Childbirth policies and practices in Ireland and the journey towards midwifery-led care.

Full Abstract

OBJECTIVE:
To describe the dominant policies and practices that have governed childbirth in Ireland, and to outline the progress made towards the introduction of midwifery-led care in one health region.

LITERATURE REVIEW:
A review of maternity-care policies in Ireland was conducted using government and regional health-authority documents and two historical reviews of government policies. A search was also carried out in PubMed and cinahl databases, using the keywords 'maternity care', 'childbirth', 'policy', 'midwifery-led', 'Ireland/Irish', with relevant Boolean and string operands. Childbirth as a social process is influenced by the model of care, and affects the physical and psychological outcomes for the woman and her family. In Ireland, routine intervention in labour is common, but, since the early 1990s, some changes in the Irish maternity services have taken place. Pilot projects on community midwifery have been introduced in some areas. Challenges to the provision of maternity care in the Health Service Executive, North Eastern area (formerly the North-Eastern Health Board) led to the production of the Kinder report, which included a recommendation to introduce pilot midwifery-led units (MLUs). THE INTRODUCTION OF MIDWIFERY-LED

CARE:
A Maternity Services Taskforce was established in January 2002 with a wide remit, including facilitation of the establishment of MLUs in Cavan General Hospital, Cavan and Our Lady of Lourdes Hospital, Drogheda, Co. Louth. The MLUs are being evaluated within the context of a randomised trial known as 'the MidU study', which compares midwife-led care with the present system of medical-led care for women who are at low risk of complications during pregnancy and labour.

CONCLUSION:
The journey to midwifery-led care in Ireland has been a long one. The phased introduction of MLUs, which are subject to rigorous evaluation, will provide quality evidence upon which to base the future development of maternity care across Ireland.

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Author information

Author/s: Devane, Declan (D); Murphy-Lawless, Jo (J); Begley, Cecily M (CM);

Affiliation: School of Nursing and Midwifery, Trinity College Dublin, 24, D'Olier St, Dublin 2, Ireland. ddevane(-atsign-)tcd.ie

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: Midwifery (Midwifery), published in Scotland. (Language: eng)

Reference: 2007-Mar; vol 23 (issue 1) : pp 92-101

Dates: Created 2007/02/13; Completed 2007/04/25;

PMID: 16677746, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Female
Health Policy
Humans
Ireland
Leadership
Maternal Health Services - organization & administration

Midwifery - organization & administration
Nurse's Role
Nursing Evaluation Research
Pregnancy
Pregnancy Complications - nursing
Quality of Health Care - organization & administration
Women's Health

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