Midwifery conference hears how face of maternity care is 'changing'

NWIHP lead midwife Angela Dunne, far left, and National Maternity Hospital director of midwifery Mary Brosnan, far right, with fellow speakers at the national maternity and midwifery festival. File picture

The HSE board has asked the National Women and Infants Health Programme (NWIHP) to assess and ensure maternity services are safe.

A midwifery conference also heard calls for women’s voices to be more at the centre of maternity care.

The HSE’s NWIHP national lead midwife Angela Dunne said the way the HSE monitors maternity care is changing.

“We’ve also been asked to reassure the HSE board that our maternity services are safe so that’s a big piece of work going forward and working with our (maternity) units with regard to that,” she said.

Changes in how the HSE is structured is leading to a bigger role for this programme. 

“We’ve changed a little bit over the last number of weeks really. NWHIP is now being looked at as a surveillance and monitoring of our maternity services,” she said.

Reviews of the nine-year-old national maternity strategy are also underway.

National Maternity Hospital director of midwifery Mary Brosnan also spoke at the event.

“We’re great at building structures around clinical governance and safety and we do not usually - and I’ll speak for ourselves too – we don’t usually have the woman’s voice in the centre of that,” she said.

“I think part of that is because we’re so driven by trying to get our guidelines in place. And guidelines have driven up our caesarean-section rates and our induction rates, for good reasons and bad.” 

I think we’re not good at inducing women. I think if we were working in a more research-driven business, we would have a better process of inducing women. We’re inducing 40% of women. We’re failing a lot of the time in that, we’re picking sometimes the wrong women to induce. 

She added: “We’re conducting more caesarean-sections pre-labour now than we ever did in the National Maternity Hospital.” 

She called on midwives to discuss birth options so women are not relying on social media. 

“(social media) is not necessarily always a bad thing, but invariably we should be — as healthcare professionals — getting our message out there better,” she said.

The Midwifery Led Unit at Our Lady of Lourdes Hospital, Drogheda's Fiona Moloney spoke about rising rates of inductions. 

“Over the last ten years it’s gone up easily by 80% so by 2023 we’re looking at 36.9% of women being induced. I don’t know how you feel about that but I’m stunned that we need to manage nearly 37% of all women,” she said.

She discussed reasons behind this including “women’s choice of course” as well as medical reasons such as pre-eclampsia or gestational diabetes.

“The big one overall is risk,” she said, adding women choose the option with the lowest level of risk presented to them.

She called for more supports and information on all options.

“If you know what you want to do and if you’ve received all that information, and if you know what the risk is for you and if you’re happy to take that risk, I don’t understand why we can’t give those women the support that they require,” she said.

The all-Ireland maternity and midwifery festival took place in Dublin with speakers from Northern Ireland and Ireland.