AIMSI Statement on the Review of Maternity and Gynaecology Services in the Greater Dublin Area

AIMSI welcome the publication of the Independent Review of Maternity & Gynaecology Services in the Greater Dublin Area. In particular we welcome the recommendation for increased choice for women regarding models of care and the recognition that there is considerable evidence for the development of midwifery led units. We agree with the finding that the GDA is out of step in being able to offer a woman-centred service, providing choice and access to services .We share the belief that the GDA needs to place much more emphasis on community based maternity services, as 60% of women will experience a normal birth.

Dear All

AIMS Ireland, (Association for Improvement in the Maternity Services, Ireland) would like to release the following statement on the Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area.

Monday, February 23rd, 2009

AIMSI welcome the publication of the Independent Review of Maternity & Gynaecology Services in the Greater Dublin Area. In particular we welcome the recommendation for increased choice for women regarding models of care and the recognition that there is considerable evidence for the development of midwifery led units. We agree with the finding that the GDA is out of step in being able to offer a woman-centred service, providing choice and access to services .We share the belief that the GDA needs to place much more emphasis on community based maternity services, as 60% of women will experience a normal birth.

We note the link between the policy of active management of labour and the high levels of assisted deliveries in the three GDA hospitals and the fact that the majority of Caesarean sections are carried out on first time mothers. We feel the report, given its limited brief, does not highlight the very significant implications of these findings—findings, of which AIMSI has long been aware. However, we welcome the conclusion that an increase in midwife led care will lead to a reduction in the active management of labour.

We believe the emphasis on reducing the average length of stay (ALOS) unfortunately focused more on the resultant freeing up of capacity rather than the impact on mother and baby and the consequent need for heavy investment in community based postnatal care. We note with concern the fact that all three Dublin hospitals exceeded their designated proportion of private patients with the result that public patients are more likely to be seen by a non consulting hospital doctor.

We note with regret the exclusion of the precedent established by home births with the assistance of Self Employed Community Midwives (formerly known as Independent Midwives).

AIMSI has long called for the provision of shared evidence-based clinical guidelines regarding the provision of care in the maternity services and welcome the fact that the report validates this call. AIMSI in meeting with the Minister for Health have called for the creation of National Guidelines for Maternity Care, including consent-related procedures and public access to data on all maternity-related procedures, practices and outcomes, by hospital and by health provider. We feel this will promote transparency and facilitate service users in choosing their preferred model of care.

We call on the Minister to honour the recommendations of the Report and ensure that the "Proposed Pathway of Care" is established before the predicted fertility boom of 2014.

Gillian Kane
Chairperson
AIMS Ireland

For more information or questions please contact gillian@aimsireland.com

www.aimsireland.com
http://aimsireland.com/phpbb/

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