There have been a number of "near misses" for both mothers and babies at Dublin's three main maternity hospitals as a result of staffing shortages, it was confirmed yesterday.
The master of the Coombe Women's Hospital, Dr Chris Fitzpatrick, said the hospitals were short midwives, doctors and support staff and this had led to situations where there could have been adverse outcomes for patients.
"We have a shortage of midwives, doctors and support staff. . . there are also infrastructural deficiencies."
The Rotunda and Holles Street, he said, were also concerned for patient safety as they dealt with increasing numbers of births.
Dr Fitzpatrick, who was speaking following the publication of the Coombe's clinical report for 2006, said extra beds had been placed on wards to cope with the numbers attending but this increased the risk of infection for patients and posed privacy problems.
He had spoken to the Health Service Executive (HSE) about the problem and had been guaranteed extra manpower and revenue, though he believed there would still be a gap between what was required and what was promised.
The HSE said a review of maternity and gynaecology services in the Dublin area was under way. It is likely to recommend a reconfiguration of maternity services and Dr Fitzpatrick said the Coombe, in its submission to KPMG, which is conducting the review, had recommended the hospital be co-located on to the campus of St James's Hospital. The hospitals, he said, already share many patients, services and staff.
"That would be five years down the line but in the meantime there needs to be interim investment. The fabric of our hospital is suboptimal."
Some 8,084 babies were delivered at the Coombe last year and births are set to increase again to about 8,500 this year. There were no maternal deaths.
While the number of births increased, the hospital's Caesarean section rate declined to 22 per cent, the lowest it has been for three years. The rate was 23.6 per cent in 2005 and 22.3 per cent in 2004.
Dr Fitzpatrick said many factors had driven up the Caesarean section rate including older first-time mothers, more complex medical conditions, patient choice and pressure of litigation.
"We have focused on it at multidisciplinary conferences. . . we are continuously auditing them. . . I think it is rewarding it has declined for the first time in three years."
Of the infants delivered at the Coombe last year, there were 141 sets of twins, three sets of triplets and one set of quadruplets.
More than two-thirds of the mothers were Irish, almost 40 per cent were first-time mothers and nearly one-fifth were still smoking.
Some 46 per cent of the mothers had not taken folic acid, which is recommended to prevent neural tube defects such as spina bifida.
Most of the women giving birth were aged 30 to 34 years.