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The State and its National Maternity Services in 2015: How we got here
Coleman Legal LLP
Mar 4, 2015

The number of maternal deaths in Ireland has risen sharply, up by 22%, meaning the pregnancy-related death rate in Ireland is now higher than that in the UK, according to a new report of the Confidential Maternal Death Enquiry, based in UCC.

In this country in the last two years, we have seen an unprecedented series of high-profile inquests into the care being provided to new mothers and their children. Savita Halappanavar, Jennifer Crean, Bimbo Onanuga, Dhara Kivlehan, Nora Hyland and Sally Rowlette became household names as their harrowing cases were brought through the inquests. Multiple reports were commissioned after the death of Savita Halappanavar and a central recommendation was that a national maternity strategy was needed. More routinely our newspapers have been informing us of the latest cases with all too common features; bereft spouses fighting for public hearings into the death of their wives, in the hope that such tragedies could be learned from and prevented in the future.

All the families involved in these traumatic and life altering cases were from different backgrounds and cultures but more often than not they emerged united in their views of the HSE after their experiences; they were at best to be described as ‘obstructive’ and would refute any claims of liability until the verdicts of medical misadventure had been hard won by the families.

The Portlaoise Maternity Unit is currently under a formal HIQA investigation, with the findings to be published in the coming months, following the deaths of four babies just over a year ago now. Just two months ago, in December 2014, a pregnant woman who presented at the hospital was wrongly told her baby had been dead for five weeks. However, only two days later and after she had spent those two days grieving for her baby another scan revealed that the baby was not dead and had a healthy heartbeat.

During that same month the inquest into the case of baby Mary Kate Kelly returned a verdict of medical misadventure. It found the baby’s life would have been saved if a doctor at the hospital had acted on the results of a scan of the foetal heartbeat. The mother was told everything was satisfactory and was subsequently discharged. Tragically, the next day her baby died in the womb.

There have been so many worrying developments and revelations in recent years that, last year, the HSE set up a panel reviewing childbirth complaints in Irish hospitals.

Portiuncula Hospital in County Galway is at the centre of the one of the latest controversies relating to standards in maternity units in Ireland. The HSE is expected to publish the terms of reference of an inquiry into problem deliveries at the hospital soon, where it will review the delivery of seven oxygen-deprived babies last year, two of whom died. The worry for Portiuncula does not end there however, as another eight families are putting pressure on the HSE to widen the inquiry’s scope to cover other problem births.

While there is no question that the HSE puts the health and safety of mothers and new babies on a pedestal, there does, of late, seem to have been a breakdown in what that entails. Ms Jene Kelly, Chair of AIMS Ireland, the Association for Improvements in the Maternity Services recently stated that ““There is a view in Ireland that the quality of maternity care does not matter, as long as you end up with a healthy baby. Well, of course that’s the most important thing but there are many other crucial issues relating to maternity care which are simply not being addressed; basically, women are not being listened to by those providing services.”

AIMS Ireland (The Association for the Improvement of Maternal Services) which was set up in 2007 is a consumer-led voluntary organisation that was formed by women, following their own experiences in the Irish maternity system which offers independent, confidential, non-judgmental support and information on maternity choices and care to women and their families.

Not surprisingly, the HSE’s 2015 Service Plan (released only two months ago) names maternity services as in need of investment – the full 100 plus page pdf can be downloaded below. This, as well as its new Quality Enablement Programme, provides the perfect opportunity for 2015 to be the year where real progress is made in our maternity units.

One can only hope that the HSE takes stock of these worrying statistics and effects change throughout its system and protocols with as much urgency and case as it requires. In the meantime, Irish women find themselves in a health system that seems to be in dire need of reform and positive change.

Kathrin Coleman, 2015

 Expand your research into the National Maternity Services:

Keith Rolls Partner Coleman Legal LLP

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