Consumer champion and money-saving guru from the Irish Times, Conor Pope was a guest on George Hook’s Newstalk show the other week. The topic was the cost to middle class parents of bringing up a child.

Conor pointed out that before the child is even born, most middle class parents pay between €3500 and €7000 to secure the services of an obstetric consultant – private health insurance does not cover this cost. Apparently you need to get straight on the blower the moment you see the little blue line appear in the pregnancy test window if you want to get the obstetrician of your choice.

Now this topic is a bit of a personal bugbear of mine. Why are women with straightforward, healthy pregnancies attending obstetric consultants for routine antenatal care and normal deliveries? Do they really need to shell out thousands of euros to have a highly trained consultant tell them that their blood pressure is fine, the baby’s heartbeat and growth are normal and that their blood sugar levels are no cause for concern? That is a midwife’s job.

The Royal College of Obstetricians and Gynaecologists in the UK lists the following definitions on its website:

  • Obstetrics deals with problems that arise in maternity care, treating any complications of pregnancy and childbirth and any that arise after the birth.
  •  Obstetricians work alongside midwives, whose speciality is usually normal pregnancy and delivery.

 In other words, during a straightforward, healthy pregnancy and delivery, there is no need for a woman to see hide nor hair of an obstetrician.

My first child was born in London 11 years ago. Private health insurance is relatively uncommon in the UK and I, like the vast majority of women, relied on the NHS for my antenatal care. Most of my antenatal visits were to the midwives clinic at my local health centre, with a couple of GP visits in between. I usually saw a midwife called Mandy, a reassuring and warm Welsh woman.

Everyone is assigned a consultant obstetrician, but only sees him or her if problems arise during the pregnancy. Because I had a history of hip problems, I was referred once to the hospital so that the obstetrician could confirm I was capable of having a normal delivery.

On the day of delivery, I was delighted when Mandy arrived on shift towards the end of the labour, and welcomed my son into the world. There was no doctor in the room. A breezy registrar had appeared shortly beforehand to check in on us, announcing that “if baby hasn’t appeared in the next 10-15 minutes I’ll be back to ventouse”. That did the trick. Ten minutes later Mandy was handing us our first child and it was wonderful to be attended by someone I knew and trusted.

Back in Ireland a few years later and expecting my second child, it seemed I had committed a terrible middle class faux pas by failing to take out private health insurance. A lot of people’s first response to my news included the question “Who is your consultant?” They seemed almost embarrassed to hear that I had thrown myself at the mercy of the public system, and I was given grim warnings about the endless queues I would face at the ante-natal clinics.

They were right, the queues literally stretched up and down the length of the hospital corridors. However, I never had to join those queues. At the end of my initial booking visit I was offered, almost as an afterthought, the option to attend a midwives clinic, as I was in a low risk category. This was apparently not a very popular option as I wouldn’t be seeing a doctor for routine care, but I jumped at the chance. At every subsequent visit I walked past the seemingly unending lines of women waiting patiently for a doctor, till I reached the door marked ‘Midwives Clinic’. Here, I never waited more than 10 minutes to be seen and was soon on my way home, passing the same women still queuing on my way out.

That was in 2002. Since then, a handful of midwife-led clinics have opened and a few hospitals are offering ‘domino care’, where midwives visit mothers before and after the birth in their own homes. These services are still very limited however, and are only available to public patients.

This seems to send out a clear signal that midwife care is somehow a second-best option. Of course there are many reasons why women need to see an obstetrician during pregnancy and childbirth. Older mothers, multiple pregnancies, high blood pressure and many other risk factors  require specialist care. Many women probably feel that they are not prepared to take any chance with the wellbeing of their precious child, and they want the reassurance of a familiar face at the birth. But if they were offered the chance to be cared for by a small team of midwives in their local area, one of these midwives would be there for them on the day. And of course at the first sign of a problem at any stage during pregnancy or labour, the midwife can call in an obstetrician.

I don’t know how this system of over-dependence on obstetric consultants and under-valuing of midwives has arisen here in Ireland. It seems an awful shame, not to mention a waste of money. After all, for most women, pregnancy is not an illness. If and when we get the long promised universal health insurance, perhaps everyone will be offered high quality community midwife care, with obstetric consultants available for those who need them, regardless of ability to pay.

Crushed

September 6, 2010

 

How old is too old to have a crush? At the fairly advanced age of 45, I’m still waiting to find out.

My first crushes were the usual neighbourhood boys who seemed not to realise that I existed (fools). I then moved on to a female science teacher, various cool, unattainable older college students, unavailable work colleagues (one of whom featured in a recurring fantasy involving us both getting carried away on a conference room table) and a selection of famous men. For many years my number one crush was Daniel Day Lewis but, alas, he has not aged well.

Once my infatuation with Daniel faded, I was crush-free for a good number of years.

That all changed in 2008 when, thanks to a friend, I attended the Grand National at Aintree as a guest of the sponsors (cheers Nigel). I spotted my future crushee standing at the far side of the crowded hospitality area, gazing slightly moodily into the middle distance. The quintessential tall, dark and handsome stranger. But there was something familiar about him. Where had I seen him before? I slowly realised he was a talented and versatile actor I’d seen in several TV dramas and films. Dredging my memory, I came up with a name – David Morrissey.

David Morrissey, crush victim

I wasn’t 100% sure I had got the name right but, undaunted, I joined his queue next time he went to the betting window. As he turned to leave, I stepped up and asked if his name was indeed David Morrissey. It was (phew) and he politely agreed to sign my racecard.

And that was it. From the moment he directed that intense gaze down at me (he is very tall, and I cannot resist a tall man) I found myself once more in the grip of a ridiculous adolescent crush. He attempted some friendly small talk, enquiring if I’d had any successful bets so far. My response? An inane fixed grin and a muttered, inarticulate answer, delivered while backing away in awe. Impressive.

Since that day I have indulged in the following behaviour:

  • Regularly Googling David Morrissey, with a special emphasis on Google images
  • Once Googling his wife, the writer Esther Freud
  • Making a point of watching any TV programme in which David Morrissey appears
  • Rewatching various clips of David Morrisey several times over (as he emerged from a swimming pool, asked a colleague for casual sex in a police drama, and solicitously enquired whether his red carpet interviewer was cold in her flimsy frock – so thoughtful!)
  • Searching fruitlessly for David Morrissey on Twitter
  • Instantly following David Morrissey as soon as I heard he had joined Twitter
  • Reading David Morrissey’s blog, which has only added fuel to the flames of my crush by demonstrating his self-deprecating wit and charitable nature
  • Engaging in mildly attention seeking behaviour on Twitter in a pathetic attempt to get a response from @davemorrissey64
  • Being stupidly excited on the two occasions that I actually did get a response from @davemorrissey64.

Don’t get me wrong. I don’t live alone with an assortment of cats and a shrine to David Morrissey in my house. I haven’t obsessively tracked down every drama or film he has ever appeared in – I have never watched ‘Blackpool’ or ‘State of Play’, apparently two of his best performances from the pre-crush era. I refrained from using my son as an excuse to watch my hero running around in manly armour in ‘Centurion’ after @davemorrissey64 told me it was “a bit violent” for an eleven year old (the poor man is doing his best to discourage me).

Nonetheless, this is quite unseemly behaviour for a middle aged woman. What do I think is going to happen? That ‘Big Dave’, as a fellow-sufferer on Twitter has dubbed him, will read one of my tweets about him and promptly dash for the next plane to Dublin in order to come and ravish me? Hmm, perhaps not.

What is the matter with me? I have a tall man of my own – my husband is six foot four for goodness sake – and we have been happily married for fourteen years. I suppose that is the key to understanding the middle aged crush. The youthful thrills of fancying boys and anticipating first dates are now so many years in the past and as they say, I’m married, not dead.

I don’t know if David Morrissey will be my last crush before I give it up for good. But as he has starring roles in two upcoming drama series (‘South Riding’ and ‘Thorne’) I reckon I’m destined to continue rewinding his best bits and benevolently stalking him on Twitter for another while yet.

 Sorry Dave.

(Photo courtesy Paul Cantrell)