Officials warned a year ago that problems with unplanned arrivals of heavily pregnant immigrants at Dublin's three main maternity hospitals had become so serious that it would damage staff morale and future recruitment.
A report of study visits to the hospitals documented concern that pressures on staff and the conditions brought about by unplanned late arrivals by non-nationals could lead to a lowering of professional medical and nursing standards.
The report, which has been obtained under the Freedom of Information Act, was written by two officials from the Reception and Integration Agency which deals with asylum-seekers and the Northern Area Health Board.
It was conducted at the request of the maternity hospitals' Joint Standing Committee, who asked the authors to report on the impact on the hospitals' workloads of births to asylum-seekers and other non-nationals.
Since the report's completion last March, a dedicated ante-natal clinic for pregnant asylum-seekers has been set up in north County Dublin to help ease the pressure on the capital's maternity hospitals.
The three Dublin hospitals visited in October 2001 - the Coombe, Holles Street and the Rotunda - all reported significant increases in births to non-EU nationals in recent years, including immigrant workers, asylum-seekers and students.
The report said unplanned late arrivals by non-nationals was the most significant problem raised by all hospitals.
"This causes serious difficulties for staff by generating very significant levels of extra work in addition to coping with the inflow of normal booked and emergency cases among the indigenous population.
"The situation has given rise to unprecedented levels of stress and frustration among staff," it said.
The report quotes an example in one hospital where a pregnant non-EU national arrived at Dublin Airport in labour and expecting twins, with the first baby in a breach position.
"The authors of this report are of the view that the situation has become so serious that if it is not addressed soon, it will so affect the hospitals as to have a deleterious affect on staff morale and the future recruitment of staff," it said.
The officials during their hospital visits also recorded concerns that some pregnant women in the indigenous population were cancelling their bookings and making arrangements to have their babies in maternity facilities in other hospitals.
Hospital staff were very concerned at "what may be perceived as a racist attitude possibly creeping into their work," arising from the sheer volume of additional work generated by non-national late arrivals, and the demanding nature of many patients in this group.
"Staff are very concerned about this issue and its potential effects on their work which they feel they are doing to the highest possible professional standards," it adds.
Staff also expressed concerns about the possible medico-legal implications for them in providing services under levels of pressure and having regard to the overcrowded conditions increasingly experienced in recent years, the authors add.
The report recommended dispersal of pregnant asylum-seekers around the State if there are no medical complications, a system which is currently being developed through the ante-natal clinic located in the Balseskin reception centre for asylum-seekers in north Dublin.
It also recommended an educational programme for asylum-seekers on health and maternity issues as well as better communication systems between the hospitals.
The authorities expect that recent restrictions on Ireland's unique residency entitlements for parents of children born in State, who are automatically entitled to citizenship, will lead to a reduction in the numbers of non-EU immigrants coming to Ireland to have children. The report had cited this Constitutional and legal provision as the most important contributing factor to the rise in the number of births to non-nationals in Irish hospitals.