Maternity services: Troubling disparities
All Irish women must have equal access to specialist obstetric services
Maternity care has become something of a bellwether for health services in the Republic. The shock associated with the death of Savita Halappanavar at University Hospital Galway in 2012 and the unacceptably substandard care revealed by investigations into the obstetrics unit at Portlaoise General Hospital sensitised the public to shortcomings in our public health system. Newly published research confirms the validity of ongoing concerns.
Among its many recommendations, the National Maternity Strategy stated there must be equal access to standardised ultrasound services for every pregnant woman.
It followed the identification of a national geographic inequity in the availability of 20-week foetal anomaly scans – a potentially dangerous omission for women unable to access them.
Researchers at University College Cork surveyed the country’s 19 obstetric units in February to establish how many complied with current ultrasound guidelines. Their paper in the Irish Medical Journal confirms that just 37 per cent of obstetric units offered foetal anomaly ultrasound to all their patients. It is not available at all in a quarter of maternity facilities.
Globally the widely accepted minimal schedule for antenatal ultrasound comprises two examinations: an ultrasound to confirm expected date of delivery in the first three months, followed by a foetal anomaly scan, usually performed between 20 and 22 weeks’ gestation. Detecting a foetal anomaly at this stage means the baby can be delivered at the optimum time and place, thus ensuring access to the highest quality neonatal intensive care. The authors of the latest research say “it is disappointing to conclude” that their study findings echo those of two previous national ultrasound surveys carried out in 2007 and 2012 and “confirm that there has been no expansion in Irish maternity ultrasound services in the last decade.” All Irish women must have equal access to specialist obstetric services. Deficits have been clearly identified and must be rectified without further delay.