Madam, - Prof Jack E. James's letter on the practices of obstetricians (March 23rd) suggests that women who attend for maternity care through the public healthcare system receive inferior care when an obstetrician is not present at birth. The World Health Organisation (1996) recognises the midwife as "the most appropriate and cost-effective type of healthcare provider to be assigned to the care of normal pregnancy and normal birth, including risk assessment and the recognition of complication" (WHO 1996, p6).
The EEC Directives (1980) - Directive 80/155/EEC in particular - continue to stipulate the education and practice of midwives in the EU and clearly outline the role and responsibilities of midwives. The most appropriate person to attend a woman experiencing normal pregnancy and birth is a midwife, regardless of the woman's economic means. - Yours, etc,
MARY HIGGINS,
Chairperson,
Midwives Section,
Irish Nurses' Organisation,
Dublin 2.