Friday, 22 March 2013

HSE set to dismantle Cavan MLU? For a non-maternity surgical day ward.

The measuring tapes are out and it would appear the Cavan MLU's days are numbered as a two room unit, according to several sources contacting Birth Matters Cavan and AIMS Ireland over the past 24 hours.

 If reports are correct, Cavan are transforming one of the two MLU birthing suites, the MLU ante-natal room and waiting rooms,the offices of the ADON for women's & children's services, the clinical midwifery managers and one of the OB consultants, and the early pregnancy unit) into a day ward for non-maternity surgical services. It would seem the remaining MLU birthing room and MLU office will be sandwiched between rooms being converted into the surgical day ward.

This will have immediate impact on the ability to provide MLU services to the full number of booking capacity MLU women - if a woman is already using the birth room there is nowhere for ante-natal checks or room for another woman to labour.

The Midwife Led Units (MLUs) were created as a pilot scheme in Cavan and Drogheda. They offer women normal birth practice and offer a unique gold standard of care within a hospital setting. AIMSI and many organizations have hoped that the MLUs would be rolled out nationally. The MLUs have been proven to provide women with safe midwifery led care, have high satisfaction ratings, and are cost effective. You can read more about the MLUs in the Mid-U study seen on this link HERE

This is not the first attempt to cease or reduce services in the Cavan MLU. In December 2011, the HSE made moves to close the unit based on 'uptake'; fewer bookings from women. So why the low uptake?

This Facebook post from December 2011 shows the low down:

AIMSI have been informed that the rationale for closing Cavan MLU is that it is functioning below capacity. How could this be so? We know that MLU in OLOL is fully booked, we know that women WANT midwifery led care (see recent study out of the Coombe showing a 42% preference for ML care. Is there something particular going on in Cavan. AIMSI have had many reports of women saying that they were (a) not informed of MLU option by their GP (b) that they wee dissuaded from care at the Cavan MLU by both their GP AND staff at the CLU, even thought they fit the criteria for low risk care.Women must be made aware of the fact that they can SELF REFER if this is the case.

In the past the women could refer themselves to the MLU, now they have to go through the Consultants. The feedback we have had from women is the Consultants and GPs are not referring women, even if they meet criteria, for the MLUs. Women have also told us bookings are left 'too late' if they indicate they want the MLU; women must be booked in by 20wks as per policy of the MLU but some women who indicated MLU preference, won't get an appointment til 24wks - too late for the Consultant to 'sign off' for MLU. AIMSI have also heard from women whom were told MLU care is risky.

Over the next few days, we will probably see a variety of excuses from the HSE as to why they are dismantling the MLU. AIMSI wants to preempt these before they begin.

This is NOT about money. The Mid-U report clearly states that for the same woman, having the same birth, the MLU costs  €400 less than the woman in CLU. For the SAME birth. Though, maybe it is...the obstetricians will certainly be getting more bookings.

This is NOT about safety. Midwife led care has been proven to be a safe option. The Mid-Ustudy shows us that midwifery- led care as practiced in these units, is as safe as consultant-led care but uses less intervention in pregnancy and childbirth.

This is NOT about women's preferences. Various research in Ireland has shown that women have high satisfaction ratings using midwife led care and women want access to MLUs nationwide. 85% of women using the MLUs would 'recommend it' to a friend.

So what is the REAL issue here?
Who benefits?
Is this another attempt by GPs and Consultants to prevent women from accessing midwife led care?

Looks like the Consultants are finally getting their way.

What can you do?

Join the Defend Cavan's MLU - facebook page:!/pages/Defend-Cavan-MLU/322709951092529

Contact your local TDs
Contact AIMS Ireland at


BIRTH MATTERS: "Measurements of the unit were taken yesterday. Our main concern was that we would be kept informed if any changes were to be made. I have received clarification from Cavan that the entire footprint of the hospital is being surveyed to try to accommodate a day surgery facility. A representative has explicitly stated that the MLU is NOT closing. I woukd interpret this as meaning som...e facilities will be rearranged. I understand that his is a highly emotive issue, and under present cost cutting measures across the country, it appears that no service is sacred, but we need to stay focused & calm & make sure our information is accurate if we are to be taken seriously at regional level. Thank you all for rallying round as usual. It is a huge comfort to know that there are vigilant people out there who value their services & are willing to fight for them......No immediate plans at present. Whole hospital survey underway. I have been led to believe that it would be a case of moving/ rearranging facilities rather than removing them."

AIMSI response:

This is good news if services to the MLU in Cavan are to remain fully operational with the current level of services; antenatal waiting room, booking room, 2 birth rooms. We look forward to being further updated on this issue. The MLUs are about 10yrs old and still in immacculate condition. The 2 birth suites are beautifully designed with state of the art facilities, including private ensuite toilets/showers and birth pools. 

Wonder how they plan on rearranging and moving them?

                                                           Birth Suite in Cavan MLU

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