Letter: Midwives are professionals as much as obstetricians

One of the charges brought against Ann Kelly, the Dublin midwife, is that she failed to send mothers to hospital where labour lasted more than 12 hours. Dublin obstetricians have been obsessed with length of labour since Keiran O'Driscoll and Declan Meagher's book Active Management of Labour was published in 1980. This advocated 12-hour deliveries to reduce pressure on maternity beds. All women were to have the waters broken on admission and slow labours were to bespeeded up with drugs.

Intervention in labour brings its own problems - increased pain leading to drugged mothers and dopey babies, increased maternal mortality from the side-effects of surgical delivery and obstetric anaesthesia, and the list goes on.

There is nothing magic about the 12-hour limit, it is an arbitrary figure. The definition of long labour has gradually changed over the years from 24 hours or longer in the 1950s. Women's bodies have not changed over that time; in fact with smaller family sizes one would expect the average length of labour to have lengthened - first labours tend to be longer than second labours and now a greater proportion of labours are first labours.

Instead of making independent midwives outcasts the maternity services should be encouraging them, relieving pressure on overstretched resources and keeping alive the knowledge that birth can be a natural life-enriching event not a medical emergency.

Margaret Jowitt

`Midwifery Matters'

Craven Arms, Shropshire

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