RCM calls for new maternity strategy for Northern Ireland

By Stuart Bonar, Public Affairs Advisor on 11 May 2021 Northern Ireland Maternity Services

A new maternity strategy for Northern Ireland is long overdue. That is the message from the Royal College of Midwives in The case for a new maternity strategy for Northern Ireland, published today.

More than a decade has now passed since Northern Ireland’s Department of Health started work on what eventually became its Strategy for Maternity Care in Northern Ireland 2012-2018. As you can see from its name, three years have passed since it came to an end.

There are lots of reasons why a new strategy is needed, and lots of reasons why the right time for it is now.

The demographics of the women using maternity services in Northern Ireland are changing, for example. Women are having babies later in life than was the case only a few years ago. One illustration of that is that around one birth in four is now to a woman aged 35 or older.

In recent years we have seen the proportion of women accessing maternity care who are overweight rise by a quarter. The proportion of pregnant women with diabetes is markedly up too.

These are just some of the indicators that show that women using maternity services need more care than they did when the last strategy was drawn up. Times are now different, and we need a new strategy to design services for the women who are using them today and into the future.

Since the last strategy ended in 2018, we have seen marked growth in the number of women giving birth in one of Northern Ireland’s midwife-led units. This is something we welcome and we want to see more women get this option; a strategy would help the service work out how to make that happen.

If we look at the age profile of midwives, we see that last year the largest group was made up of midwives in their late fifties. Indeed, there were more than twice as many in their fifties than in their twenties. This needs to be examined and addressed now, and the perfect opportunity for that is as part of a strategic review.

And of course this past year has seen big changes in how healthcare is delivered, in response to the COVID-19 pandemic. Services have innovated in ways that would be useful post-pandemic, for example the use in one trust of a helpline for women that is answered by midwives. This service fields calls that would normally have gone direct to maternity units, pulling midwives away from direct, face-to-face care. A new strategy right now would help capture some of these innovations before they are discontinued as services seek to return to a more normal, pre-pandemic rhythm.

We should be looking across the Irish Sea to lessons that can be learned from the Ockendon Review and other reports, to help us improve the safety of services in Northern Ireland.

Essentially, a lot has changed since the former maternity strategy was drawn up. Some changes have been positive, some negative. Our call, from the RCM, is for a new maternity care strategy for Northern Ireland that can set the service on the right track for the decade ahead. Let’s not delay. Let’s get on and do it.