Doctor contrasts births at Portlaoise hospital and the Coombe in Dublin

Expectations of women who attend Portlaoise are very different but their ‘normal’ outcomes are better

Conor Ganly


Conor Ganly


Doctors in Laois set out their vision for the future of the Midlands Regional Hospital Portlaoise

Very few women who attend Portlaoise hospital to have babies have birth plans while the number of spontaneous births is higher in Portlaoise than its sister hospital the Coombe.

Consultant obstetrician and gynaecologist Dr Aoife Mullally also said that an increasing number of “over anxious, middle-class mothers” have unrealistic expectations of having “perfect births”.

Dr Mullally practises at the Coombe Women’s and Infants Hospital in Dublin and the Midland Regional Hospital Portlaoise Hospital. She spoke at a Medico Legal healthcare conference in Dublin last week which was chaired by Laois native Claire Byrne. 

The conference was supported by La Touche Training, Irish Times and the Association for Improvements in Maternity Services Ireland AIMS Ireland.

The doctor, who specialises in labour ward services, noted the difference between the Dublin and Laois hospitals which were made part of a network after the deaths of babies in Portlaoise.

"Most women in the Coombe have a birth plan. Very few in Portlaoise have birth plans, and the spontaneous births are higher in Portlaoise. Their expectations are very different and yet their ‘normal’ outcomes are better. It may have something to do with the age differences,” she said an Irish Times report.

Dr Mullally also said the average age of women attending Portlaoise maternity services was younger.

She contrasted the approach of women coming to both hospitals. Despite Portlaoise's problems she indicated that women are presenting with less preconceptions of what should happen than women who attended the large Coombe hospital.

She said there is anxiety among many women about not having epidurals, C-sections or being induced. She claimed women were “disappointed” if they had any of these while going home with a healthy baby and healthy themselves.

“As feminists we need to change the narrative around maternity care in Ireland, around fighting for equal access to all services for all women, around improving morale, recruitment and retention, and supporting healthcare professionals in the aftermath of adverse events,” she said.

Dr Mullally claimed the idealistic not intervention view of birth was an “elitist” view. She said it was as valid a birth whether the mother chose an epidural, a C-section, or a birthing pool.

“Women put huge pressure on each other and themselves. There is a mismatch in expectation...Natural birth is a philosophy that assumes economic security, ready access to medical technology and the leisure to construct an ‘identity’. It is about the mother and how she would like to see herself, not about childbirth and not about babies,” she said.

Dr Mullally said everyone would “know the women because we’ve all had them” who “think they are the only woman who’s ever given birth and they certainly think they are the only woman giving birth in the labour ward that day”.

She quoted American obstetrician Amy Teuter, she said: “For many women the birth experience has acquired a similar status to one’s wedding day – over privileged, over-anxious middle-class ‘birthzillas’ harassing well-meaning hospital staff with unrealistic birth plans, all the while egged on by ill-informed, overpaid midwives and doulas.”

She said feminists should be fighting for safe, affordable maternity services for all women.

“You can only refuse an epidural when an epidural is available,” she said.

Dr Mullally's biog for the conference said her special interest is the managment of high risk labour and birth, early pregnancy complications and adolescent gynaecology. It also said she is a advocate for improvement of maternity services and woman-centred healthcare.