There are other options for ante- and postnatal care

I read today’s article Pregnant women face long delays at hospitals in The Irish Times with interest. The sentence that really got me going was “A woman who was three months pregnant when she recently approached the three main maternity hospitals in the city for a public appointment with an obstetrician was told the first available appointments would be when she was 7½ months into her pregnancy.” I can only take the writer’s word for it that this woman specifically asked for an appointment with an obstetrician. It is probably true because women in Dublin do not seem to be aware that there are other options that would make far better uses of the resources made available to them by the strung out maternity hospitals.

Both the National Maternity Hospital (Holles St.) and The Rotunda offer Domino schemes. These are schemes that are led by a team of midwives. On both of my pregnancies I opted for the Domino scheme in Holles st. I originally heard about the scheme from my GP. On both my pregnancies I opted for combined care which meant that the practice nurse (who also happened to be an experienced midwife) and the team of midwives split my care between them. I think the longest I had to wait for any appointment in the hospital was 15 minutes (not so in the GPs but it wasn’t too bad because I was always seeing the practice nurse). On my second pregnancy, because I opted for a homebirth, I only had one appointment in the hospital; all the rest of my appointments took place at home usually on a Saturday so I never missed any work. I do know that I’m entitled to time off for my antenatal care but I didn’t need it. The only reason I was ever in Holles st. was for my (brilliant midwife led!) yoga classes, for 2 scans, and for the final delivery of my overdue son. I was back home less than 12 hours later.

For me this scheme acknowledged my belief that I was pregnant, not sick, so I therefore did not need to be in a hospital. There was a consultant assigned to the scheme so if any complications had arisen I had access to specialist care. (and I do not have the stats but I BET a majority of pregnancies are without complications of any kind.) I felt completely specially cared for by the midwives on the team who were knowledgeable, interested, down-to-earth, and community focused. They included Himself in all parts of the experience and even on my second pregnancy, and to my parents’ amazement, my midwife asked me if they would like to hear the baby’s heartbeat during one visit thus including the grandparents in the experience. When I was giving birth it was in the company of people I knew and trusted which was a great comfort. When I learnt all the new things a mother needs to learn about feeding, bathing and holding a new baby, I learnt them in my own home environment during daily follow-up visits from the team of midwives. My first days with my babies were in the quiet, comfort and privacy of my own home. There was no pressure to be able to confirm that breastfeeding was established within the three days of delivery before the hospital discharged me. Visitors could come and go at times that suited me. I could eat food that I enjoyed rather than endured. I could watch TV, listen to music, get out of the house and into the garden. Had all gone to plan Nipper 2.0 would have been born in this environment too.

The Coombe Women’s Hospital, as I understand it, are applying for funding for a Domino scheme. While there are costs in recruiting, equipping and setting up facilities for such a scheme it is a fact that they cost far less to run that obstetric clinics with specialists especially when those specialist spend time consulting with women who have no real need for their services. It’s a criminal waste of resources. As I understand from the midwives who cared for me, they have a high success rate but at-risk women are excluded from the programme although I’m not sure if this includes those expecting twins. In the meantime the Coombe have a midwifery led unit and an early transfer home programme and community antenatal clinics.

On the way home this evening I heard Michael Robson, Master of Holles St. speaking to Matt Cooper on The Last Word about this issue. I was very happy to hear him point out that most GPs would be qualified to look after a woman during her pregnancy and would have the knowledge to know when she should be referred to a consultant obstetrician. While he emphasised care in the community he didn’t not mention his community midwives specifically.

I also understand that there is a Domino scheme available from Wexford General Hospital. There may be more available or midwifery led units or community care/ early transfer home programmes available in your area. Ask about them, find out more and at the very least, know your options before you choose to be treated as a patient rather than a healthy woman.

Also check out this article from The Irish Independent where two women describe their experience of midwife ante- and postnatal care.

If today’s news doesn’t lead you to demand more options for your ante- and postnatal care from your local TD, and the Minister for Health I don’t know what will.

2 Replies to “There are other options for ante- and postnatal care”

  1. Being currently pregnant with my 4th baby and having had the other 3 in the UK, I agree that a lot of pregnant women are not aware of their options regarding their antenatal care here in Ireland.
    My first 3 children were all born under mid-wife lead care and thankfully I never had the need to complain about it and felt I was getting the best possible care at the time.
    whilst pregnant in Ireland i was basically told by friends and family that the only way to go was privately. Having said that I didn’t have any problem getting an appointment with an obstetrician and never experience delays with my appointments.
    However, perhaps if i had looked into it a little further I may have opted for the domino scheme run by so many of the Dublin hospitals.

    Antenatal Classes are also another grey area for pregnant women. Hospitals do run antenatal classes usually held over the course of 5 or 6 weeks in the evenings. This doesn’t always suit working parents to be and a better option is a One Day Antenatal Course usually held on a Saturday.

    We at run One Day Antenatal Courses in 3 venues around Dublin which informs parents on all they need to know before the big day. Run by practicing midwives the course is invaluable to first time parents.

    On my 4th I’m looking forward to my 3 day stay in hospital – its one of the perks !

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