Maternity care in Ireland has seen 'a lot of change', leading to better outcomes, leading doctor says

'Sometimes the space where you think you want to put a pool doesn’t support it,' Dr Murphy said, adding there had been 'infrastructure barriers'. File picture

Maternity care in Ireland has seen “a lot of change” over the last decade, despite discontent and public protests at the lack of access to some services, the HSE’s top obstetrician has said.

Dr Cliona Murphy, national women and infants health programme clinical director, said trends from the National Maternity Strategy 2016-2026 are more visible now.

“People will always have different perspectives on things. One argument is we’re not doing enough. However, if you look at the facts and if you say there’s been no change in Ireland for 20 years, that’s clearly not the case,” she said.

Change in those years is leading to better options, she said.

“If you look at the investment in maternity, there’s been €28m in new development funding from 2016,” she said.

That has offered a choice of pathways, an expansion of midwifery-led care services in the supported care pathway. That’s a big difference from 10 years ago.

“Midwifery-led antenatal clinics are held across all 19 units with 174 clinics per week, and midwifery care is available in 59 community locations.”

She described this as “a big push to have care closer to the person’s home”.

Protests led by the Irish Birth Movement outside the Dáil last week called for birth centres alongside maternity hospitals, as promised in the strategy.

Dr Murphy pointed to 13 new home-from-home rooms, describing them as “an alternative to birth centres” now.

“These are within the hospital, but a much softer environment. They have nicer rooms, more homely, not as clinical as they would have been before”, she said.

She also highlighted an increase in the use of birthing pools. She is aware of 13 such pools in hospitals.

“Sometimes the space where you think you want to put a pool doesn’t support it," she said, adding there had been "infrastructure barriers". 

A training programme is in place, and she welcomed “a new waterbirth guideline coming out soon which will support those units which maybe haven’t had as much experience with this".

In the National Women's Health Survey 2025, carried out for the Irish Examiner, concerns were raised about gaps in postnatal care. 

Dr Murphy said the ongoing expansion of postnatal hubs offering “another mother-centred initiative in the community” was changing that picture.

Homebirth access was also disputed by the Dáil protesters.

“Access varies across the country; it does depend on access to community midwives, which are a rare resource,” Dr Murphy said.

So staffing is an issue for homebirths. They are very popular where they are established. I think it’s a great service.

She could not comment on the suspension of homebirths for Limerick since June 2022, as each region now has responsibility for local services.

Another homebirth option, Private Midwives Ireland, closed abruptly in August.

The HSE was not given advance warning, she said, saying Cork University Maternity Hospital “made a big effort” to help women affected.

“It was similar to when Mount Carmel [a private maternity hospital] closed, the HSE was there to help,” she said.

“I would make the point that private companies are there for profit, but the State is always there for you.”

She also welcomed the publicly funded IVF scheme as another improvement, along with better access to contraception and terminations.