How will closure of Causeway’s maternity unit impact on you?
When Devin McMullan gave birth to her first child, he arrived so quickly that her wife missed his arrival.
It’s far from perfect – nobody wants to give birth without their significant other in the room, offering them support and helping them bring new life into the world, and partners certainly don’t want to miss those first miraculous and life-changing moments.
So, given the speed at which little Shea arrived three years ago, it is only natural that 33-year-old Devin is concerned she may experience another rapid labour.
While all mums-to-be naturally want to avoid a long and drawn out delivery, Devin is worried because she lives between Ballycastle and Bushmills and now faces a drive of at least one hour to get to hospital when she goes into labour.
It comes after the Northern Trust took the decision to close the labour ward at the Causeway Hospital, with all births now happening at Antrim Area Hospital.
Clinicians had advised the trust that the provision of maternity services at Causeway Hospital was unsustainable because of falling birth rates, challenges attracting and retaining specialist staff to work in Coleraine, and the absence of neonatal special care baby facilities there.
Issues finding specialist staff willing to work in smaller units are nothing new. Requirements to deal with a certain number of cases each year are harder to achieve when you see fewer patients. Meanwhile, many healthcare professionals prefer to work in specialist units where they treat patients with more complex conditions.
The trust has argued it has carried out exhaustive but unsuccessful recruitment campaigns and the safest option is to move all births to Antrim Area Hospital.
It has also issued multiple statements of reassurance in response to concerns that Antrim Area Hospital’s maternity unit will be able to cope with the additional demand placed upon it as a result of the changes to service provision.
Yet, its response to a query by Local Women magazine is troubling. When asked how many times very sick or premature babies have been transferred to other hospitals because of a lack of specialist cots at Antrim in recent years, incredibly, the trust was unable to answer.
How then, can it say with certainty that it has adequate capacity to cope with an increase in patient numbers?
It has also emerged that in less than two weeks on from the closure of the maternity unit in Coleraine, it had to postpone the admission of women scheduled to attend for induction on four occasions.
The trust has said “during times of increased activity within any maternity unit, is part of normal process for scheduled births to be delayed, if appropriate, to ensure the safety of the women and babies in our care”.
This may be the case, but it can be extremely distressing for women and should be avoided as far as possible.
Speaking about her own concerns, 33-year-old Devin, who is due in November, says: “When my son was born, I went overdue and I was encouraged to come in for induction, which I agreed to do. But when it all started, he actually came very quickly.
“My wife was sent home in the evening because things seemed to be going really slowly but then they sped up and I asked someone to come and monitor me again. All of a sudden, it was panic stations and I just remember people rushing around.
“Shea’s heart rate had dropped, he had decided he was coming there and then. They rang Kasia and she tried to get back in time, but she didn’t manage it. She was devastated, she just missed it. Now I have significant anxiety about travelling from my house to Antrim because it more than double the travel time.”
Amy Gault (33), who lives off the Finvoy Line outside Ballymoney, is also concerned about the additional travel time to Antrim.
Mum of one Amy, who is due to give birth next month, says: “I just don’t think the communication has been very good at all. I heard births had stopped at Causeway in the media.
“I’m not sure there are going to be enough beds at Antrim and I also have big worries about being sent home if my labour isn’t progressing and what might happen now we have to travel so far.”
As the trust’s response to the query on neonatal transfers suggests, concerns about capacity at Antrim are well-founded – and they may very well impact on women living outside of the North Coast area.
What about women in parts of Mid Ulster and Antrim who would have ordinarily delivered their babies in Antrim? Will there be adequate beds for them? What is the likely impact on Altnagelvin Hospital? Presumably, there will be women living in and around Limavady who may previously have opted to labour at the Causeway and who now choose to give birth in Derry.
The Western Trust has said it has service provisions in place to accommodate any additional women who choose Altnagelvin Hospital to deliver their baby. Meanwhile, the Belfast Trust will continue to rely upon existing informal arrangements between trusts with regards to helping other maternity units when they come under pressure.
As for women who arrive at Causeway Hospital when in labour, the trust has said they will be “transferred to Antrim for ongoing care”. In those cases where the birth is imminent, they can deliver at Causeway, with emergency staff on site to enable care to be provided.
Another issue of concern is the ability of the Northern Ireland Ambulance Service to cope. Already struggling to meet target times to attend to some of the sickest patients, it isn’t known how the changes to maternity services will impact on already overstretched paramedics.
In addition, transfers to other hospitals while in labour or shortly afterwards may be required for patient safety, but they are far from ideal in terms of the patient experience.
So, the problems the Northern Trust has encountered in running a fully functioning maternity unit may appear to only be relevant to women living in the North Coast. But the truth is, the impact may be felt much further afield.
