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The National Women and Infants Health Programme proposes the establishment of an internal service with rotating community midwives to address gaps in homebirth services across West Ireland, citing staffing and recruitment challenges.
Future model could see mandate for hospitals to have internal service with rotating community midwives New services supporting women who wish to have homebirths could be created in the West of Ireland under proposals to address a gap “on the western seaboard”.
The State’s first national maternity strategy, running from 2016 to 2026, highlighted a lack of choice for expectant mothers, as well as a geographic variation in services available. The roadmap set out different pathways for pregnant women, including the supported option for those with normal risk pregnancies, which allows for birth at home or in hospital.
Boy killed in Mayo rail incident named locally as Eoin Doyle However, there are only 23 SECMs throughout the State, some of whom only work part-time in the community, leaving many parts of the country without access to the service. Kilian McGrane, programme director of the National Women and Infants Health Programme responsible for the implementation of the strategy, said significant progress had been achieved over the past decade.
However, he said there is “inconsistency of implementation” of the supported care pathways, “particularly on the western seaboard”.
“There is no homebirth service available in a number of the units. They don’t have labouring in water in a number of the units, and then there’s a few units that still don’t have home-away-from-home rooms,” he said.
“The issue for them is predominantly a staffing one – not being able to hire a designated midwifery officer. This is the person who reports in to the director of midwifery who assesses all of the proposed homebirths, and then supports the self-employed community midwife in delivering the care to the women.
” Angela Dunne, national lead midwife at NWIHP, said another difficulty lies in recruitment of SECMs, as many midwives do not want to work in the community by themselves. Dunne believes the model going forward will see a national mandate for hospitals to have an internal homebirth service, through which their own community midwives rotate in and out of the maternity unit, such as in the cases of the “That keeps their skills up, keeps their support, and it’s a much better model.
That’s the one we’re going to look at going forward for those areas who don’t have a homebirth service, and is well integrated. It would be part of the community midwifery service to actually deliver babies,” she added. HSE homebirths in the midwest region were suspended in 2022 following the death of Laura Liston soon after the birth of her son at her home in Limerick.
McGrane said there was an intention for these to resume, but there were “major staffing challenges” in Limerick maternity hospital, which impacted on its ability to do anything “outside the basic management of maternity care”.
“We’ll re-engage with them maybe early in the new year and see can we develop a plan. And again, rather than looking at the self-employed community midwife, maybe can we grow our own service and maybe start with a shorter distance initially.
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