The National Maternity Hospital at Holles Street, has warned that it may have to turn patients away midwifery crisis in the major Dublin maternity hospitals is addressed.
Dr Declan Keane, the master at Holles Street, said: "We will have to draw a line in the sand. If we say, for example, we will take 650 patients a month and patient number 651 comes in, we will have to say we can't take you but it will be done well in advance."
By next spring, Holles Street would also have to stop patients coming in from outside the Eastern Regional Health Board region, Dr Keane said. He said health and safety at the hospital were at risk. "It's like operating a flight to Boston; if more passengers turn up for the flight than expected, you can't pack them all on board."
Quotas would apply across the board to private, semi-private and public patients. Expectant mothers outside the ERHA region would be excluded, although the hospital would continue to take former patients and those referred from other hospitals.
Dr Keane predicted the other two major Dublin maternity hospitals, the Rotunda and the Coombe Women's Hospital, would also have to introduce quota systems to cope with the crisis.
Each hospital is down by between 25 and 40 midwives, having lost approximately one-sixth of the midwifery complement in the three major Dublin maternity hospitals. They are leaving the service for a variety of reasons.
Highly skilled midwives are paid a maximum of £25,000 a year. Some are dissatisfied with the system of obstetrics-based care which, they claim, leaves little room for midwifery. Many are choosing to work outside of Dublin.
The pressure in Dublin's overcrowded hospitals is intense, with non-nationals making up an increasing segment of their workload. In the first half of this year, 20 per cent of the Rotunda's intake were non-nationals, who sometimes arrived in labour straight from the airport or boat. The corresponding figure at the Coombe was 18 per cent, while at the National Maternity Hospital, the proportion was substantially lower (8 per cent).
The National Maternity Hospital, the Coombe Women's Hospital and the Rotunda are among the largest maternity hospitals in western Europe. Between them, they deliver more than 40 per cent of the State's babies.