the matrons of Dublin's three main maternity hospitals have met the Minister for Health and Children to raise concerns about the safety of mothers and babies because of the crisis in midwifery staffing.
Their concerns are highlighted in a document presented to Mr Martin and senior civil servants which has been seen by The Irish Times. The document says current staffing levels "fall short of recognised international guidelines and what we consider safe to meet present day clinical activity.
"Midwives in our hospitals are becoming demoralised. Clinical practice satisfaction levels have fallen. . . This can be attributed to some extent to overcrowding on our wards."
The "debilitating haemorrhage of midwives from the maternity services in Dublin" has led to ward closures and, the paper states, their members feel discouraged when they are required to discharge patients early to accommodate newly delivered mothers. "A significant worrying factor that we should draw to your attention is that all three hospitals are consistently replacing midwives with registered nurses from abroad," it adds. "The law in this country requires that only a midwife, a doctor or a student from either discipline may attend a woman in childbirth." The matrons point out that the retention of a significant core of senior, experienced and highly skilled midwives is needed to ensure the safety of mothers and babies. "This is also important in these litigious times in order to make it possible for the hospitals to defend any future claims," they add.
The matrons say caesarean section rates are increasing in the three hospitals they represent, the National Maternity Hospital at Holles Street, the Coombe Women's Hospital and the Rotunda Hospital. The number of premature births and births from "high-risk mothers" is also increasing.
Birth rates have increased at the hospitals by between 14 and 30 per cent since 1993.
The matrons say their objective in presenting the paper to the Minister "is to make you aware of our concern for the safety of mothers and babies and the health, safety and welfare of our staff. We have no vested interest in issues of industrial relations, geographic location of maternity services or the public/private mix."
They want an urgent and "imaginative response" from the Department. Unless this happens, "we regret to inform the Minister that in our opinion the capacity of our hospitals to continue to function as National Tertiary Referral Centres is questionable".
A spokeswoman for the Department of Health and Children said it recognised the staff shortages and "is seeking to come up with a strategy to address it". She added that "any increases in pay or allowances could only be dealt with in the context of the benchmarking process".