The number of women turning up unbooked and in labour at Dublin's Rotunda Hospital was "startling", the hospital's Master, Dr Michael Geary, said yesterday.
Dr Geary said 249 women or 13 per cent of all non-Irish women giving birth in the hospital in 2002 fell into this category. "That is a startling statistic," he said.
He told The Irish Times many of them were turning up, having just arrived off a plane.
Asked about the numbers turning up in this manner, he said: "I can't quantify that number but it's not an infrequent occurrence." He also pointed out that 324 women or 17 per cent of of all non-Irish women giving birth in the hospital turned up unbooked and within 10 days of delivering their baby.
And of the other 70 per cent of non-Irish women who gave birth in the hospital in 2002, many of them booked in late.
Asked how many of these were giving birth in the hospital to obtain Irish citizenship for their offspring, Dr Geary said: "All I can say is that when a number of women were asked why they travelled here so late, they gave that as the reason. I can't give a number for these.
"I would ask the open-ended question: why should somebody staying in the UK and receiving antenatal care at a hospital there, why would they get on a plane at 40 weeks and come here?"
Dr Geary stressed that the Rotunda, like the other Dublin maternity hospitals, looked after everyone who came to its door, regardless of their colour, race or religion, and would continue to do so.
"But if we see pressures on our hospital resources or practices develop that are dangerous, we must raise it. We have done so and sadly this is continuing. I do not believe it's a safe practice," he said.
"We all embrace the asylum-seeking person fleeing a war-torn country, but I think it's difficult for somebody to understand why somebody would live in another EU country and when in labour get on a plane. It makes no sense and is unsafe.
"We have been fortunate that there have not been any maternal mortalities as a result of this but there have been some near misses. I know of three cases where there were near misses as a result of people getting on a plane late in the day. If this continues it's a question of time until there is a disaster."
Dr Geary refused to express an opinion on the forthcoming referendum. He said his personal view was irrelevant. He said there had been a lot of discussion over what was said to the Minister for Justice, Mr McDowell. At the end of the day it was a matter of interpretation, he said.
"The Minister may have interpreted our concerns as a plea for something to be done. I don't believe it was a plea. But at no stage did I tell him how to run the country.
"I think far too much has been made about what the Minister said and what we said. It's unfortunate that individuals are trying to score political points on this issue," Dr Geary said.
"The debate should move on from this ... there are much wider issues than just the numbers. The issues of safety and risk are ones to be considered very strongly."
Meanwhile the Master of the Coombe Women's Hospital, Dr Seán Daly, said 225 women arrived unbooked at his hospital with three weeks to delivery in 2003. Just over half of them, 116 women, were non-nationals.
He told RTÉ's Morning Ireland that if the women coming to the hospital to give birth specifically to gain Irish citizenship for their children were taken out of the equation, the pressure on the hospital probably wouldn't change significantly. He said the Coombe needed to be better resourced to cope with its increased workload but refused to express a view on the referendum.
The Master of the National Maternity Hospital, Dr Declan Keane, said he believed citizenship was the motivation for "a high proportion" of women travelling to the State late in pregnancy.
"I think that is being highlighted even more by a big shift in the nature of these patients coming even in the last year.
"Up until about 2002 many of these patients were coming directly from eastern European countries or indeed from sub-Saharan Africa to this country almost directly, but more recently we have noticed a change whereby African women and eastern European patients who are living in Paris, Holland and indeed Britain, and are getting their full antenatal care there, are coming to this country at the last moment, at 35, 36 weeks.
"Now they cannot be coming for medical reasons because these countries offer extremely good maternity and obstetrical care, so I do believe that they are coming for one reason and one reason only, and that is for citizenship reasons," he said.