Midwifery expert says birth facilities need major reform

IRELAND’S first ever professor of midwifery has said “it doesn’t make clinical, social or economic sense” for pregnant women to give birth in centralised, specialist facilities.

Speaking after his post was confirmed, NUI Galway lecturer Prof Declan Devane said thinking on what is best for mothers and newborns may be out-dated and in need of reform.

The expert, who has 22 years’ experience teaching in the field and has an international reputation as a leading researcher, acknowledge any changes will need to be carefully thought through as more than 75,000 babies are born in Ireland every year.

However, he said most of the births in this country currently take place “against a backdrop of sub-optimal infrastructure in large and ageing hospitals with too few delivery suites” — an issue he is keen to address.

“Unlike some other areas of healthcare, there is no evidence to support the view that centralisation of maternity services in large hospitals improves outcomes for women and their infants.

“On the contrary, there is substantial high-quality evidence demonstrating benefits for midwifery units in which the skills and expertise of midwives are used to their full potential.

“Common sense suggests, and scientific evidence demonstrates, that it doesn’t make clinical, social or economic sense for most women to give birth in large centralised hospitals that are heaving at the seams.

“Yet this is precisely what is happening,” said Prof Devane.

He added that as midwives, obstetricians and GPs all have specific roles in the provision of maternity care, “no one model of care or birth-setting should be advocated for all women”.

The leading expert is a member of the International Confederation of Midwives’ expert network of research and advisors; a member of the midwifery committee of An Bord Altranais; and an honorary visiting fellow of Britain’s Cochrane Centre and the Coombe in Dublin city.

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