Working Life: I care for pregnant women with substance and alcohol misuse issues

Justin Gleeson — clinical midwife specialist in substance and alcohol misuse, HSE

Fri, 04 Sep, 2026 - 02:00

Catherine Shanahan

“Growing up in a small rural village in Co Galway, I was heavily influenced by my grandfather, a GP, and my mother, who was a nurse. After my Leaving Cert, I followed in their footsteps and studied nursing at the University of Galway.

“During my training, I always admired the professional autonomy and independent clinical responsibility that midwives had while caring for normal pregnancies and births. I completed a postgraduate diploma in midwifery studies at Trinity College Dublin and practised as a midwife in the labour ward at Dublin’s Rotunda Hospital.

“During those years, I encountered many women who arrived in labour, unbooked and had received little or no antenatal care. The vast majority came from traumatic backgrounds, [marked by] substance and alcohol misuse. The outcomes of these pregnancies, in which babies required neonatal medical intervention and social work involvement, only added to their trauma.

“With encouragement from colleagues and management, I specialised in substance and alcohol misuse and took a position as a clinical midwife specialist with the HSE substance misuse service in north Dublin and the Rotunda Hospital. I am now also working with the HSE drug and alcohol service in Galway, Mayo, Roscommon and Sligo.

“My role is to case manage all pregnant women with substance and alcohol misuse issues and help them achieve the best possible pregnancy outcome for their babies. Since I started this role, I have learned so much from the women I meet. Their life stories, which are often ignored by society, have transformed me personally and professionally.

“Social prejudice, negative attitudes and stereotyped perceptions of problem drinkers and problem drug users may lead to a lower standard of care for this client group. It is my goal to generate change in the care provided to these vulnerable women and to emphasise the importance of treating them as human beings, capable of change, rather than focusing on their addiction.

“Work can be pretty intense, and it is important to maintain a positive work-life balance. I enjoy spending time with family and friends and appreciate the little things we sometimes take for granted."