Maternity units led by midwives 'just as safe'
Maternity units led by midwives are just as safe for mothers and babies as those where obstetricians are in control, a new report has found.
There are still only two midwife-led maternity units in the country -- one in Our Lady of Lourdes in Drogheda, Co Louth, and the other in Cavan General.
At a midwife-led unit, women are helped through their labour by the nurses alone and they cater for patients who show no signs of difficulty in giving birth naturally, referring any problems to an obstetrician if necessary.
When the woman starts labour, she goes to the midwife-led unit -- a separate unit in the maternity hospital -- and is welcomed into a private room where she stays for the labour, birth and postnatal resting time.
Each room has a bed, pull-out couch for her partner to sleep on, a birthing pool, birthing aids, television, and tea/coffee-making facilities.
A consultant-led unit is staffed by obstetricians and and midwives, offering full pain relief cover such as epidurals.
The HSE report involved a study of 1,653 women who had babies in the northeast from 2004 to 2007 and compared both types of service.
It revealed:
- The number of babies needing resuscitation at birth or admission to the special care baby unit was the same in both groups.
- 60pc of women in the consultant-led unit had their baby's heartbeat monitored continuously in labour by an electronic monitoring machine, compared to 38pc of women in midwife-led units.
- Almost half the women in the doctor-led units had their labour speeded up by having their waters broken or having oxytocin, a hormone given intravenously by drip, compared to a third of those in the other.
- Up to 85pc of women in the midwife-led unit said they would recommend it, compared to 70pc of those having the traditional care.
Although the facilities in the midwife-led unit were "luxurious", the cost per patient was €332 less than in the traditional hospital system.
Relief
Despite having fewer epidurals, 83pc of women in the midwife-led units expressed satisfaction with their pain relief, compared with 68pc of women in the consultant-led unit.
Professor John Bonnar, Emeritus Professor of Obstetrics and Gynaecology in Trinity College Dublin, said: "Midwifery-led care has potential to provide greater choice for the majority of low-risk women, better continuity of personal antenatal care and a more satisfying birth experience."
The HSE, however, has given no timescale for the expansion of these units to other hospitals.
Fionnuala Duffy, assistant national director of Acute Service Reconfiguration at the HSE, said: "This comprehensive study provides further evidence to support the need for development and expansion of such units as an integral part of a comprehensive maternity service offering appropriate range of services for women."
- Eilish O'Regan Health Correspondent
Irish Independent
