The National Maternity Strategy - Creating A Better Future Together 2016 - 2026 - aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place. The Strategy recognises that, while all pregnant women need a certain level of support, some will require more specialised care. Accordingly, it proposes an integrated model that delivers care at the lowest level of complexity and encompasses all the necessary safety nets in line with patient safety principles. The model consists of three care pathways - Supported, Assisted and Specialised.
The Supported Care Pathway is intended for normal-risk mothers and babies, with midwives leading and delivering care within a multidisciplinary framework. Through the implementation of the Strategy, care will be delivered by a community midwifery team, with most antenatal and postnatal care being provided in the community and home settings. The Strategy makes it clear that women should be offered choice regarding their preferred pathway of care, in line with their clinical needs and best practice. The woman should be able to exercise a choice with her healthcare professional with regard to the birth setting, which may be in an Alongside Birth Centre in the hospital, or at home. Home birth services will over time be integrated with the community midwifery and the wider maternity service as part of the maternity network.
I should perhaps explain that the Strategy recommends that Alongside Birth Centres should be located in a maternity hospital and ideally situated immediately alongside a Specialised Birth Centre so that any necessary critical care services will be immediately available to a woman in need. The Steering Group, which developed the Strategy, noted that freestanding birth centres i.e. birth centres not co-located with an obstetric unit, were provided in some jurisdictions. However, they did not recommend the provision of freestanding birth centres in Ireland at this stage in the development the new model of care and pointed to the need, in the first instance, to monitor and evaluate the implementation of Alongside Birth Units in an Irish context.