Developments in the northeast have led to the most significant shift in maternity policy in the State in more than 50 years with the emphasis for the first time on the mother as consumer, a conference heard at the weekend.
A senior lecturer in social policy at University College Dublin, Patricia Kennedy, said an innovative woman-centred maternity service was emerging in the northeast, a region which has been rocked in recent years by the Michael Neary scandal and the closure of maternity units in Monaghan and Dundalk.
"In the past 50 years, maternity services in Ireland have consistently become more medicalised and hospital-based. This pattern has accelerated since the 1970s with the focus steadily shifting from the needs of the mother as consumer, to the needs and demands of busy obstetricians working in increasingly technology-dominated maternity units," Ms Kennedy said.
However, she pointed out that in recent years, there had been a small step in the direction of providing domino care and, in very particular situations, domiciliary care.
Ms Kennedy was speaking at a conference on Mothering in Contemporary Ireland: Issues, Images and Actions which was hosted by the Board of Women's Studies at University College Cork.
An Irish branch of the Association for Research on Mothering (Arm) was launched at the conference.
In May 2001, the Maternity Services Review Group was established under the chairmanship of Patrick Kinder. Among the recommendations of the Kinder report was the establishment of midwifery-led units (MLUs) in Cavan and Drogheda.
"The midwifery-led units involve the provision of antenatal, intrapartum and postnatal care to women defined as low risk, the provision of midwifery services in the community and the establishment of a region-wide consumer committee for maternity and childcare services," explained Ms Kennedy.
A pilot midwifery-led service, which was introduced in the North Eastern Health Board in 2004 for low risk women, is being evaluated. Since July 2004, 308 women have given birth in the MLU in Our Lady of Lourdes Hospital and 82 in the midwifery-led unit in Cavan General Hospital.
University of Limerick PhD student Clare O'Hagan told the conference that working mothers in the State were using full-time homemaking mothers as a benchmark for perfect motherhood.
"Women feel a heightened individual responsibility for what goes on at home . . . as well as an individual responsibility to work . . . and this leads to increasing pressure and guilt," she explained.