Fears for future of midwifery-led service in Cork

Changes to Domino initiative as maternity hospital has up to 80 vacancies

The Cork University Maternity Hospital service saw around 400 women during 2024. File picture

There are fears for the future of a midwifery-led service in Cork which deals with 400 women a year amid claims the maternity hospital has up to 80 vacancies.

Changes to Cork University Maternity Hospital’s (CUMH) Domino service have been shared with expectant mothers at appointments this week.

Under the Domino system, women are seen by a team of about eight senior midwives working with a GP. 

The same midwives support them during birth at CUMH and post-natal care at home.

Domino stands for ‘domiciliary care in and out of hospital’. 

Only four other units offer the service including Waterford. 

The Cork service saw around 400 women during 2024.

However HSE Southwest said on Tuesday: “From October 12, some changes to staffing arrangements within the service will come into effect.

“The Domino scheme will continue to provide midwifery-led community care, with patient safety remaining the overriding priority.” 

Women can still choose this for pregnancy care and classes but a spokeswoman said midwives from a different team will do the post-natal care. 

For births, she said: “Where operationally feasible, Domino midwives will continue to support women who present in labour in the birthing suite at CUMH.” 

A 24-hour Domino phone line will redirect women instead to the maternity emergency room telephone.

The spokeswoman also said a separate Home Birth service at CUMH “remains unchanged”.

The Irish Nurses and Midwives Organisation raised concerns about the changes. 

Assistant director of industrial relations Liam Conway said it is linked to “restrictions on the filling of vacant clinical posts” across Cork and Kerry.

It is taking "far too long" for CUMH to get posts approved at national level, he said. 

“Since June 2026, no promotional posts have been approved. As a direct consequence, there are now over 80 nursing and midwifery vacancies in CUMH,” he said.

Mr Conway added: “The provision of this service, and the wellbeing of women and their babies, must not be curtailed due to a stand-off between local HSE management and national HSE structures.” 

AIMS Eire (Association for Improvement in Maternity Services) maternity advocate Krysia Lynch said: "The outcomes for mothers and babies from Domino care are exemplary." 

She called for a recruitment drive instead, saying: "The HSE really needs to assure mothers that if there are 80 unfilled midwifery or nursing posts, that women and their babies are getting the safest level of care."

Social Democrats health spokesman Padraig Rice said: “This community midwife-led service should be expanded to other maternity hospitals and units, not reduced. This decision is deeply regressive."