Minister for Health attends 25th anniversary event for Community Midwifery Services at the National Maternity Hospital

The Minister for Health Stephen Donnelly has today addressed the 25th anniversary event for Community Midwifery Services at the National Maternity Hospital.

This Community Midwifery Service was established in 1999 to provide choice for women who wished to receive midwife-led care within the community. The service was the first of its kind nationally and remains one of the largest community midwifery-led service in the country.

Since 1999, the service has evolved and expanded to include specialist midwives, lactation consultants, midwife prescribers, newborn examination practitioners, and ultrasound providers.

The 25th anniversary event celebrates the dedication and innovation of the Hospitals Community Midwifery team. It brings together current and past staff members and service users. Professor Declan Keane (former Master of the National Maternity Hospital) and Maeve Dwyer (former Director of Midwifery), who first developed the service attended the celebration.

Minister Donnelly said:

The National Maternity Hospital (NMH) Community Midwifery Services opened in 1999. The Community Midwifery Services include:

A Domino (‘Domiciliary care In and Out of hospital’) and Homebirth Service, and A Community Satellite Clinic and Early Transfer Home Service.

To date, the Community Midwifery Service has provided care for over 35,000 women both during pregnancy and after birth.

The Domino and Homebirth Service has cared for over 10,000 women and facilitated over 800 home births.

The Community Satellite Clinic and Early Transfer Home Service offers midwifery care in community clinics for women who are on the Supported Care Pathway and the Assisted Care Pathway. Women in the catchment areas can also avail of early transfer home, and have their postnatal care continued by the Community Midwifery Team in their own home.

National Maternity Strategy

The National Maternity Strategy, ‘Creating a Better Future Together’ (2016 – 2026) was published in January 2016 and represents a significant development in the delivery of national maternity policy to fundamentally change how maternity care is delivered.

The Strategy identifies four strategic priorities:

1. A health and wellbeing approach.

2. Safe, high quality, nationally consistent, woman centred care.

3. Facilitation of a woman’s choice through the development of a new model of maternity care with three care pathways (Supported Care, Assisted Care and Specialised Care) depending on individual need.

4. Strong governance and an appropriately resourced skilled workforce.

To date, €25.6 million has been invested in progressing the Strategy’s actions. This includes recruitment of over 500 additional full-time staff into maternity services, across a range of specialities.

Postnatal hubs

A pilot project for the development of postnatal hubs is being implemented. Postnatal hubs are giving women access to postnatal care in community settings, away from a hospital environment. These hubs are offering a range of services, including postnatal review appointments to women prior to discharge from the postnatal ward, birth reflections, infant feeding assessment and supports, discussion of choices for future pregnancy, general health promotion, and telephone support. To date, these services have been very well-received by women, and are providing welcome additional structured postnatal support.

A total of five postnatal hubs are now operating, including in Sligo, Carlow-Kilkenny, Cork, Kerry, and Portiuncula.

Funding of €0.31 million has been secured in 2024 under the Women’s Health Action Plan to fund an additional four postnatal hubs.

Investment

Since 2020, more than €1.4 million has been allocated to the NMH to develop services through National Maternity Strategy, Gynaecology and Women’s Health Taskforce funding. This funding has supported 18 additional specialist posts, including senior social workers, neonatologists, advanced midwife/nurse practitioners, occupational therapists, and physiotherapists.

National Perinatal Genomics Service

A structure to extend existing services to form a National Perinatal Genomics Service was designed and approved in 2023. Through this service, women are accessing evaluation, diagnosis, management, and treatment of anomalies before birth. The additional recruitment of staff will enable more women across the country to access this service, with shorter referral times.

The National Maternity Hospitals’ perinatal genetics and genomics service will be the cornerstone of the National Perinatal Genomics Service. Agreement has been reached to initially establish one national and cohesive Perinatal Genomics service located across the three Dublin maternity hospitals (NMH, Rotunda and the Coombe) with structured pathways of access involving all six foetal maternal services.

eHealth

The NMH has also been at the forefront of developments in eHealth. The Maternity and Newborn Clinical Management System (MN-CMS) is a full Electronic Health Record and was implemented in its first phase in NMH in January 2018. MN-CMS is continuing to be rolled out in maternity hospitals and units across the country.

Gynaecology

In keeping with the government’s commitments to promoting women’s health, significant funding has been provided for gynaecology services from 2019. This has enabled the NMH to expand its gynaecology-related services to include the following:

• ambulatory gynaecology service and enhanced gynaecology theatre capacity
• a Regional Fertility Hub for the Ireland East Hospital Group
• a National Mesh Complications Service in collaboration with Cork University Maternity Hospital
• a specialist menopause clinic
• an endometriosis hub as part of the National Endometriosis Framework
• termination of Pregnancy Service