Monday 25 September 2017

The lack of choice for pregnant women is adding to pressure on hospitals, warns midwifery expert

Irish hospitals do not offer pregnant women enough choice as facilities face unnecessary pressure by pushing all pregnancies through the one model, a midwifery expert has warned
Irish hospitals do not offer pregnant women enough choice as facilities face unnecessary pressure by pushing all pregnancies through the one model, a midwifery expert has warned
Caroline Crawford

Caroline Crawford

IRISH hospitals do not offer pregnant women enough choice as facilities face unnecessary pressure by pushing all pregnancies through the one model, a midwifery expert has warned.

Prof Declan Devane, Professor of Midwifery at NUI Galway and the Saolta University Health Care Group, said the current system was a "one size fits all" approach to maternity care, when research has demonstrated that most women do just as well with midwifery continuity models of care.

He warned that the current model of maternity care in Ireland is putting the system under massive stress when it was not needed.

"We currently have the majority of women booking for birth in large obstetric units under the care of a consultant obstetrician. In that context, you have people who are highly skilled in providing complicated care, providing care to a large portion of women who are experiencing normal pregnancy and birth.

"That's not a good use of a scarce workforce and certainly not a good use of expertise. So you are certainly diluting the system and diluting the level of care women are getting by funnelling women through one system," he said.

The work of Prof Devane and colleagues in evaluating the effectiveness of different models of maternity care, both in Ireland and internationally, demonstrates that the clinical, social and economical outcomes for midwifery care models are at least as good as for other models of care.

This work has informed health care policy and clinical practice guidelines internationally but has not yet been implemented in Ireland.

"We have good evidence to say the clinical outcomes for women are as good, it costs less and women are highly satisfied with it. Unfortunately, not everyone believes the message but strongly held views are a poor relation of robust research evidence," he added.

He said that moving away from a largely single model of maternity care would take the pressure off an over-burdened system.

"There isn't an acute hospital in the country that isn't creaking at the seams in poor infrastructure, inadequate obstetric staffing and inadequate midwifery staffing.

"We've got to look at that fix in the context of providing different pathways to women based on what they need, and we have good evidence to say actually this is an appropriate thing to do.

"And the sooner we do that, I think we'll look back on our provision of maternity care in Ireland and think 'what took us so long to actually move to providing care based on women's needs', given the good evidence we have on the clinical, economic and social benefits," he added.

Irish Independent

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