Fact File
Name: Declan Keane
Age: 36
Family: wife Joanne (a midwife); children Eloise (6) and Gregory (3)
Occupation: consultant in obstetrics and gynaecology
Why he's in the news: just appointed master of the National Maternity Hospital in Dublin
One baby brings with it much responsibility. Being responsible for over 50,000 new-borns is almost unthinkable. But this lies before Declan Keane, the new master of the National Maternity Hospital, Holles Street, during his seven-year tenure.
But he loves bringing babies into the world and chose the speciality because it is "the happiest branch of medicine". He still feels joy at a successful delivery, after caring for the mother over the preceding nine months. That joy is certain to be stretched in the coming years. He can expect to work over 80 hours a week.
Unusually, in maternity hospitals a doctor is in overall charge. Dr Keane will effectively be chief executive, combining the delivery of babies with policy decisions, staff relations and budgets. As far as this doctor is concerned, it makes sense that a medic is in charge: "We know where the money should be spent".
The hospital has an annual budget of £15 million.
The William Dunne case in the 1980s, where the parents of a severely brain-damaged boy sued, showed the hospital in an extremely poor light.
A settlement was eventually reached in 1989 with the parents, who had fought a brave battle.
When Peter Boylan took over as master in 1990 the hospital was at a very low ebb. He has been credited with responsibility for the major changes that have taken place, working in partnership with the matron, Maeve Dwyer.
Declan Keane is taking over a buoyant hospital in which 7,556 babies were born in 1997, almost half to first-time mothers. The problem now is how to cope with the number of couples who want to have their babies born there.
Some people have told him he is mad to attempt to follow in Dr Boylan's footsteps, but he has his own ambitions for the hospital, which he first entered almost exactly 14 years ago, as a UCD undergraduate.
At the end of an eight-week stint he was required to write an essay on his experiences. He wrote that he wanted to pursue a career in obstetrics in that hospital. His professor, Kieran O'Driscoll, himself a former master there, wrote in the margin: "We shall see".
Since graduating he and his family have been "four times over and back the Irish Sea". He worked for three years as an assistant master in Holles Street. He left a position as consultant obstetrician at the John Radcliffe Hospital in Oxford to take up his new post.
Irish babies are healthy. About 20 per cent weigh over 8 1/2 lb, second in the European league only to those born on the Faroe Islands. Only 5 per cent of babies are born prematurely, and such strides have been made in reducing perinatal mortality that efforts must now be concentrated on patient satisfaction at what he considers "the greatest maternity hospital in the world".
Couples are planning pregnancies, having fewer children and taking much more care about where they have the delivery. They shop around, and word of mouth among expectant mothers counts for a lot.
Birth plans are becoming the norm, detailing exactly what the mother wants and does not want during labour. If she wants an epidural she gets one, no questions asked, unless it is something that her team feels is not a good idea medically. Caesarean sections are carried out in only 10 per cent of births.
The hospital management keeps in regular contact with groups such as ISANDS, the stillbirth and neonatal groups, the Association for Improving Maternity Service, La Leche League, the breastfeeding group, and Cuidiu, the Irish childbirth trust. In this way they are getting regular feedback about what mothers and fathers think of their maternity services. The majority of women are now accompanied by their partners at the birth.
There appears to be a strong sense of camaraderie and relative informality among the 460 staff. The new master describes it as "a uniformity of purpose".
Strolling along the hospital corridors you are quite likely to hear musicians playing or see an art exhibition being hung, all arranged by the hospital arts officer. Most of the midwives are mothers themselves, a stark contrast to the time when women had to leave work after they got married and babies were delivered by women who themselves have never had the experience.
During his interview for the position before a panel of 14, Dr Keane outlined his proposals, which included the setting up of a risk-management team. This would look at cases where "management was sub-optimal so we could learn from our mistakes. Unfortunately a lot of people are looking over their shoulder and practising medicolegal medicine because of a fear of being sued."
He also wants an extension to the labour ward, new and improved theatre and intensivecare facilities and post-natal accommodation. New out-patient facilities are to be developed this year in property owned by the hospital along Mount Street.
He agrees that the title of master is a little archaic (a female has never held the position). But he expects his successor may well be a woman. Right now, he is concentrating on his own tenure and the babies that are relying on him for safe delivery.