24% of maternity patients now opt for midwife-led care

All Irish maternity units can provide antenatal midwifery clinics, with 174 clinics held every week. Clinics are also offered outside of hospitals by 17 units, coming to 59 altogether, giving women the option of getting some appointments locally. 

Midwives now lead pregnancy care for 24% of women, an assessment of progress around this type of care by the HSE has found.

The assessment of midwife-led ‘supported care pathways’ by the National Women and Infants Health Programme (NWIHP) found that, since May 2021, this has been offered as an option in all 19 maternity units. In 2016 midwife-led care was available in just six maternity units.

The National Maternity Strategy (2016 – 2026) recommended offering normal-risk pregnant women the choice of having their pregnancy led and delivered by midwives on ‘supported care pathways’.

It advocates for “most antenatal and postnatal care being provided in the community and home settings.” 

'Positive achievements' in a challenging year

This assessment, the second baseline review of these services, states: “The national average percentage of women who are managed via the supported care pathway now stands at 24%.” 

Angela Dunne, national lead midwife with NWIHP, said:  

The year 2020 was a challenging year for maternity services as Covid-19 adversely impacted most aspects of life in Ireland.  

Despite this, the review found “many positive achievements” in expanding midwifery care for women. 

“Despite these challenges, maternity services continued to provide care around the clock to mothers and babies throughout the country,” Ms Dunne said.

All 19 maternity units now offer antenatal midwifery clinics, with 174 clinics held every week. Cork has six such clinics, Limerick and Waterford three each, and Tipperary two, with one each in Kerry and Clare.

Clinics are also offered outside of hospitals by 17 units, with clinics being offered at a total of 59 sites, giving women the option of getting some appointments locally. 

Women at 11 units can have the same midwife lead their care from the community through to birth in a hospital. The assessment report states: 

In many instances this involved a midwife from the community team being rostered in the labour ward or the emergency room.

Women can apply for an ‘early transfer home’ after a hospital birth with midwives visiting them through 13 hospitals, with University Hospital Waterford expected to offer this from 2021.

Focus on two midwifery-led hospital services

The assessment details work done at the two midwifery-led hospital services; Our Lady of Lourdes in Drogheda and Cavan/Monaghan Hospital.

The report says: “The NWIHP will be assisting Cavan to refurbish their MLU [midwifery-led unit] in 2021.” 

A review of this service was published in March, following protests by midwives and advocates at plans to close the unit last year. 
In the North, most maternity units offer parallel or "alongside" maternity-led units, with three stand-alone MLUs up to 2019. 

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Pregnant women can labour in water at nine units in Ireland, and two offer water-births. The report says these services will be expanded to five other units.

Ms Dunne also said maternity services developed innovative services including "on-line antenatal classes, virtual appointments, virtual tours of facilities" during the pandemic.