HEALTH MINISTER JENNIFER Carroll MacNeill has expressed confidence in Irish maternity care after the former national maternity hospital master criticised new guidelines.

Dr Peter Boylan recently expressed “grave concerns” about the National Clinical Practice Guidelines on labour and called for an urgent, warning that the current recommendations can lead to dangerous outcomes for women and babies.

Speaking on RTÉ Radio One on Monday, he pointed to recent findings of the Ockenden report in the UK, which found that more than 500 mothers and babies suffered avoidable harm or died in the country’s maternity system.

“My concern is that we are going to introduce something in Irish labour that has led to catastrophic outcomes in the UK,” Boylan said.

He added that the guidelines say that the first stage of labour doesn’t start until woman is at four centimetres dilation, which is “40% of the way” into birth given delivery will take place at 10 centimetres dilation.

Boylan said that as the guidelines advise that foetal monitoring doesn’t need to start until the beginning of labour, it could mean “that from o to 4 centimetres the baby is not monitored, and that’s dangerous”.

The current National Maternity Strategy expires this year and a consultation process for the next 10 years is expected to open within months.

File Photo: Dr Peter Boylan

Minister’s response

Asked if she wanted to see Boylan’s concerns examined in that process, MacNeill said:

“I have every respect for every retired consultant, every retired minister, every retired Taoiseach, but the people who I take advice from are the clinical leads of the day.

“And Cliona Murphy is doing a fantastic, fantastic job as the clinical director of the Women and Infants programme, and I look forward to seeing her recommendations as we move into the next national maternity strategy for the future.”

She said women were being provided a “a much better” and “more transparent” service than 10 years ago.

“We have 19 maternity units, all of their outcomes are available on the internet to be able to track, monitor, watch. We have a very, very high standard of care,” said the minister. 

“We have very few events that have poor outcomes, they’re exceptionally serious when they do happen, but there are much fewer events than would have been the case, and I have real confidence in the clinicians of today to deliver for the women of today,” she added. 

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Murphy said this week that Boylan had “over-interpreted the guideline”, which she said are for “women with uncomplicated single pregnancies, and women who are trying to avoid over intervention and less medicalisation”.

“Things have moved on in Ireland, women are involved in their care, women are advocates for their care, and midwives develop good relationships with women, so it’s individualised care,” Murphy said.

She contrasted this with the previous, “slightly more paternalistic model where women were told what was happening, and there was no discussion with women” about their choices during labour.

The minister said her department is currently evaluating the previous 10-year strategy but said there had been “huge progress” in maternity care.

“I gave birth in 2015 and it is a different landscape in terms of the care and the focus of women, putting women at the centre of their own advocacy, putting women at the centre of their experience,” said Caroll MacNeill. 

Over the next 10 years, the minister said a “very different maternity landscape” will be built, stating there’s a very clear direction.