I was nineteen when I was first sent out alone into the slums of Dublin to deliver a baby.
It was the middle of the night.
‘Wake up nurse, you’re needed for district.’
By the time I reached the front door, dressed in the dark and half-awake, I knew this was not going to be a routine call.
We were heading to Corporation Place, one of the worst slum complexes in the city.
Locals called it The Cage.
Five storeys of concrete, arranged around a central courtyard, with iron gates that were often locked from the outside. The smell of sewage hung in the air. Laundry dripped from balconies. Families lived crammed into single rooms, sometimes a dozen people to a space.
This is where women gave birth. This was 1960s Ireland. Contraception was illegal.
Many of the women we attended had already had multiple children. Their husbands relied on casual work at the docks. If there was no work, there was no pay. If there was no pay, there was no food. And yet, the babies kept coming.
Looking back now, what strikes me most is not just how different things were, but how easily those realities can return in new forms. We think this is history. But the same forces still exist.
Today is International Day of the Midwife, a moment to reflect on the realities many women, and the healthcare professionals who supported them, once faced.
Today, access to reproductive healthcare remains uneven across the world. While it is improving in some places, including parts of Australia, in many countries it is still shaped by policy, culture and cost — limiting a woman’s ability to decide if and when to have children.
When we arrived that night, the woman pleaded with us:
‘Please don’t bring me in, nurse. I don’t want to go to hospital.’
We understood why.
Hospitals were not always places of comfort or choice. For many women, they represented a loss of control over their bodies, their decisions and even their babies.
We had no real option anyway. No car. No easy way to call an ambulance. No guarantee help would arrive in time. So we delivered the baby there. In that small room. On a bed covered in newspaper. This was not unusual.
As midwives, we were trained to assess risk quickly:
Was the baby positioned correctly?
Was the mother stable?
Could we safely proceed?
But what stayed with me was not just the medical decisions. It was the environment these women were living in, and the lack of choice that shaped every aspect of their lives. Women did not have the ability to plan their families. Pregnancy was not always a decision it was often an inevitability. Behind closed doors, we saw the toll this took.
Exhaustion. Fear. Resignation.
And sometimes, quiet resilience.
That night, the baby was born safely, a healthy girl. Two hours later, we left, promising to return for the next ten days. We walked back through the gates, into the cold morning air, and back to the hospital. For us, it was one shift. For that woman, it was her life. It was her ninth baby, but her twenty-second pregnancy.
Today, conversations about reproductive rights are often framed as political or ideological but for those of us who worked on the ground, it was never abstract. It was practical and it was immediate.
It was about women trying to navigate their lives with the options available to them, or the lack of them. We often think of progress as permanent, but history suggests otherwise.