In 2015, the National Maternity Strategy said “there is a lack of choice for expectant mothers” by international standards. It proposed a model of care that “represents a fundamental overhaul of services” which are currently “largely consultant-led and hospital-based”.
Yet, in a 2020 report, HIQA said that the majority of births (99%) occur in a hospital setting in Ireland with less than 1% occurring at home. It was “concerned about the overall level of progress of implementation” of the strategy.
One service that offers a different choice is a midwifery-led unit which is designed for women who prefer little or no medical intervention. They have been shown to decrease the risk of interventions and increase maternal satisfaction. Yet, in spite of being introduced here in 2004, there are only two units in the entire country.
At the start of June 2020, the unit at Cavan General Hospital was set to close but former Health Minister Simon Harris then said that there was no threat to the service. However, this threatened closure highlights the lack of such units and slow implementation of the National Maternity Strategy which was published in 2016.
So, why does the Irish health service offer so little choice for expectant mothers even though an overhaul was promised years ago?
HELP US INVESTIGATE
We want to investigate if this lack of choice is what people should expect when they’re expecting, by comparing Irish practices to best international practice.
A study in 2017 which examined midwife-led care in Ireland concluded that it is “a safe option that could be offered to a large proportion of healthy pregnant women”. Yet, there has been no increase in unit numbers since they were first introduced. We want to find out what is causing this delay.
We want to look into the decision process behind the provision of services, such as home births and midwifery-led care, to find out how decisions such as the threatened closure in Cavan are made. We will do this by talking to those involved as well as through freedom of information (FOI) requests.
Finally, for the National Maternity Strategy, we want to find out if a “comprehensive, time-bound and fully-costed implementation plan” has been put together by the HSE, as recommended by HIQA.
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