Master's voice: Mahony stresses need to properly fund abortion services
Outspoken Dr Rhona Mahony, who finishes her seven-year term as Master of the National Maternity Hospital this month, has appealed for the new extended abortion service to be properly resourced.
The privacy of women availing of the service and the staff involved must also be protected, she said.
Dr Mahony, who was a prominent supporter of the Repeal the Eighth campaign, has revealed that 60 women attending the hospital during 2016, whose unborn baby was diagnosed with a fatal foetal abnormality, travelled to Britain for a termination.
The Government has set January as a target for allowing these terminations in Ireland, as well as medical abortion up to 12 weeks of pregnancy. Maternity hospitals will also provide abortions in cases of risk to the life of the mother and if her health is assessed as at risk of serious harm.
Writing in the hospital's annual clinical report, Dr Mahony said: "The introduction of wider availability of termination of pregnancy in Ireland will require careful implementation."
She pointed out: "The specialty of foetal medicine is increasing in complexity and our ability to identify genetic and structural anomalies in the foetus in utero is increasing."
The hospital had 8,619 births last year - an average of 700 babies a month, or 23 a day. "On the busiest day on July 26, we delivered 42 babies," Dr Mahony said.
The smallest survivor weighed a mere 420 grams, and spent six months in the neonatal intensive care unit.
"Two-thousand babies were admitted to our new neonatal unit. 149 babies weighed less than 1.5kg," she said.
Over the first six years of her term, the hospital delivered 55,000 babies and cared for 60,000 pregnant women.
The corrected perinatal mortality rate has been consistent at three to four per 1,000 live births. The maternal mortality rate stood at three per 100,000 maternities.
"These are truly excellent outcomes for a tertiary institution but behind these figures are the individual losses and attendant heartbreak and we never forget that - nor do we ever take good outcomes for granted."
Dr Mahony said there have been many demographic changes in the past decade. Over 30pc of patients attending the hospital are classified as high risk. "Almost 40pc of women attending for maternity care are over 35 years of age."
While increases in body mass index in pregnant women are stabilising, one-third attending the hospital is overweight.
And "one in eight is obese with all the attendant medical risk, including miscarriage, congenital malformation, gestational diabetes and increased and more complex obstetric intervention."
The caesarean section rate last year was 27pc, a 1pc increase on 2016. The main driver is women presenting who had a previous caesarean section.
There has also been a striking increase in prelabour caesarean section, which accounts for 16pc of deliveries.
The most pressing risk is of postpartum haemorrhage, heavy bleeding after birth, of which there were 95 cases last year.
Dr Mahony said that 1,200 women in Ireland are diagnosed with a gynaecological cancer every year and 500 women die.
"Despite this, services are patchy...Ireland sees some of the poorest outcomes in women with gynaecological cancer in Europe."
There is currently huge demand for these services in Ireland and it requires significant development.
She said the new national maternity hospital, to be built on the campus of St Vincent's Hospital, will have operational independence which will underpin all legal agreements.