Weight and age of mums 'makes St Vincent's only maternity option'
Older and heavier women giving birth are adding to the risks that mean the new National Maternity Hospital (NMH) must be co-located beside an acute hospital, a senior obstetrician warned.
Patients are more likely to require an emergency caesarean section than before, a planning hearing into the €300m development was told, and the NMH cannot be developed at another site because delays in transporting patients would put their lives at risk.
It came on the same day as official figures showed that women in Ireland are almost 31 years old on average when they first become mothers.
The HSE intends to build the new hospital at a site beside St Vincent's University Hospital (SVUH) at Elm Park in Dublin 4. This would allow the NMH to utilise medical facilities in SVUH for complex cases. Currently, patients in need of such care are transported from the National Maternity Hospital at Holles Street to SVUH by ambulance.
Speaking at the An Bord Pleanála hearing, obstetrician and gynaecologist Professor Shane Higgins said the majority of work in a maternity hospital was "unplanned" and "life-threatening emergencies arise without notice where mere minutes can count in the context of overall outcome".
Appearing on behalf of the HSE, he said that submissions made to the board suggested that the hospital could be built on RTÉ lands or at a site in Clonskeagh, but that would require patients to continue to be transferred.
"These and other alternative sites which lack co-location represent a fundamental compromise on the core principle of achieving the required direct clinical adjacencies to the adult hospital, such as operating theatres and adult intensive care and critical care facilities," he said.
He added there had been a "major shift" in the nature of patients attending the existing hospital at Holles Street, which had resulted in more complex medical requirements.
"Currently, 35pc of patients are older than 35 years of age, 43pc are overweight and we have an average caesarean section rate of 23pc, the majority of which are performed in emergency circumstances," he said.
"The requirement to transfer such critically ill women across the city for intensive care provides the strongest possible argument for the co-location of the NMH with SVUH."
The hearing will continue until tomorrow.
Separately, figures from the Central Statistics Office show that the average age of first-time mothers continues to rise, up 0.2 years to 30.9 years. Some 1,098 teenagers had babies in 2016 and of these, 20 were aged under 16 years. There were 4,393 births to mothers aged 40 and over in 2016.
One-in-three babies (36.5pc) was born outside of marriage, and there were 63,897 births registered in 2016, some 2,012 (or 3.1pc) fewer than 2015.