In an interview in today’s Irish Examiner, Professor Fergal Malone said they had been “struck over the years” by how “emotionally difficult” it is for women to have to travel overseas for termination.
“We have had parents bring their child’s remains back in a shoebox in the back of a car. We’ve had parents have their child’s remains sent back by courier, to arrive by DHL.”
The position at the Rotunda is that they would “wish to provide all care to our patients here”, Prof Malone said: “We do not believe that it is right that individual patients who make the choice [to travel to the UK]... that they should not be able to have that procedure done here. So we would like to see that situation change.”
In about 75% of cases where the unborn child was diagnosed with anencephaly, a fatal foetal abnormality where parts of the brain and skull are missing, parents chose to terminate, Prof Malone said. There are 20 to 30 such cases at the Rotunda each year.
Parents in about three quarters of cases where the diagnosis was Trisomy 18, where the baby has an extra chromosome in its cells, chose to terminate, he said.
For those who opted for termination, most went to the UK and Prof Malone said his staff have done their best to make the process less traumatic for patients.
“Our staff have actually gone over to the hospitals to look at the journey our patients will take,” he said. “So we know the individual names of practitioners and counsellors that they will meet and we are able to demystify it as much as possible. Because we know if you are changing hospital location, that can be very intimidating.”
The most tragic aspect of these journeys is the extreme trauma it causes for patients, Prof Malone says.
Prof Malone, a consultant obstetrician and gynaecologist, said his profession is “under tremendous pressure” with “significant stress and anxiety and indeed eventual burnout” because of the level of litigation around childbirth.
“I am personally aware of obstetricians and midwives who have stopped practising after a case, they’ve been so badly affected and traumatised. Things happen in obstetrics that are just unexplainable. We have unfortunate cases where women come into us at 39 weeks with an unexplained stillbirth, where despite a complete autopsy, genetic studies, ultrasound scans, we still can’t explain what happened.”
Prof Malone said his key priority during his seven-year tenure is to oversee relocation of the hospital from Dublin city centre to Blanchardstown. He will also prioritise expanding their benign gynaecology service.“The difficult thing about benign gynaecology is it could be something like irregular heavy periods, post menopausal bleeding, it may be benign. But what you don’t know is — are there certain cases of cancers lurking in there?”
The hospital’s figures show there are 1,506 patients waiting to be seen.
Prof Malone is also hoping for a significant improvement in midwifery numbers. The deficit for the coming year based on the level of births is 45: “It’s a critical issue. Even if tomorrow there was money for it [to hire midwives] we actually couldn’t find them.
“There used to be a time when there was severe competition and a waiting list to get into the midwifery training scheme in the Rotunda. But we actually couldn’t fill all the places last year.”