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June 26, 2016

Rotunda vs Rwanda

Dr Ruairi Hanley

Dr Ruairi Hanley takes issue with a recent column criticising the standard of obstetric care in Ireland and says that if the author is correct, we GPs must change our referral policies.

There are some opinions that are so nonsensical they are unlikely to ever be published. For example, one is unlikely to read in Hot Press magazine that Jedward are more talented musicians than the Rolling Stones. Similarly, only a sports journalist under the influence of hallucinogenic drugs would write that Stephen Staunton was a better footballer than Pelé.

Unfortunately, a few weeks ago an article appeared in IMT, which I believe feature a statement so ludicrous as to make the examples I have given seem rational. I am referring to Dr Juliet Bressan’s declaration that Ireland “is probably the lousiest place in the world in which to be expecting a baby” (‘Delivering her verdict on childbirth’, January 21, 2011, http://www.imt.ie/opinion/2011/01/delivering-her-verdict-on-childbirth.html). I genuinely doubt a more ridiculously inaccurate comment has ever appeared in print.

While I accept the author’s right to her opinion, I cannot allow this assertion to go unchallenged. I will begin by listing 10 countries where I suspect maternity services are somewhat inferior to those in Ireland.

I invite readers to imagine giving birth in: Somalia; Afghanistan; Rwanda; the Congo; Angola; Ethiopia; Eritrea; Liberia; Sudan; or Chad.
In the apparent opinion of Dr Bressan, none of these are quite as “lousy” as Ireland.

However, assuming Juliet is correct, I think we GPs must change our referral policies immediately. As Ireland is apparently the worst place on the planet to go through pregnancy, we should instead refer our expectant mothers to a maternity unit in downtown Mogadishu. After all, this violent kip would be a better place to go into labour than the Rotunda.

I do think, however, we need to look at the article in its context. Specifically, we must recognise that Dr Bressan has been a prominent advocate for abortion in Ireland for many years.

I have long noticed that whenever obstetrical issues are raised, some pro-choice supporters appear to lose the ability to engage in reasoned argument and instead revert to shrill proclamations that make no sense.

For the record, I remain genuinely open to persuasion on abortion, however the standard of debate from its advocates is so consistently poor that I cannot support their stance. Furthermore, I fail to see how their cause is advanced by making patently absurd statements about the standard of Irish maternity care.

I happen to know Juliet Bressan is both a nice person and a talented author of several best-selling books. In my opinion, she should consider revising her ill-judged remarks, which I feel are unworthy of her.

Now, let us move from fiction to fact. Ireland is indeed one of the safest countries in the world to have a baby. This is primarily due to decades of wonderful work carried out by Irish obstetricians, a branch of medicine in which this nation has always excelled.

In the 1960s, these wonderful doctors developed the ‘active management of labour’, which was arguably the greatest medical breakthrough this nation has ever produced. This medical model saved thousands of lives and brought Irish maternal mortality rates to among the lowest in the world.  As a result of the brilliance of Irish obstetricians, there are many healthy people walking the streets of our nation who would otherwise have died at birth. This is a fact, and the statistics that prove it are beyond dispute.

Unfortunately, in Ireland there has always existed a hard-line group of radical feminists who fundamentally despise obstetricians (who are mostly men). These people refuse to acknowledge reality and instead, egged on by doctor-hating journalists, produce vast quantities of virulent anti-medical bile.

This diatribe usually consists of ignoring the figures, highlighting rare cases of past bad practice backed up by personal anecdote, and then having a competition to see how many times Michael Neary can be mentioned in a single paragraph. No doubt they will soon be sending me hate mail.

Well, I have news for you. Ireland is one of the best places in the world to have a baby. And much as it might sicken you to accept this, many of the people responsible for this are indeed men. So get over it and move on.

Finally, there is another country that could arguably be described as the ‘lousiest’ place in the EU to go through labour — the one where the rate of perinatal death is the worst on the continent. That nation is the Netherlands, which also happens to have the highest rate of non-medical home births in Europe.

Needless to say, such awkward statistics rarely appear in any article written by a midwife. To acknowledge the Dutch death rate would be to reveal the truth that the ‘medical model’ saves lives and babies will die if it is routinely abandoned.

Of course, it is far easier to indulge prejudice and make irrational statements about Ireland than to recognise this reality.

How depressing is that?


Dr Hubie O'Connor

I would like to conclude this week by expressing my sadness at the recent passing of Dr Hubert O’Connor — distinguished obstetrician, international rugby player and author.

Hubie and I exchanged correspondence over a number of years. He was a kind and decent man who wrote one of the most wonderful historical works it has ever been my pleasure to read — The Emperor and the Irishman, an account of Napoleon and his Irish doctor, Barry O’Meara, on the island prison of St Helena.

In 2010, I had the honour of attending a lecture at the RCSI where Dr O’Connor presented his life’s work and was awarded a much-deserved medal.

Unfortunately, a matter of weeks after this happy occasion, he was to suffer a severely debilitating brain haemorrhage.

I visited Hubie at his home with two of his friends in Dublin a few weeks before he passed away. Over an enjoyable afternoon we talked about Napoleon, Ireland, our own national struggle and the return of the previously extinct bittern.

Indeed, on that day Hubie himself poignantly quoted Francis Ledwidge’s lament for Thomas McDonagh:

“He shall not hear the bittern cry,
In the wild sky, where he is lain,
Nor voices of the sweeter birds,
Above the wailing of the rain.”

There are few people I have met who were more worthy of the title of ‘a gentleman and a scholar’ than Dr Hubert S O’Connor. My deepest condolences to his family and friends.

May he rest in peace.