Save Midwifery in Ireland

Maternity services in Ireland are in great crisis. Midwifery care is grounded by the respect for each woman and her right to choose what is best for her and her family. Some big changes need to be made in order to give women what they deserve. Please sign this to support a change which affect so many women and their families in Ireland. According to latest figures from the National Perinatal Reporting System (ESRI) - Between 2007 and 2008 there has been a 5 per cent increase in births - 75,587 births in 2008 - Birth rate of 17 per 1,000 population the highest of the 27 EU countries in 2008 - Current Caesarean section rate of 27.1 per cent marks an increase of 4.1 per cent between 1999 and 2008 - We stand only 13th of 20 EU countries in respect of good perinatal outcomes- 12 countries have lower rates of perinatal mortality than we have Additional aspects of the crisis include the following: - Our maternity units are understaffed throughout: according to the KPMG study of the three Dublin maternity hospitals in 2009, they were almost 300 (293) staff short of what they require for safety - We have high rates of routinised interventions, according to the Cuidiu national surveys, preventing women with low-risks from having normal births - Our maternity hospitals and maternity units do not routinely use evidence-based care as set out in the UK NICE guidelines - The AIMSI 2010 national survey indicates widespread unease and dissatisfaction of women with our maternity services - Initial antenatal consultations can be as short as 10 minutes, even for first-time mothers - Many of these initial consultations may come in the second trimester of pregnancy rather than the first because of shortages of resources - Water birth is NOT used at all in any RoI maternity unit, yet it is promoted by RCM and RCOG in UK and UK NICE guidelines also promote it for safe birth to help women give birth without epidural pain relief (epidural pain relief leads to increased instrumental deliveries of babies with resultant trauma for babies) - Postnatal support is negligible within the community, leaving women unsupported, especially first-time mothers, at a critical point in their lives - Our newly qualified four year degree midwives, who are urgently needed to bring staffing levels up to complement, are unable to find work here and are emigrating - In respect of home births, our rates are woefully low by comparison with the UK and woefully under-supported by the HSE and our maternity units. - Sections 24 and 40 of the proposed Nurses and Midwives Act, if passed unamended, will criminalise midwives working as independent community midwives to support women in home births Irish Data to Support Change The lack of extensive support for genuine midwifery-led care leaves our services spending far in excess of what they should, resulting in far less than optimum care for women and babies. Any birth where interventions are involved: instrumental delivery, Caesarean section and epidurals ups the overall costs considerably with no benefit to the woman and her baby for normal low-risk women. The randomised controlled trial study of the two pilot midwifery-led units in the HSE northeast, the MidU study ( School of Nursing and Midwifery, Trinity College Dublin (2009) An evaluation of midwifery-led care: the Report of the MidU Study. Dublin: HSE) indicates overwhelmingly that midwifery-led care has better outcomes for mothers and babies and is economically a much more cost-effective model of care than the conventional consultant-led care currently available for normal low-risk women in our public maternity hospitals. What we demand: - that every woman has a genuine option of electing to have and being able to access midwifery-led care - that Sections 24 and 40 of the Nurses and Midwives Bill be amended as a matter of urgency before the state faces High and Supreme Court actions about their unconstitutionality - that a substantial sum of the 1.3 billion in fees from the banks arising from the 2008 Eligible Liabilities Guarantee now held in an account in the Central Bank be utilised to do the following: - expand the scope of the midwifery led units in the HSE northeast - establish midwifery-led units in the three Dublin hospitals, as well as in Cork, Galway, Limerick et al. - expand proper support for home birth schemes and self-employed community midwives in Dublin, the southeast (Wexford/Waterford), Cork and Kerry - initiate these tried and tested home birth schemes elsewhere in the country - establish ongoing posts for newly graduated midwives, so that we do not lose them in a brain drain like that of the 1980s - restore the 36 week payment of 80% baseline salary to fourth year midwifery students These measures can also be funded through: - the downsizing of current consultant-led units with resultant savings for Midwifery-led units which will deliver better care and outcomes - strict enforcement of consultants’ public contracts - strict enforcement of a 100,000 Euro ceiling on all HSE administrative and managerial scales of pay