Sir, – Obstetricians in Wales have a lower case-load of women (Home News, April 27th) because midwives in that country see every woman in the community for their first “booking” visit in pregnancy. All women assessed as being healthy and well, with no risk factors for labour and birth, continue to have midwife-led care throughout pregnancy and can choose to birth at home, in a community birth centre, or hospital. This takes a tremendous load off hospital-based obstetricians.
In Ireland, over-worked obstetricians are responsible for 30,000 “low-risk” women who do not routinely need their care. Midwives are educated, and qualified, to care for such women.
The remaining 40,000 women in Ireland who need medical attention in pregnancy receive less detailed care than they should, because obstetricians are having to spread their time over a wider population of women. This is despite the 2008 KPMG report on maternity care in the Greater Dublin Region, which recommended midwife-led units for the whole country, units that incur, on average, €300,000-800,000 in initial capital costs and result in a saving of €332 per woman birthing there.
Irish research, as well as many international studies, demonstrates consistently that midwife-led care, in a unit close to a maternity hospital, is at least as safe as consultant-led care and is associated with less intervention and greater satisfaction.
Our maternity services are at breaking point. Thirty thousand healthy, normal women receiving expert midwifery care in pregnancy, labour and birth, would save the country €10 million per annum. What is the Government waiting for? – Yours, etc,
CECILY BEGLEY, Prof of
Nursing and Midwifery,
Trinity College Dublin &
DECLAN DEVANE, Prof of
Midwifery, National
University of Ireland,
Galway,
C/o D’Olier Street, Dublin 2.