Andrew Boylan
Question:7 Mr. Boylan asked the Minister for Health if he has satisfied himself with the level of counselling available for women who have had stillbirths or miscarriages.
Ceisteanna — Questions. Oral Answers. - Counselling on Miscarriages and Stillbirths.
In general, where woman have miscarriages or stillbirths, maternity hospitals offer counselling services as a matter of course. Follow-up counselling, after the discharge of the patient from hospital, is also arranged where necessary.
(Carlow-Kilkenny): Will the Minister accept that very often women who leave maternity hospitals may live 40 miles away and perhaps when they get to their homes they need counselling? Has the Minister any plans to diversify or use existing expertise in different rural parts in particular?
I am mindful of the trauma of stillbirths and miscarriages. A number of issues has arisen in that regard. I have requested hospitals to provide separate accommodation because it is difficult for women who have lost children to be in a ward with women who have just delivered children who are in the cots next to them. I have asked my Department to contact every maternity hospital in relation to the provision of counselling during their stay in hospital and afterwards.
(Carlow-Kilkenny): Who will give the advice afterwards?
The service will be provided by a range of individuals, sometimes medical staff, sometimes professional counsellors and sometimes spiritual advisers, depending on what is most appropriate in the circumstances. Every maternity hospital offers that service.
I ask the Minister to examine the problem in the context of the dearth of adequate post-natal services generally for women in Ireland. This is one area of women's health which has been neglected during the past number of years. Because of the very short stay in hospital following a birth — usually three days — young women are sent home without any post-natal services.
There is some merit in looking at the antenatal and postnatal situation in relation to counselling, support services, proper preparation and counselling afterwards. We have a commitment to establish a stillbirths register. It is very important for people who have lost children that there should be an official record of it. That is the responsibility of my colleague, the Minister for Equality and Law Reform, Deputy Taylor, who is actively pursuing the matter.
Is the Minister aware of a recent report indicating that in many cases of health education, women were considered by the medical profession as being very good at transmitting information and advising young mothers? In Ireland there is a very good stillbirth association. Would the Minister not consider investing in that type of care? Would he agree that in many circumstances a medical practitioner to advise a woman during the post-natal period is probably not the most appropriate use of funds? It may well be that people who are not medically qualified but are committed to helping mothers — women who have had stillbirths — could be brought in by a paramedical service to advise people, particularly in rural areas, where it may be difficult to provide the full professional services that may be available in urban centres.
The Deputy has raised two points which are worthy of consideration. Certainly, the whole issue of having non-medical advisers is something I will consider. In regard to the gender of counsellors, it strikes me that it would be preferable that it be a woman. I would refer to the lack of women in consultant posts which arose in the previous question. Both of those points deserve consideration.
Does the Minister accept that much of the ongoing post-hospital counselling service could be delivered through family support centres in the community if they were given the resources and alerted to the need that exists in many communities? Perhaps that would be the ideal vehicle through which to deliver the service on an ongoing basis.
I am not sure I agree with the Deputy. Many of the family support services are involved with particularly vulnerable families. A person who has lost a child cannot be regarded as vulnerable and in need of a family centre. They have a specific need for counselling during a period of crisis or trauma and the family centre may not be the best vehicle to deliver the service in all circumstances.