Author Archives: Sinéad Redmond

The political and personal landscape of choice in Ireland

Posted on April 17, 2016 by Sinéad Redmond

This piece has been previously published in print by the Workers Solidarity Movement in the magazine Common Threads. Since its publication one of the pending prosecutions in the north referenced in the piece has resulted in a conviction for a young woman for having a safe though illegal abortion using the abortion pills.

It is all but impossible, both in theory and in practice, to legally obtain an abortion on the island of Ireland, both north and south of the imaginary border that divides this island. It is completely impossible to safely and legally obtain an abortion anywhere in Ireland; the legal framework in the south specifically requires that in order to obtain an abortion without being criminalised for so doing, the woman who needs it must be ill enough to die; thus it is rendered impossible for her to be safe in access to legal abortion.

In the north, the Offences Against the Person Act dating from 1861 – over a century and a half ago – is what renders women taking control of whether or not they give birth and remain pregnant illegal. It describes abortion as ‘procuring miscarriage’, a description which is very apt for what those who need abortions in the north of Ireland today are forced to do by this archaic piece of legislation; obtain the abortion pill illegally online via organisations like Women on Web, Women Help Women, or less reputable means. It states that anyone who does this “shall be guilty of felony, and being convicted thereof shall be liable [..] to be kept in penal servitude for life”. However there was an exception made to this under the Criminal Justices Act of 1945. This Act, while it created the offence of “child destruction”, defining it as “any wilful act [that] causes a child to die before it has an existence independent of its mother” allowed that such a “destruction” could be carried out without legal penalty if one is acting in good faith to preserve the life of the “mother”.

Unlike in the south, this has been interpreted by subsequent judgements to mean not only that the woman must be on the brink of death, but also that the woman’s health was important as well. (In the south, the Supreme Court ruling on X in 1992 specifically excludes the woman’s or girl’s health from being in any way relevant to whether she is permitted to access an abortion.) In 1994 a court in the north found that this “does not relate only to some life-threatening situation. Life in this context means that physical or mental health or well-being of the mother and the doctor’s act is lawful where the continuance of the pregnancy would adversely affect the mental or physical health of the mother. The adverse effect must however be a real and serious one and there will always be a question of fact and degree whether the perceived effect of non-termination is sufficiently grave to warrant terminating the unborn child.” However it is very difficult to establish clearly the criteria under which this is deemed to be the case; on the 26th of March of this year the Northern Ireland Executive finally agreed to publish guidelines for healthcare professionals on when it is legal for women to access abortion. This was following enormous pressure on the Executive owing to a ruling from Belfast High Court in November 2015 which found that to deny abortions to women carrying pregnancies that will not survive to term, or beyond birth, or pregnant as a result of “sexual crime” was a breach of their human rights. Again, as in the south, this legislative framework ensures that a woman cannot be safe if she is unwell and endangered enough to fit the criteria of being ‘permitted’ to access a legal abortion.

Despite the obvious outdatedness of the Offences Against the Person Act of 1861, there are nonetheless not one, but two pending prosecutions in Belfast at the moment under it. One is of a woman who procured the abortion pill for her teenage daughter; subsequent to its administration they presented at a hospital in search of medical treatment, worried for the daughter’s well-being. Though details of the case are as yet unclear, it seems that a (presumably anti-choice) medical professional they encountered there felt the need to report them to the police for something that would render them open to life imprisonment. The second pending prosecution is of a woman in her twenties who obtained the abortion pill for herself and apparently for others. Again, details of her situation are unclear, but given that there is no prosecution or pursuit of any of the over 200 women from the north who have openly and deliberately incriminated themselves under their full names in repeated open letters and publications in various media as people who have needed access to the abortion pill, it seems likely that this prosecution too came about under pressure from another party.

The legal structure in the south of Ireland is the 8th amendment to the Irish constitution. It states that “The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.” The obvious afterthought of the right to life of the carrier of the foetus granted was only included in the wording after a vigorous campaign from feminist groups of the time. The referendum for its inclusion in the constitution of southern Ireland was passed in 1983 after a vitriolic debate in a referendum in which only 53% of the electorate voted. 67% of those who voted, voted for it. This means that a decision made by a mere 35% of the electorate of southern Ireland 32 years ago, none of whom are likely to be women of reproductive age today (the youngest a voter in that referendum would be now is 50), is deemed relevant and appropriate to force every person capable of becoming pregnant in the south of this island to remain that way regardless of that person’s own opinion on the matter.

The 8th amendment also strips from any pregnant woman or other person the right to consent or refuse any treatment a higher power than herself(!) may deem necessary for the foetus she carries in pregnancy. It also means that it is at the whim of a medical treating power to deny a pregnant woman potentially lifesaving medical treatment if they consider it may damage the foetus she carries, as was seen in the case of Michelle Harte. Michelle Harte was a cancer sufferer who was receiving treatment denied to her by Cork University Hospital’s “board of ethics” (what a misnomer) when she became accidentally pregnant. The same ethics board denied her, a dying woman, access to an abortion and forced her to travel to the UK while incredibly ill with cancer to obtain the healthcare she needed – an abortion. She subsequently died. A Catholic bishop sits on that ‘ethics’ board.

Since the context of choice and bodily autonomy in most public discussions, even most leftist public discussions, seems only to be understood as the choice to continue or to end a pregnancy, it is imperative to highlight that the 8th amendment is used also as a tool of coercion against women and others in continued pregnancy and during birth. The 8th amendment is regularly cited to pregnant women wishing to go against what their doctor deems to be the best for them; the phrase, “I could bring you to court if I have to, you know” is one used against pregnant and birthing women in Ireland far too often. This is explicitly stated in the HSE’s National Consent Policy, which cites the High Courts as the appropriate place to determine what can be perpetrated upon the body of a pregnant woman without her consent. Doctors, midwives and social workers are more often those doing the coercing in this scenario; it rarely goes as far as the courts, as most women when told by the social workers who arrive on their doorstep (as has happened in more than one instance) that their existing children will be taken from them into care if they continue to refuse to comply with their doctor’s vision of what is best for them, do not feel capable of struggling back when in all likelihood they will lose anyway. However there is one instance in which the High Court has been invoked, in Waterford in 2013 in the Mother A case.

The Mother A case involved Waterford Regional Hospital taking a woman, known as ‘Mother A’ by the court, to the High Court in an attempt to secure an order coercing her into a caesarean section. They took this action despite the fact that Mother A was not utterly refusing to consent to a c section; she specifically said that despite her desire to have a vaginal birth, should an emergency arise, she would consent to a section. It was not an emergency situation; the spur for the coerced c section was a foetal trace which was categorised by the person interpreting it as “non-reassuring” rather than emergency. She also wanted to delay the birth by at least 24 hours, because her partner was out of the country until then and she wanted him to not only be present at the birth but also to be able to be there to care for their older child during the period she was in hospital. Further, while the hospital insisted she was 41 weeks and 6 days pregnant, she deeply disagreed with their assessment. (It is worth highlighting at this point a similar case in Our Lady of Lourdes Hospital in Drogheda in 2003 where a woman, Therese Darcy-Lampf, was coerced into a section at 34 weeks owing to the hospital having wrongly noted her gestation after a scan, despite the fact that she pointed this out to them repeatedly. Her baby, Jessica, died shortly after being born far too early.) All very reasonable things to want; yet all things that were utterly denied her at the apparently capricious behest of an obstetrician and a hospital that stripped her of her voice and her autonomy. No judgement was handed down in this case as the woman “consented” to the caesarean section before one became necessary.

The nightmarish reality of forced caesarean sections has now been publicly enshrined not only in Irish practice by the Mother A case, but also in law and in practice by the passing of the Protection of Life During Pregnancy Act of 2013. The first draft of this bill was called the Protection of Maternal Life During Pregnancy Bill; but clearly this concept, that women should not die because we are pregnant, was deemed far too radical by the Labour-Fine Gael coalition government to pass into law and thus it was renamed to ensure that nobody reading it should become confused and think perhaps that women’s lives matter. Such confusion is however highly unlikely given the content of the Act, which requires that a suicidal woman must prove that she is suicidal to up to 6 doctors before eventually being granted a lifesaving abortion. This despite the fact that suicide is a leading cause of death during pregnancy in Ireland, and despite the fact that we are constantly being reassured through ad campaigns telling us to ‘please talk’ (talk to whom is never made clear) that mental health is in fact real health. It is only real health until it comes to pregnant women, as was made obvious by the atrocities perpetrated on Ms. Y by the medical establishment and the state in the south in 2014.

Ms. Y arrived in the south of Ireland on March 28th, 2014 as a refugee. At what is described as a “health screening”, six days later she found out she was pregnant; she made known to those performing the screening on behalf of the state that she had been raped and that she could not possibly under any circumstances have a child. She was very distressed. A nurse made an appointment for her two days later with the IFPA who informed Ms. Y that abortion is not accessible in Ireland and that travel for her “may” be difficult – as an asylum seeker travel documents and visas into and out of Ireland are time consuming, costly and difficult to obtain. The IFPA made an appointment for Ms. Y to have a dating scan and referred her to the Immigrant Council of Ireland for advice and support on travelling as a migrant. Four days later, Ms. Y had a dating scan performed and it was discovered she was 8 weeks pregnant.

At this point it would have been possible to hand her three pills and for her to have ended her own pregnancy as she wished, with minimal impact on her, minimal further violation of her bodily autonomy and integrity, and minimal pain and suffering. Three pills.

Instead, she was handed about from pillar to post, having contact with three separate NGOs as well as the HSE staff she initially encountered, and her situation appears to have slipped between the cracks of these, unnoticed by anyone except herself as with the continuation of her pregnancy her despair and hopelessness deepened. A doctor from Spirasi, one of the NGOs she had contact with, wrote to the GP of the direct provision centre she was consigned to, describing her as “having a death wish”. The GP of this centre says that the letter was not received. A co-ordinator at the ICI formed the opinion that Ms. Y might change her mind about needing an abortion based on apparently nothing whatsoever. A counsellor at the IFPA suggested adoption to her. For a further 16 weeks she was handed around and around until eventually, on the 23rd of July (almost four months after her pregnancy was first discovered and she initially declared herself utterly unable to contemplate going through with it) she had an assessment with a consultant psychiatrist who told her it was too late to have an abortion and then coerced her into being detained in a maternity hospital under constant surveillance, where she refused all food and fluids for several days.

By that time she had met a consultant obstetrician who was of the opinion, despite the fact that Ms. Y was so despairing and suicidal that she was even refusing water, “that Ms Y could be maintained on the ward for as long as possible and hopefully to 30 weeks so that the baby could be delivered appropriately.” This would have meant another 6 weeks of detention against her will; another 6 weeks of sedation against her will in order to forcibly feed and hydrate her against her will in order that her body and autonomy undergo repeated violations in order to host a pregnancy she loathed so much she would rather have died than have it in her body any longer. Instead however, as Ms. Y continued in her determination to refuse fluids, a caesarean section was carried out on her several days later; enforced major abdominal surgery also against her will.

This horrifying and traumatic ordeal inflicted upon Ms. Y was torture; state-sanctioned, state-inflicted torture, state-legalised torture. And were another Ms. Y to arrive in the south tomorrow, in the same harrowing circumstances, the state would more than likely torture her in precisely the same manner.

It is important to note here the degree to which the maternity hospitals in the south are complicit in, and even the driving forces behind the denial of basic bodily autonomy to pregnant women; both in abortion and in continued pregnancy. It is for these reasons that those of us who are involved in the pro-choice movement should be deeply wary of embracing the “masters” (the word alone should be warning) of the Dublin maternity hospitals such as Rhona Mahoney and Peter Boylan when they declare themselves to be opposed to the 8th amendment. At least one of those ‘masters’ has been known to invoke the courts in order to coerce pregnant women into interventions during their pregnancies, labour and births, and both of them are opposed to women’s choice of type of care (midwife-led or obstetrician-led) and the choice even of birth position in the case of Peter Boylan. Furthermore Peter Boylan in 2015 testified in the High Court in defence of the barbaric practice of symphysiotomies. Tempting though it is to reach for a “higher authority” in defence of our stance, these are not our allies in the struggle for women’s bodily autonomy.

However those who are our allies in this struggle are, in fact, the majority of the voting public in the south. An exit poll carried out at the general election in February of this year found that 64% of people support the repeal of the 8th amendment. This number is all the more invigorating for those of us in the trenches of this fight given the increasing vehemence of the well-funded anti-choicers over the last number of years. It’s also all the more inspiring because there’s a general misunderstanding of what the pro-choice position is in the public discourse around abortion in the south; the case is constructed as “Would you agree with and support her decision in this case?” rather than “Would you personally stop her?”, a much truer reflection of what the pro-choice stance is and means.

As the fight continues, it becomes more and more important to avoid the slippery slope of only publicly advocating and arguing for abortion access in terms of the “hard cases”, such as where the pregnancy will not survive outside the womb or in the case of survivors of rape. The majority of those who seek abortions do not fall into these categories and would be left by the wayside. Only allowing abortion access for pregnancies conceived by rape and incest would not only be impossible to legislate safely for but also makes clear that the enforcement of continuation of unwanted pregnancy because the woman chose to have sex is outright misogyny; either one believes that an embryo or foetus has rights overriding that of the person carrying it or one does not.

We own our own bodies. We are not property of any state. We can and will birth where, how, and if we choose.

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Posted in Abortion, Health, Reproduction. Bookmark the permalink.

We see you, writing us out of history. Again.

Posted on February 18, 2016 by Sinéad Redmond

The radio was on this weekend while I was in the kitchen. I was doing about seven different things at once at the time so I’m not sure what show it was or who was on it, but it was some male author or playwright or actor or some such being interviewed on it by a male presenter. The interviewee was being asked about his favourite authors and was predictably listing off Joyce and Beckett et al, and talking about taking part in a production of Waiting for Godot when younger with a listing of his male relatives and how lifechanging it all was and it suddenly occurred to me that what I was listening to was the ongoing act of removing all women writers and thinkers and playwrights and artists and dramatists and actors from the accepted list of ‘important’ work yet again.

We see it everywhere really; male bloggers and self-appointed, as well as actually appointed ‘political analysts’ only commenting and retweeting and talking to one another in their all-men’s social media echo chambers that may as well be the all-men’s exclusive social clubs of yesteryear and not even noticing that the voices of women and other not male people are missing from their conversations. It becomes particularly obvious when they start offering their (generally incredibly facile and poorly thought-out) opinions on women’s bodies, women’s health, and women’s rights as though they and their opinions were both revolutionary and also the final possible say on the matter. We see you.

We see you, men of the left who wouldn’t give up a platform to a woman even if you were paid to, suddenly proclaiming that the women of 1916 are revolutionary unsung heroes and listing all of their names and achievements; a list you have absolutely definitely lifted from the academic research of other women of today whose work you didn’t even credit in your oh-so-feminist shout-out.

We see you, men who call yourselves feminists who absolutely Never Ever even think to include a single solitary work by a woman in any of your social media listings of your absolutely favourite, groundbreaking writers, artists, social commentators, thinkers, musicians, and creators. You claim you think we’re people too; just not people with anything of import to ever say about the world.

We see you, male curators of this year’s performances in the Abbey Theatre who decided that not a single solitary play by a single solitary woman was worth including in their year long celebration of Irish theatre. Teresa Deevy‘s entire body of work was utterly forgotten by an Abbey Theatre of 1937 onwards, who found her too uncomfortably revolutionary and feminist in Dev’s Ireland; the same is happening with the women writing and directing and performing plays in Ireland of 1990 onwards as their work, our work is being overlooked and ignored all over again by the men who continue interviewing each other and deciding that each other’s work and each other’s opinions are what is canon and important and Worth Reading.

We see you, Kate O’Brien, Edna O’Brien, Nell McCafferty, Teresa Deevy, Augusta Gregory, Eva Gore-Booth, Nuala O’Faolain, Éilis Ní Dhuibhne, Jennifer Johnson, and many many others and your works being written out of history, out of the context of 20th century Ireland, and left to gather dust. We see you Rosaleen McDonagh, Belinda McKeon, Sarah Clancy, Rita Ann Higgins, and the many other vivid, radical, angry women’s voices of 21st century Ireland who are only ever treated as the ‘other’ voice, writing from the edges; never as though their narratives were a genuine and driving one, on which entire stories and entire movements could be centred.

We see you.

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Ireland: we need to drop the pretence of being a country that loves children

Posted on August 29, 2015 by Sinéad Redmond

This post discusses intensely distressing topics, among them violence against women, violence against children, child abuse, and infant and child death.

Ireland, we all need to have a good talk. You know the way we all buy into this idea that there’s a massive overarching image of ourselves presented to the world and that somehow it matches up to the reality? That we’re the friendliest country to visit in the world, and other common or garden varieties of horseshit along these lines. We’re so invested in this portrayal that to question it is nearly tantamount to treason, and other tourism destinations found to ALSO be friendly in media polls is almost cause for the mass donning of sackcloth and ashes. Well, there’s one aspect of it in particular we really need to stop hawking and face up to it just Not Being True.

We need to stop pretending to ourselves and the rest of the world that we’re a country that loves children.

It’s a longstanding lie, and one we’ve told ourselves repeatedly throughout the years. It was even the primary basis for pushing through the horrendous 8th amendment, and all the toxic fallout of that that has been inflicted on women and children, of whom Miss X, aged 14, was one, in the 32 years since 1983. It should go without saying that if we loved children, we would allow those of them who needed and wanted to access abortions to do so, rather than force those children, some of whom have been abused and raped, as Miss X was, through the rigours, hardships, and dangers of unwanted pregnancy and unwanted birth.

If we truly loved children, we wouldn’t let the most vulnerable of them suffer as we do and as we have done consistently throughout the history of our nation. Look at the Mother and Baby homes and the Magdalen Laundries, the incarcerations and starvation and deaths and beatings and shame and forced adoptions and forced family breakups that went on in those institutions for decades, with the full support of the Irish state as well as the church.

If we truly loved children, we wouldn’t still refuse to investigate properly what went on in those homes, with local historian Catherine Corless having to bang the drum alone for the nearly 800 babies and children and 5 women the Sisters of Bon Secour, funded and supported by the Irish state, left lying in unmarked graves in Tuam as though they had never mattered at all. And of course to the church and to the Irish republic, they didn’t. After first attempting to paint Catherine Corless as an incompetent amateur attempting a gross exaggeration for some malevolent entertainment of her own, the government finally, grudgingly established a body to look into this. This body, The Commission of Investigation, is a year on still dragging its heels, not even bothering to reply to Catherine Corless when she provided them with her most recent research which indicates that there are 5 mothers buried on the grounds of the Tuam Mother and Baby home along with the hundreds of tiny children’s bodies also lying in the ground there. There have been no indicators of any progress being made in a paid and funded group of over a year’s work, despite having had another person’s extensive unpaid, unfunded research handed to them on a plate. No answers, no recognition of those children’s tiny lives and appalling deaths. No acknowledgement that those babies, those children, weren’t loved by us at all.

If we truly loved children, we wouldn’t ignore the truths of the stories that the Magdalen survivors tell us, many of whom were children when they were first incarcerated in those institutions, and many of whom had children stolen from them and sold with no regard to their best interests or their need for their mothers; how we patted ourselves smugly on the backs when the McAleese report came out, trumpeting that now justice had been done, they had been heard, never bothering to ask the women themselves how they felt about it. How they felt about it for very many was abandoned, betrayed, shamed and lied about all over again by the Irish state. The report spoke over, ignored and attempted to make liars out of the survivors of the laundries, the women whose needs it should have most urgently sought to meet and whose voices it should have been required to amplify. The women whose forgiveness the Irish state should be begging on bended knees every day for as long as they live. Justice for Magdalenes – co-founded by Claire McGettrick, who tweeted on this this week – published detailed research on the serious issues with the report. A key phrase from that research is “Most concerning was the Report’s contention that a very small level of physical abuse took place in the laundries” , a contention that is in direct contradiction of the evidence of the survivors of the laundries. It’s a key pointer to how little value and worth the authors of the report put on the testimony and accounts of survivors that their words weren’t considered ‘evidence’. The Irish state cares so little about these women, their stolen children, and their feelings and needs, and yet so much about its precious reputation abroad that it will even seek to prevent the media of other countries from broadcasting the truth of the McAleese Report.

If we truly loved children, we wouldn’t stand idly and quietly by as the Minister for Social Protection – what a heinous joke of a title – inflicted savage financial cuts on children living in lone parent families who are dependent on social welfare for their income, children who are already amongst the most marginalised and at risk of poverty in the country. Joan Burton had promised to only implement these cuts to the financial supports of children over 7 if a “Scandinavian style system of childcare” was implemented – which was also in her remit to do – thus proving she was more than well aware that depriving children of 7 and older of the care of their parents by rendering it financially impossible for their mother (87% of lone parent families are headed by women) to either stay at home with them or afford to access childcare is barbaric. Yet she implemented them anyway, with no support net for these children and no apparent interest in what happens to them. If we loved children, as a country, we would never allow this to happen. It is an outrage. It is beyond a disgrace.

If we truly loved children, as we love to claim, we would see instantly that Frances Fitzgerald telling the media that Ireland’s doing ‘more than its fair share’ in taking the absolutely paltry amount of refugees in that we are, and then forcing them into the horrors of direct provision indefinitely is nothing short of repugnant. Hundreds, thousands of people are drowning in the Mediterranean in an attempt to escape from suffering and misery while Labour and Fine Gael are intent on shoring up the walls of Fortress Europe. If we cared about children at all, we would be welcoming them and their families with open arms, cheering them on in their escape, not penning and corralling those who manage to survive against the odds like animals on the border points of Europe. Not forcing them to live for years with their family in one room of a run-down, miserable ‘hotel’ with no ability to cook their own food, or enough money to even buy it, or access public transport to go anywhere – if indeed public transport is accessible from the direct provision centre we’ve incarcerated them in.

There is no such thing as a ‘fair share’ of the work to be done when the drowned bodies of babies and toddlers continue to wash up on European beaches. The fact that anyone could speak of it so is something we should all find beyond comprehension.

” you have to understand,
that no one puts their children in a boat
unless the water is safer than the land” – Warsan Shire.

If we truly loved children we would collectively remember when once it was the people living in Ireland who had to put their children on coffin ships in their hundreds of thousands, on water that was safer than the land on which they were starving, and cast themselves upon the cold mercy of an uncaring world. We would seek, urgently and desperately, to do everything within our power to prevent those horrors being inflicted on these other suffering and starving and drowning children of today. We would support this direct action group travelling with an aid convoy from Cork to the refugee camps in Calais, to alleviate the suffering and misery of those children and families and people who did survive but who are now trapped, without hope, in a Europe they hoped would be their promised land. We would campaign, furiously and energetically, arm in arm with the refugees living here to end direct provision in our own country and stop shutting our ears and eyes and mouths to the reality that incarceration of innocent suffering children is not a thing of yesteryear in today’s Ireland.

Until then, we have no right whatsoever to the claim.

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Posted in Abortion, Equality, The family. Bookmark the permalink.

Island of no consent – maternity care and bodily autonomy in Ireland

Posted on April 26, 2015 by Sinéad Redmond

This piece was previously published in the print version of the Irish Anarchist Review

On the last day of August 2014, in a ruling the country and the media barely noticed, Mr Justice Ryan in the High Court in Kerry found against Ciara Hamilton and for the HSE in an utterly terrifying moment for every person pregnant or giving birth in Ireland from here on out. Ciara Hamilton had taken a case against the Health Service Executive after the birth of her second child, during which a midwife had, without obtaining consent, broken her waters, leading to an umbilical cord prolapse and an emergency caesarean section.

The breaking of waters during labour, in medical terms amniotomy or Artificial Rupture of Membranes (ARM), is not recommended best practice precisely because it can lead to a cord prolapse, which is a serious emergency when giving birth as it cuts off the blood flow and air supply to the baby. If the person giving birth is a Strep B carrier (as Ciara Hamilton was) it can also carry an increased risk of Strep B transferring to the newborn and causing serious damage to the baby (as happened to Ciara Hamilton’s child). It is listed as a Do Not Do under NICE recommendations. Despite this, and despite ARM being known to carry dangers and risks to both birthing woman and baby, it is still a widely carried out procedure in many Irish maternity hospitals. In the case of Ciara Hamilton’s birth, it was a procedure carried out by a midwife without seeking consent to do so.

This, too, despite being obviously grossly unethical and a fundamental violation of both human rights and bodily autonomy, is something which routinely occurs in Irish maternity hospitals. In the spring of 2014, AIMS Ireland carried out a survey of those who had given birth in Ireland between 2010 and 2014. The survey was available to be filled out online, and was spread through various social media channels, as well as through media coverage. The pool of respondents was a self-selecting one, and numbered 2,836. It found that only half of all those giving birth – 50.2% of respondents – were given an opportunity to refuse tests, procedures or treatments being carried out on them. This is a truly frightening figure. What is, however, more frightening, was the wording of Mr Justice Ryan’s finding against Ciara Hamilton.

“Mrs Hamilton would have seen the hook and would have known what was going to happen because of the sheet that was put under her in bed. Since, on the evidence, this was a routine procedure that Ms Kelliher was carrying out for the purpose of diagnosis to see if her fear of foetal distress was justified or not, it does seem strange that she would not have mentioned to the patient what she was going to do and have obtained her consent. The very fact that it was so routine suggests that the midwife would have done so. I am satisfied that the probability is that Midwife Kelliher obtained the plaintiff’s consent and informed her about the ARM that she was going to perform.”

What the judge has here concluded is that the midwife obtained consent because she should have done so – and that a woman giving birth who had consented only to a vaginal examination, NOT an ARM, should have known that ARM would have happened because of the presence of an amnihook and a sheet. This is a truly bizarre conclusion. Why would a person giving birth be assumed to be able to identify an amnihook – a specialised piece of medical equipment – and further be assumed to know that it would mean an ARM would be carried out on them without having been consulted or informed about the risks and benefits of the procedure? Again, this judge with no evidence to prove this assumption – and indeed the more recently published evidence from AIMS shows that not giving women a chance to refuse procedures is a large part of normal practice – asserts that a health care provider would have obtained consent because they should have done so, with no onus on the healthcare provider to prove evidence of informed consent being obtained. The fact that Ciara Hamilton testified to the fact that she was not given an opportunity to consent to an amniotomy is not even mentioned by the judge in this decision. Even more disturbingly, he goes on to say:

“The patient’s co-operation was needed in terms of re-positioning on the bed, the procedure might take some time and the implement was quite long, so it is not something that a person would or could do without the knowledge of the patient. The plaintiff got into position, was co-operative and consented to the vaginal examination. Ms Kelliher used a hook and gel and of course surgical gloves. She put a sheet under the plaintiff and got her to move down in the bed and discussed with the plaintiff what she was going to do. Midwife Kelliher said that she “would have discussed”, but in my view that was a matter of usage and she clarified that she actually meant, not that she would have in the sense of describing a practice in a conditional sense, but that she did with Mrs Hamilton.”

Mr Justice Ryan is here saying that Ciara Hamilton positioned herself in such a way as to consent to an ARM. She consented to the vaginal examination and moved down the bed. Is this really so different from the “short skirt” argument put before courts in trials of other forms of violation of women’s bodies? Yet again, with no proof, he asserts that an ARM could not be carried out without the knowledge of the person giving birth, despite the evidence of a woman who had undergone it that indeed it had been. AIMS Ireland has heard from many, many more women around the country who have had nonconsensual amniotomies – and indeed many other procedures – performed without their knowledge. This is a far from rare occurrence; yet the voice of the woman upon whose body this was perpetrated is once again, in the arena she sought redress for her exclusion from the decisions being made about her body and her birth, being spoken over, ignored, and deemed uninformed, inconsequential, and irrelevant.

But by far the most frightening aspect of all in this case is that, despite clearly stating in his ruling that Ciara Hamilton had “underwent a frightening and disturbing experience that would leave long term troubling recollections”, Mr Justice Ryan punitively awarded the full costs of the HSE’s defence against her and her family. This was unarguably a move designed to discourage other women and people who have experienced violations of their consent during pregnancy and birth from pursuing legal action against those responsible. A move meant to punish a woman and her family who did dare to speak up against the unacceptable, indefensible treatment AIMS Ireland hear of in Irish maternity wards all too often, and whose experiences, as before during their birth, were once again ignored by the State and its enforcers, quite literally judged to be meaningless. The truth of what happened to Ciara Hamilton and her recounting of it and its consequences for her and her son was callously dismissed by a judge who simply refused to believe it because he thought it shouldn’t happen.

What this ruling means is that it is now legally not a requirement for any Irish maternity ward or healthcare provider to prove either that a procedure is necessary for the person giving birth or the baby they’re giving birth to, or that they obtained informed consent from the person giving birth to carry out that procedure. In a country in which pregnant women are specifically excluded from the HSE’s National Consent Policy as being the final arbiter of what happens to their own bodies, with the High Court cited instead as the appropriate decision maker for these cases, this ruling is a further reminder to anyone with a uterus that if they are, or if they should become pregnant, they are no longer in control of their own body. They are lesser; they do not own themselves. Instead the State owns them.

This, of course, is in part a consequence of the 8th amendment; but it’s also in part a consequence of a larger prevailing attitude in maternity care in Ireland, that women in general and specifically women who are pregnant and giving birth are not trustworthy decision makers and cannot be allowed to make choices around their pregnancies and births as they cannot be trusted to be concerned with a safe outcome for their baby. This is bizarrely at odds with the State and HSE attitude to those who have given birth; they become at once the only possible caretaker for that child, not in need of any support or care in so doing, left entirely alone to do so with no formalised system of support around them even when they look for the assistance of one. Again, Ciara Hamilton and her family are an example of this; a family who need specialised supports for their son, damaged due to the poor management of his birth, they live in a state that will do its utmost to avoid shouldering the cost of it and avoid recognising Ciara Hamilton’s son as a valued member of our society who should be provided with all that he needs in order to allow him to participate in that society in a just and equal way. Now both they and he have been further punished for their attempt to right that balance and address the wrong done to him and his mother during their birth. For a family to be faced with the crippling financial burden that is the HSE’s extravagant legal costs of defending a birth claim will further deepen the gap between what their child needs and what they can afford to give him. Their situation is a haunting and horrific one that should never have been allowed to happen, and in many other jurisdictions never would have.

Contrasting the judgement in the Hamilton vs HSE case with a recent UK Supreme Court judgement, Montgomery v Lanarkshire Health Board, is an exercise designed to induce both heartbreak for the Hamiltons and rage on behalf of all pregnant women in Ireland. In this ruling, the Supreme Court held there exists for those giving birth an explicit right to information about ‘any material risk‘ in order for them to make fully informed decisions on the process; without this information being provided, informed consent cannot be said to have been given. In this instance, Nadine Montgomery was pregnant, diabetic, carrying a large foetus and was not informed by her doctor of her increased risk of shoulder dystocia, which is, in the words of an expert witness of the case, “a major obstetric emergency associated with a short and long term neonatal and maternal morbidity [and] an associated neonatal mortality”. She did indeed experience a shoulder dystocia during birth, which was a horrendously traumatic experience for her and caused severe long term brain damage to her son.

Despite the fact that Nadine Montgomery had repeatedly expressed concerns about giving birth vaginally, her doctor said that she as a matter of course chose not to explain the risk of shoulder dystocia to diabetic women because the risk of serious injury to the baby was very small and that if she did, “then everyone would ask for a caesarean section”. The doctor makes no mention of the risk to women’s health and wellbeing of shoulder dystocia in her decision making.

A key and obvious difference here between the Montgomery case and the Hamilton case already is that the very concept of explaining risk of interventions, or of not performing interventions, to women is discussed at all in the Montgomery case. It does not appear at all in the Hamilton vs. HSE judgement. Given Mr Justice Ryan’s discussion of how Ciara Hamilton was treated it is probably safe to assume that informed consent is completely outside his frame of reference – again, a terrible but unsurprising indictment of the Irish maternity system as well as the Irish court system. The idea of informed consent literally does not make any showing here. Extensive discussion of the idea of informing women and how that should best be performed by healthcare providers takes place in the Montgomery case and yet the Hamilton judgement does not mention this concept even once.

In stark contrast, not only was the concept of informed consent discussed at length during the hearing of the Montgomery case itself, but it is also given a strong legal definition and set of requirements in the ruling itself.

“An adult person of sound mind is entitled to decide which, if any, of the available forms of treatment to undergo, and her consent must be obtained before treatment interfering with her bodily integrity is undertaken. The doctor is therefore under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. The test of materiality is whether, in the circumstances of the particular case, a reasonable person in the patient’s position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it.”

The final and deepest cut of bitter envy from the Montgomery judgement to those of us in Ireland forced into the maternity system here, comes from Lady Hale’s part of the judgement, thus making it case law in the UK from the highest court in the land. It is as follows:

“In this day and age, we are not only concerned about risks to the baby. We are equally, if not more, concerned about risks to the mother. And those include the risks associated with giving birth, as well as any aftereffects. One of the problems in this case was that for too long the focus was on the risks to the baby, without also taking into account what the mother might face in the process of giving birth.”

Could any paragraph and context more succinctly highlight the appalling gap between the treatment of pregnant women in Ireland and the expected sheer basics of human rights of pregnant women elsewhere in the world?

For more on this see AIMS Ireland – www.aimsireland.ie, also on Facebook and Twitter.

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Posted in Health, Reproduction. Bookmark the permalink.

Parental (and paternity) leave is a feminist issue

Posted on December 20, 2014 by Sinéad Redmond

The Irish Times this week, followed en masse by other papers and mainstream media outlets, breathlessly rushed to report that 2 Irish MEPs were the MEPs with the worst record of attendance at voting sessions of the European Parliament in Strasbourg. What they didn’t manage to initially include in the story, and which transpired over the course of the day that the story broke, was that one of the MEPs (Brian Crowley) has been unable to attend at all as he’s ill, and that the other, Luke ‘Ming’ Flanagan, has needed to be at home with his wife, newborn baby, and other children. His wife has also been ill, in addition to having all the intensive, non-stop demands of a newborn to contend with. As at the time of writing, the Irish Times has run four separate follow-up pieces by Suzanne Lynch, all focusing on Ming’s ‘dismal voting record’, how he should suffer financially for it, and should Irish MEPs (and by obvious inference Ming) have even bothered to run at all if they were going to let down the electorate like that by non-attendance through having the nerve to have babies and families that need caring for? In one piece, Lynch attempted a mealy-mouthed pretence at recognising the fact that Ming was at home, caring for his unwell wife and their newborn baby as well as their other children, calling this ‘mitigating circumstances’, claiming that “[n]o one is suggesting [his need to take paternity leave] should elicit anything less than complete empathy” while immediately following this up by suggesting that his low attendance “while drawing full salaries raises the question as to whether Ireland’s MEP system is fit for purpose.”

No, actually, that’s exactly how parental and paternity leave systems SHOULD work. Nobody should be financially penalised for having a baby. (This is not a conversation about whether people who are supposed to be representing the public should be paid as much more than the majority of that public than they are, though that’s a conversation worth having too.) Nobody should be forced to attend their workplace immediately after the birth of a child for fear of losing their job – or indeed, as in the Irish system and in this instance, depending on the time of the birth, DURING the birth of a child. (In Ireland, because there is no entitlement whatsoever to paternal leave, new fathers are reliant on their holiday leave and employer’s vagaries to be able to be present at the birth of their children should that birth be during working hours, as well as to be home with their partner and newborn in the time after the birth.) Nobody should have their absence from their job as the result of the birth of a child and needing to be at home to care for that child, their unwell partner, and their other children reported in the national media and the subject of this kind of intense and judgemental scrutiny. No man should be expected to abandon his sick partner for her to provide alone the kind of intensively demanding all-around-the-clock care that a newborn provides, in order to show up at a place of work. And certainly no sick woman should be left alone to care for a newborn without the support she has a right to expect from her partner in creating that newborn, as well as support in caring for herself and her other children. What kind of barbaric social system would demand that?

Only, of course, the one we live under; a horrible combination of capitalism and patriarchy, which holds ‘work’ (meaning, of course, paid work, done outside the home, not something as petty and gendered as simply bringing a child into the world, caring for its every need, raising it as a moral being and seeing to its needs around the clock) as supreme; as an unquestionable overlord to be served without regard to personal needs and circumstances. “Doing your job”, in this paradigm, is paramount, and excuses everything from the actual killing of another human being to being expected to abandon one’s partner, the person one is assumed to love and honour above all others, to the 24/7 backbreaking work of caring for a house full of children (one a newborn) alone. And sure if you’re paid enough can you not just pay someone else to do that caring nonsense for you?

At no point in any of this coverage has the fact been mentioned that no Irish political representative – whether at local government level, at national level, or European level – has ANY right to any parental leave, whether that be paternity or maternity leave. It took Nessa Childers on Twitter to do that first. Nor did any of the coverage point out that while it’s “only one session a month” (as many on Twitter appeared to enjoy very much repeating), that “one session a month” extends to four consecutive days, and there are no direct flights between Dublin and Strasbourg, meaning this “one session” could very well in fact have demanded a full week every month away from Ming’s wife, newborn baby and other children. Even if his wife weren’t unwell, this would be an utterly unreasonable burden of care to lay on a woman who has just become a mother all over again. The blanket and unquestioning expectation apparent in not only the mainstream media coverage, but also the majority of the Twitter commentary on this, that if she weren’t sick (and in some cases that even though she is; and in yet some more, even more deplorable ones, that somehow they have the right to know HOW sick she is, and why, and since when, and why didn’t they know earlier), that he should have abandoned her, their newborn, and their other children, to the almighty power that is Work, is frankly sickening. A father should have the right to be with his newborn, just as a mother should have the right to not be the enforced sole, isolated carer of her newborn simply because its father needs to worship at the altar of Work. One of the most telling things of the coverage of this whole (non) issue is that there hasn’t been a single piece which can point to any of the votes he missed and name it as a topical one, as one that’s relevant to Ireland’s interests, or indeed one of those missed votes of his as having had any possible impact on the outcome if he had attended. Why isn’t that what’s being questioned as being a broken political representation system, rather than his having needed to take time to be with his family?

It is not possible to expect to see, and argue for, women’s participation in politics and public life rising from its current dismally low level, while also creating a society which excoriates men for taking up their part of the caring responsibilities that having a family entails. Perpetuating the idea and the necessity that only women can have space to do that not only condemns women to unpaid work in the home but also does not allow for space to honour that work; which has the potential to be beautiful, rewarding, and thoroughly worth doing. The work of caring for and raising a child is every bit as important to society, if not more so, than paid attendance at a workplace.

Sometimes people with babies need to be with those babies. Sometimes people with sick partners need to be with those sick partners because that’s what a partnership looks like. (It’s definitely what my partnership with my husband looked like when I was having an absolutely hideous time after our daughter was born, suffering from intense and unexpected postnatal depression, and would absolutely fall apart when he needed to be out of the house for even an hour, let alone travelling to another country for a full week.) No society that is worth living in should seek to punish or castigate its members for so doing.

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Posted in capitalism, Equality, feminism, Politics, The family. Bookmark the permalink.