As my husband and I packed our belongings and said goodbye to eight years in Boston to return to Ireland, we learned we were pregnant with our third child. The first two children had been born in Boston and I, an American citizen, had no experience with maternity care in Ireland.
We purchased private health insurance upon arriving in Ireland, but realised too late that we could not avail of the maternity services it offers; a 52 week waiting period is first required. No matter, I thought, as my head spun with settling young children into school, contacting doctors, and finding a new home in a foreign country, I’ll just go with the free midwives.
All cultures have accepted norms for the conducting of life’s little chores such as booking a doctor’s appointment. My experiences with doctors’ offices in the U.S. had not prepared me for the National Maternity Hospital’s midwife clinic, and even the process of booking an appointment was bewildering. Calls often went unanswered, my appointment was confirmed by traditional mail instead of online or over the phone, and when I called to change an appointment, the results seemed hazy at best. I was never really sure whether anyone expected me to show up or not. It was altogether a far more casual affair than the clipped efficiency of an American doctor’s office.
I soon realised that in a busy midwife clinic like Holles Street, “appointments” are more of a cattle call, with loose time-frames suggested to a host of expectant mothers and then awarded upon their arrival at the clinic on a first come, first served basis. I was lucky that my husband could mind our other two children while I sat for up to two hours in the waiting room – like most of the rooms in the aging building, it’s rather cramped.
As I walked into the examination room that first day, I was beginning to form a harsh opinion of the Irish midwife scheme and maternity care in Ireland generally, but the care I received in Holles Street was second to none. The midwife who greeted me was capable and kind. She approached my pregnancy not as a medical condition but as a natural part of the female experience. Leaving Holles Street after my appointment, I began to realize that my delivery experience in Ireland would be less clinical than in the U.S., but more empowering.
My labours in the U.S. had been assisted with an epidural but, as is common there, it was not completely paralysing, so I was able to feel each contraction and push with it. I could even stand, though I was encouraged to lie down instead. This is the accepted path of most deliveries in the U.S. and the excellent nurses I saw dutifully guided me down it.
However, epidurals in Ireland leave mothers completely numb from the waist down during labor and I was not comfortable with that idea. So, with the help of a friend, I began practicing prenatal yoga with the intention of using it as a way to cope with labor pains. I’ll be honest – I was nervous. The memory of my first two labors did not leave me convinced that a drug-free labour would be a viable option.
Over the next few months, I continued visiting Holles Street when scheduled, and my general practitioner between midwife visits. This is another departure from the American way: GPs are never involved in maternity care in the U.S. I didn’t mind, however, as I live in west Wicklow and getting to Dublin for appointments was cumbersome.
The GP was a far more convenient visit, though I did discover that the medical records at Holles Street were not available to my GP and vice versa, so at each visit, I was updating the GP or midwife on the results of my latest visit to the opposite care team. It felt disjointed, but, given my previous experiences at Holles Street, not surprising.