The Independent Review Panel report into the death of baby Bronagh Livingstone concludes that the staff and equipment at Monaghan General Hospital were more than adequate to initially resuscitate and stabilise the infant.
The reports summary states: "If baby Bronagh Livingstone had been delivered in Monaghan General Hospital, the nurses and doctor all knew what the appropriate steps were in terms of the management of this situation.
"The consultant anaesthetist would have been called and an incubator would have been obtained from the labour ward.
"The consultant anaesthetist has certification and training in neonatal resuscitation. Baby Bronagh could also have been placed in an incubator which was more than adequate to maintain heat.
"There was a sophisticated resuscitaire available in the delivery suite which could have been used to ventilate the baby although the consultant anaesthetist who was on call that night was unaware of this. Subsequently, we presume that this would not have been utilised.
"However, it is our assessment that both the personnel and equipment available in Monaghan General Hospital were more than adequate to initially resuscitate and stabilise a baby like Bronagh Livingstone.
"While it could be argued as a result of the expert level of care given by the emergency medical technicians, that the condition of Bronagh Livingstone on arrival in Cavan General Hospital upon transfer in the ambulance did not affect the outcome, we are of the opinion that best practice would dictate that Ms Denise Livingstone should have been delivered in Monaghan General Hospital and that delivery during transport in an ambulance is not optimal.
"Given Bronagh's birth weight, the fact that she was born at 24 weeks and 6 days, and the fact that the premature labour appears to have been associated with a placental abruption, her chance of survival could be less than 10 per cent. Unfortunately more than 50 per cent of survivors could have significant disability."
The report makes 14 main recommendations. They are:
1. That all women in the NEHB have access to a woman-centred quality service which is safe, accessible and sustainable.
2. That the north-eastern region should be self-sufficient as far as possible in providing maternity and childcare, offering a comprehensive range of services.
3. The establishment of a Task Force to develop the recommendations in terms of policies and protocols to be put in place, to process key appointments which have to be made urgently and to plan adaptations to the existing buildings.
4. A level 3 obstetric unit to be based at Our Lady of Lourdes Hospital, Drogheda, together with the Regional National Intensive Care Unit.
5. A Level 2 obstetric unit to be based at Cavan General Hospital together with a Level 2 Special Care Baby Unit.
6. Midwife-led units to be developed in Cavan and Drogheda.
7. The phased opening of midwife-led units in Dundalk and Monaghan as soon as possible.
8. Development of an ambulatory community paediatric out-patient service in Monaghan and Dundalk.
9. A midwife-led unit to be established in Navan as soon as this is judged to be necessary.
10. Provision of a midwifery service in the community separate from the public health nursing service.
11. Provision of shared care between the general practitioner and the maternity services.
12. Extra consultant appointments in Obstetrics/Gynaecology and Paediatrics.
13. Our Lady of Lourdes Hospital to be approved as a training centre to allow placement of students in neo-natal nursing course.
14. Accommodation at Monaghan, Dundalk to be upgraded/replaced.