AIMS IrelandMaternity service users outraged over planned closure of Cavan Midwifery-led Unit
Maternity service users are outraged at the news that Cavan MLU, one of only two midwifery-led units in Ireland, is set to close. This action directly contradicts the government’s commitment, to provide choice in care and improve the quality of care provided to people birthing in Ireland.
After 20 years of scandals and unacceptable incidents within Ireland’s maternity services which destroyed lives, the government allocated millions to set out a road map under which outcomes for pregnant people and their babies could improve. The National Maternity Strategy was launched in 2016 and was completely underpinned by the idea of providing different care pathways through which maternity service users could birth safely and with the support that matched their preference and clinical risk factor.
The closure of Cavan Midwife-Led Unit hammers yet another nail into the coffin of the National Maternity Strategy which has been routinely unravelled since its inception through diversion of funding and lack of commitment.
According to the much heralded National Maternity Strategy Implementation Plan, by now, every area of Ireland should have access to “discrete Alongside Birth Centres or a designated space for ‘supported care’ birthing with a minimum of these to be 10 nationally by Q3 2018”.
Yet, here we are in Q3 2020 closing one of 2 such centres in the country.
Another element of the fairy tale which the National Maternity Strategy has become, was that maternity service users would be consulted and would input into all decisions made in maternity care development. To our knowledge, service users were not consulted at any point nor involved in this decision in any way.
Midwifery-led care and MLU units are proven, scientifically, to be
- As safe as consultant-led care
- Associated with fewer interventions, like having continuous electronic fetal monitoring or augmentation of labour (thus reducing the risk of morbidity/mortality)
- Cheaper than consultant led care at a cost €182 less per woman
- Associated with greater satisfaction in service users for some aspects of care
(https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1285-9)
Removing this choice completely contradicts medical evidence.
In October 2017, the office created to implement the maternity strategy told the people of Ireland that they were aware they needed to “build public confidence in our maternity services, ensure greater choice for women and provide appropriate care in the right place at the right time.”
This latest decision directly contradicts this.
AIMS Chair Krysia Lynch says the decision to close the MLU in Cavan highlights the failure of the ‘hubs and spokes’ approach which led to the creation of hospital groups: “One of the key issues is that this decision came as a result of discussions held at hospital group level. The groups were set up as a ‘governance backstop’, to try and ensure that no local hospital could be run by a local cartel as had been the case in the past.
The Hospital Groups were set up so that smaller hospitals could benefit from the expertise and support of the larger hospitals in the group and most importantly they were set up to ensure no covering up of unsafe practices. The process by which this decision has been made is evidence that this ‘backstop’ measure has been unsuccessful. Local maternity hospitals still do what they want and the clinical opinion of one or two obstetricians within them is still permitted to override national policy and evidence based research.”
Maternity service users deserve and demand detailed information on how this decision was made and what parties were consulted to ensure transparency and to aid understanding of how and why the decision to close the MLU has been made.
For further information or to arrange an interview please contact Emily McElarney, AIMS PR Officer on 0863856225 or AIMS Chair Krysia Lynch on 0877543751
Notes: AIMS Ireland is a consumer-led voluntary organisation that was formed in early 2007 by women, following their own experiences in the Irish maternity system. Our mission is to inform the public on models of care, birth practices and settings, which are supported by evidence-based research and international best practices, and to identify areas of excellence within the Irish Maternity System and to advocate for their extension. Our mission is also to speak on behalf of the service user experience in Ireland as to where evidence based practices are lacking, as to where care is unsafe and as to where new investment and services are needed. We also campaign for recognition of maternal autonomy and issues surrounding informed choice and informed refusal for maternity service users in all aspects of maternity services. In addition we offer support to people who have been adversely affected by their experience of the Irish Maternity System via our support team and our support network.
Evidence on MLU outcomes: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1285-9
National Maternity Strategy:
National Maternity Strategy Implementation Plan: