Babies are dying because pregnant mothers do not have adequate access to ultrasound scans, the Oireachtas Joint Committee on Health has heard.
UCC professor of obstetrics and consultant obstetrician and gynaecologist Louise Kenny said in Cork fewer than half of pregnant women have access to the 20- to 22-week ultrasound screening scan.
She said all pregnant women should undergo the scan, but clinicians are in a position where they have to allocate scans on a triage-style system based on potential risk.
But, she added: “The vast majority of babies that are born with complex foetal abnormality or significant neo-natal conditions are not born to women with any risk factors.
“In that kind of situation we will miss the majority of babies that are born with problems… If they are not picked up it will increase the mortality from those conditions – babies will and do die as a direct result of a lack of access to ultrasound.”
Concerns expressed
At the same meeting, the Irish Nurses and Midwives Organisation (INMO) expressed concerns over delays around the implementation of the National Maternity Strategy 2016-2026.
INMO vice-president Mary Leahy said the strategy was widely welcomed, but little had been done a year after it was published.
She said the strategy committed to bringing about a midwife-to-birth ratio of 1:29.5, but that in some areas the ratio remains as high as 1:40.
Ms Leahy said the strategy would require increasing the number of midwife posts, but current services remain completely understaffed.
A “fundamental requirement” is to increase the number of direct entry undergraduate midwife places by 25 per cent, she said.
Also appearing before the committee, chair of the Institute of Obstetricians and Gynaecologists Peter Boylan said the mastership model of governance that applies to the three Dublin maternity hospitals should be introduced nationwide.
He said maternity hospitals should have an accountable master who would be responsible for safety and services. The model would also give maternity services control over their own budget, as well as the recruitment of staff.
Dr Boylan said the governance model whereby maternity units are integrated into hospitals is a failure, as shown through well-documented tragedies in maternity care.
He also said expert ultrasound should be available for all women around the country and that current geographical inadequacies needed to be addressed. He added that Ireland required an additional 100 consultants to bring the country up to international norms.
Later, the HSE’s national director of acute hospitals Liam Woods said primary care services have invested in externally provided ultrasound services along the western seaboard.
‘A critical component’
He said these support hospitals are struggling to deliver in terms of volume demand. “So absolutely we see the provision of more ultrasound as a critical component both of our wider interaction with the primary care service and as part of this strategy.”
He also said plans were in place to recruit officials to ensure the implementation of the national maternity strategy. “We are putting an office in place for implementing plans,” he said.
On the question of maternity service governance outside Dublin, Mr Woods said: “We don’t see the appointment of a person titled master in the other 16 units - we do see the appointment of strong clinical leadership with a managerial input in the networks and within the individual hospitals to support what they are doing.”
