a bit. As soon as I came out of recovery and he was out of the incubator the midwives were hopping all over me trying to get him to feed. For all the other women who were wheeled in after me, they were brought up to the ward after delivery, moved onto the bed, and they too got the same treatment as we did, straight away. There was a lactation consultant who was fantastic and with her help I actually got my boy to latch on for a good hour, and that was the only time we managed to properly feed. She even offered to call to my house after we were discharged.


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    #50
    taz70
    Registered Users Posts: 154 ✭✭taz70


    I have to agree that the lactation consultant in Holles St was spectacularly good - but even she couldn't get the midwives in NICU/Special Care to stop giving my son formula! And they couldn't explain from a clinical standpoint why giving my son an inferior, non-sterile powdered milk of another species was preferable to the milk his own mother was producing. Their only reason was that they could write down a specific amount on his chart. So great - his virgin gut is contaminated just so they can write down a number.


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    #51
    Hannibal Smith
    Closed Accounts Posts: 3,893 ✭✭✭Hannibal Smith


    taz70 wrote: »
    I have to agree that the lactation consultant in Holles St was spectacularly good - but even she couldn't get the midwives in NICU/Special Care to stop giving my son formula! And they couldn't explain from a clinical standpoint why giving my son an inferior, non-sterile powdered milk of another species was preferable to the milk his own mother was producing. Their only reason was that they could write down a specific amount on his chart. So great - his virgin gut is contaminated just so they can write down a number.

    If they had enough machines you could even have expressed it and they could have given him that instead of the formula, but those machines are like gold dust! Did you manage to bf in the end?

    I did notice though that if the bf worked for you, away you went, but if it didn't work that's when the support fell.


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    #52
    muffinob1
    Registered Users Posts: 56 ✭✭muffinob1


    embee wrote: »
    Could we please endeavour not to villianise Obstetricians? That second article is so lobsided it's about to fall in on itself. It's all about the bad things doctors are purported to have done. Yes, some doctors have a questionable bedside manner but every birth I've attended thus far where a doctor has to be involved, the doctors are very very sure to gain consent from women. In fact, the presence of the doctor in the delivery suite is not necessary in a normal, low-risk labour and birth, but that doesn't mean that we should be villifying the medical profession. There are plenty of Obs out there who do fantastic work. They save the lives of babies and women alike... that article makes doctors sound like monsters and I think we all know that that just isn't the case.



    http://www.dohc.ie/publications/pdf/salary_scales_jan10.pdf?direct=1

    A comprehensive list of the pay scales of every HSE employee as at January 2010. As you will see, they are paid a flat salary and do not get paid per procedure. It's pretty dispicable to even suggest that, to be honest.


    If this is true then please explain to me why I paid my ob privately and then he also got paid an extra 385e on top of that by vhi for performing and episiotomy? I think you may be wrong here and that they do actually get paid extra money per procedure on top of their flat fee.

    By the way my ob was excellent and I don't begrudge him the money for a second but I do think you may be wrong as this was an extra payment on top of other payments in my vhi statement of expenditure


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    #53
    muffinob1
    Registered Users Posts: 56 ✭✭muffinob1


    Also in relation to the stats that started this debate originally I delivered my 1st baby in kk and c section was never mentioned and before I had my episiotomy and vac birth it was explained to me and I did give consent. I really couldn't fault the care on the labour ward.

    The bf support was seriously lacking and it was only due to my own determination and stubborness that we managed to bf successfully. Orion I'm delighted you had such a positive bf experience with the midwives but I have to say I was offered a few "top-ups" in hospital, was given very little help with latch and then got home to have a phn obsessed with topping up with formula and baby weight. i think we really need to have some more information given to mums re the positives of bf and the obsession with topping up and giving formula has to stop. I defend every woman's right to decide how she feeds her baby but it is a scientific fact that breast milk is more appropriate for the human baby and better for their development than formula milk. It is factually incorrect to say that they are the same or equal - they are not. Formula does not give the baby immunity from illness, it is harder to digest, it causes excessive weight gain in many cases. These are FACTS and not some kind of made up tales to help promote bf, just facts


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    #54
    taz70
    Registered Users Posts: 154 ✭✭taz70


    Hannibal Smith wrote: »
    If they had enough machines you could even have expressed it and they could have given him that instead of the formula, but those machines are like gold dust! Did you manage to bf in the end?

    I did notice though that if the bf worked for you, away you went, but if it didn't work that's when the support fell.

    They did have enough machines - two mega-pumps in Special Care - and whilst I pumped and stored milk in their fridge (and breastfed), they still were more likely to reach for formula first. It did gradually change, but I felt I had to make a LOT of noise to be heard when it should have been second nature for them to support breastfeeding, particularly in a ward where the babies need extra care.

    We left the hospital breastfeeding and are still going strong 9 months on :)

    muffinob1 - you're absolutely right re the PHNs and their obsession with weight and top-ups. For the life of me I cannot understand why they think an artifical product is going to be as good as or better than the real thing! Formula is a fair enough substitute if the real thing is not available, but to even suggest that it measures up to breastmilk is just ridiculous. And for me personally, "near enough" is nowhere good enough for my child!


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    #55
    metrovelvet
    Closed Accounts Posts: 9,376 ✭✭✭metrovelvet


    taz70 wrote: »
    They did have enough machines - two mega-pumps in Special Care - and whilst I pumped and stored milk in their fridge (and breastfed), they still were more likely to reach for formula first. It did gradually change, but I felt I had to make a LOT of noise to be heard when it should have been second nature for them to support breastfeeding, particularly in a ward where the babies need extra care.

    We left the hospital breastfeeding and are still going strong 9 months on :)

    muffinob1 - you're absolutely right re the PHNs and their obsession with weight and top-ups. For the life of me I cannot understand why they think an artifical product is going to be as good as or better than the real thing! Formula is a fair enough substitute if the real thing is not available, but to even suggest that it measures up to breastmilk is just ridiculous. And for me personally, "near enough" is nowhere good enough for my child!

    I had my baby in the US and there was no pressure from the nurses to go onto formula. However, the breastfeeding consultants put so much pressure on, the whole thing was inhibiting, plus after surgery you barely have 10 minutes to yourself with nurses coming in and out its hard to relax. It was when the pediatrician came in three or four days afterwards who said there was too much weight loss and that I'd have to go to the bottle. THe machine didnt really work that much with me either.


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    #56
    Babyblessed
    Registered Users Posts: 229 ✭✭Babyblessed


    taz70 wrote: »
    I had my son in Holles Street and was already planning to breastfeed so availed of the advice from the lactation consultant. My son however was premature and taken to NICU and two days later was moved to Special Care. So much for an "intrusive" breastfeeding policy - they shoved formula down his throat DESPITE my insistence that he only receive milk from me directly or expressed milk. This continued for several days and caused a huge amount of distress to me. Even when I did feed him, they immediately gave him a "top up". I was so upset and angry at this, as it was explicitly against my wishes. I was even asked to STOP breastfeeding so that the doctors could do their rounds. Seriously? You want me to stop feeding my little premmie baby? I was digusted.


    Taz, I am appalled. My experience in NICU (not the same hospital) has been the exact opposite; Doctors who were educated and experienced in how vitally important BM is to babies but especially premmies. I am so sorry for your experience!


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    #57
    Babyblessed
    Registered Users Posts: 229 ✭✭Babyblessed


    Raybells wrote: »
    I had my baby in cumh and had decided to breastfeed, unfortunately I had not researchd enough and on the first night when DD was feeding constantly I was told she probably wasnt getting enough and was given a bottle of formula. I luckily received fantastic advice from a breastfeeding forum once I came home and dropped the formula and DD has been ebf since
    For many others though the introduction of formula in hospital is the beginning of the end for breastfeeding

    Glad you got advice in the end.. Not surprised at your hospital experience unfortunately. Well done you on EBF!!!


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    #58
    hamsterchen
    Closed Accounts Posts: 43 ✭hamsterchen


    i had my baby in rotunda and my experience with bf was rather split - i was lucky to get a fantastic midwife for the two first days /had a section/ and then it was a hit and miss. i kept on breastfeeding because i will never understand why someone would bother with bottles, sterilizing, measuring and preparing dried cows milk with some other chemicals added if you can just have your baby latched on and enjoy the contact. the biggest problem for me was the phn - if she could she'd show down the bottle my dd's throat because she felt like she wasn't putting on enough, she was jaundiced etc. i ignored her, kept on feeding and my dd's weight has always been the top of charts which are actually for formula fed babies.
    as for section - i had it and i think the decision to do it wasn't taken lightly. combination of placenta previa, baby in breech position and being quite big, i'm glad i didn't have to go through labour with several risk factors for my child.


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    #59
    Cat Melodeon
    Registered Users Posts: 1,617 ✭✭✭Cat Melodeon


    I think the work of the likes of AIMS and Cuidiu are essential in raising awareness about the lack of choice most women face in the maternity services. Perhaps people who live in well-serviced areas are not aware of the utter inevitability of a medicalised birth for many women in Ireland. Here in rural Tipp, I have one choice only, consultant-led hospital based care. No home births, no midwife-led clinics, no water births, not even a shower available for use during labour. Facilities may vary from hospital to hospital, but for most of us there is no choice.

    In my opinion and experience, choice and consent must also be factors in the high rate of c-sections in hospitals like Kilkenny. Pregnancies seem to be managed according to statistics rather than to the individual needs of the woman/baby. Personally, I was encouraged to have sweeps from 37 weeks and was under pressure to be induced (for no valid medical reason)
    from 38 weeks. When I questioned the doctors on the procedures they were advising, rather than explain fully the pros and cons of particular procedures, I was treated with hostility and told I was endangering my baby (my own GP and regular obstetrician were happy with our progress). Women who agree to procedures in such circumstances cannot be said to have given consent or to have been presented with a choice - they may have said yes, but that yes is based on the assertiveness of the doctor rather than on any sense of having been informed by the doctor.

    In terms of the validity of the AIMS report, I think it plays a significant role in raising awareness that the maternity services we have at present are far from ideal. They may of course be biased but they still reflect the experiences of real women and real concerns. Those concerns are not always recorded in hospital statistics. The notes in medical files do not always correlate to a person's experiences in hospital, so while reports like those from Cuidiu (based on HSE-released data) may be more comprehensive, the data they are based on is not always a reliable source - doctors and nurses may also be subjective in how forms are filled and incidents recorded. Certainly a number of incidents over the course of my own care were not recorded. The notes from my sister's first labour reads like a fiction compared to her actual experience. The Office of the Ombudsman deals with an increasing number of cases every year linked to maladministration alone (such as care being compromised due to lack of detail or false information in patient files), so data emanating from the hospitals themselves cannot be seen as independent or unprejudiced any more than that collected by an organisation like AIMS can.


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    #60
    SanFran07
    Registered Users Posts: 230 ✭✭SanFran07


    Just back to the original topic.



    http://www.esri.ie/publications/latest_publications/view/index.xml?id=2822

    A paper published in August 2009 by the Economic and Social Research Institute, Recent Trends in the Caesarean Section Rate in Ireland 1999-2006, documented a 25.5% cesarean rate in Ireland as of 2006 and found that “at least half of the rise in c-section rates is due to changes in physician behaviour’ not older mothers or other risk factors.”


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    #61
    Hannibal Smith
    Closed Accounts Posts: 3,893 ✭✭✭Hannibal Smith


    SanFran07 wrote: »
    Just back to the original topic.



    http://www.esri.ie/publications/latest_publications/view/index.xml?id=2822

    A paper published in August 2009 by the Economic and Social Research Institute, Recent Trends in the Caesarean Section Rate in Ireland 1999-2006, documented a 25.5% cesarean rate in Ireland as of 2006 and found that “at least half of the rise in c-section rates is due to changes in physician behaviour’ not older mothers or other risk factors.”

    In the case of Ireland, Farah et al. (2003) suggest six possible reasons for the increased caesarean section rates. These include, fear of malpractice litigation; increase use of electronic fetal monitoring with a high false positive detection of fetal hypoxia; increased expectation of the parents and past experience; decreased tolerance of possible bad outcomes; convenience both for the mother and physician; and damage to the pelvic floor with subsequent urinary and faecal incontinence.

    ^^^ that's what the report gives as the reasons behind changes in physician behaviour, which seem reasonable to me? :confused:


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