The Master of the National Maternity Hospital has said maternity doctors and midwives are ‘overexposed to volume and case complexity' and are working in an extremely challenging environment.

Dr Rhona Mahony said Holles Street had in the past decade seen a sharp increase in activity without any concomitant increase in staff.
Writing in the hospital's clinical report for 2013, she highlighted severe shortages of consultants and midwives at the hospital.

She said the UK had three to four times the number of consultants in obstetrics compared to Ireland.

Dr Mahony said the recruitment freeze prevented the hospital from recruiting midwives in adequate numbers and low entry salaries were causing recruitment problems and leading to pressure on staff.

"Over-exposed to volume and case complexity, doctors and midwives find themselves in an extremely challenging environment."
She pointed out that obstetric complications can be unpredictable and severe.

Dr Mahony said on average, Holles Street delivered more than 25 babies per day last year; however in October 2013, 50 babies were delivered over a 28 hour period.

A total of 9,000 babies were delivered at Holles Street last year. The report shows that the perinatal mortality rate (fetal death after 22 weeks' gestation or infant death within seven days of birth) increased from 3.5 to 4.7 per 1,000 in 2013.

The stillbirth rate at Holles Street increased from 2.2 to 3.2 per 1,000, according to the report.

Dr Mahony said the 4.7 perinatal death rate was still an ‘excellent result by any national or international standards'.
The caesarean section rate at Holles Street increased slightly, from 22.8% to 23.1% in 2013. The figures show the caesarean rate is rising year on year - it was 19.1% in 2008.

The report reveals that there were no maternal deaths at Holles Street last year. There have been four maternal deaths at the hospital over the past five years.

Dr Mahony welcomed the Government's approval for the planned move of Holles Street to the St Vincent's site. She said the current stand-alone hospital operated without an ICU and without direct access to the specialist facilities of a major acute hospital.
She said stand-alone maternity units belonged in the past.