Join us in Challenging Maternity Bill which breeches women's rights!

national | rights, freedoms and repression | press release Friday January 14, 2011 12:58 by AIMS IRELAND - The Association for Improvements in Maternity Services Ireland (AIMS Ireland) chair at aimsireland dot com

14 Reasons to Amend sections 24 and 40 of the Nurses and Midwives Bill

Please join AIMS Ireland, The Home Birth Association of Ireland, The Community Midwives Association, Trinity Birth Group, INMO Midwives Section, National Birth Alliance, Clare Birth Choice, The Doula Association of Ireland, and some near 4000 signatories to a petition in challenging the proposed Nurses and Midwives Bill which is set to go before the Dáil on Tuesday January 18th.

The above organisations have put forward amendments to sections 24 and 40 in order to make the Bill more inclusive of the professional autonomy of midwives and the right of women to make informed decisions in their maternity care.

Please join us in writing your local TDs, Senators, and Health spokespersons and representatives in order to push these amendments through!

Here are 14 reasons to Amend sections 24 and 40 of the Nurses and Midwives Bill:

1. The Bill fails to reflect modern midwifery legislation. Ireland lags 20 years behind in recognising and funding services provided within a midwifery model of care. New Zealand midwives secured self-regulation and state recognition as independent providers of maternity care in 1990, for example. Canadian legislation giving midwives prescribing powers, rights to order blood tests and ultrasound scans, access to specialist medical opinion and hospital privileges also recognises the midwifery model of care.

2. If Section 24 is passed as drafted, then midwives will be the only health care professionals in Ireland without the ability to govern themselves. The Bill ignores the Health and Social Care Professionals Act 2005, which gave twelve professions the power to rule themselves.

3. Midwives must be given the power to regulate their own profession, if it is to survive. Midwifery is in crisis: the shortage of midwives in the main Dublin maternity hospitals is running at around 30 per cent.

4. The Midwives Committee must be self-governing. The Bill empowers the Board to regulate indemnity, the single biggest barrier to providing midwifery services in the community. Appropriate indemnity arrangements are required to enable midwives to exercise their scope of practice to the full.

5. Strengthening the profession of midwifery would help retain midwives. The current haemorrhaging of midwives threatens the health and welfare of mothers and babies. The risk of serious adverse events in hospitals has increased significantly.

6. Developing midwifery as a profession would improve the quality of maternity care and contribute to the sustainability of the health system as a whole.

7. In making insurance compulsory for midwives but not for medical practitioners (or nurses) and copperfastening an indemnity scheme that is in itself discriminatory, the Section discriminates against all midwives, both employed and self-employed. In so doing, it appears to breach of Article 14 of the European Convention on Human Rights, which protects against discrimination, as does Article 21 of the Charter of Fundamental Rights of the European Union.

8. Underpinning Section 40 lies an invisible undercarriage of coercion aimed at controlling independent practice in the community. The Section is (invisibly) tied to a state indemnity scheme that is embedded in a restrictive state contract that significantly limits the range of services that can be provided independently by midwives in the community, regardless of their employment status. In making it unlawful to practice without indemnity in circumstances where the only insurance available derives from an oppressive state scheme, Section 40 undermines the economic rights of all midwives, by effectively stifling autonomous practice.

9. Section 40 criminalises midwives who practice outside the state’s onerous terms and conditions by setting lengthy terms of imprisonment and/or heavy fines for those who break the rules of indemnity. Self-employed midwives who feel ethically bound to continue to assist a home birth mother whose labour does not conform to insurance rules, for example, now face jail. This is an unjust, unprecedented and unwarranted level of coercive interference by the state in the exercise of an independent profession.

10. In making it unlawful for a midwife to practice without indemnity, Section 40, as drafted, makes private practice unlawful, in effect. Indemnity for independent practice is tied to a state home birth scheme. This is a serious infringement of the economic rights of all midwives, regardless of their employment status. Section 40 appears to contravene EU Directive 2005/36/EC, which guarantees the right of establishment. The right to offer services independently is a right afforded to all other health care professionals in the state.

11. In restricting the practice of self-employed midwives, Section 40, in effect, violates women’s human rights. The terms under which midwives are legally required to work are also the conditions under which women are obliged to give birth. In effectively denying large numbers of women the freedom to give birth at home, Section 40 denies them their right to respect for private life under Article 8 of the European Convention on Human Rights.

12. Section 40, in effect, conflicts with the right to self-determination in relation to medical treatment, including the right to decline certain medical interventions during labour. The European Court of Human Rights has ruled that the notion of personal autonomy is fundamental to the interpretation of Article 8 of the Convention. The section may also conflict, in effect, with the right to bodily integrity, the right not to have one's health endangered by the state.

13. Section 40 also appears to breach the right to respect for privacy by copperfastening the mandatory handover of midwifery notes to the state. In policing the rules of its home birth scheme, HSE contractually requires self-employed midwives to surrender their records, including to bureaucrats.

14. Finally, Section 40 makes private midwifery practice unlawful, in effect. In doing this, it denies tens of thousands of women the freedom to choose the midwifery model of care during pregnancy, birth and postnatally. Such a model is associated with community midwifery services, which are uncommon. The Section also denies prospective parents the choice of private midwifery services, in effect.