Decisions, Decisions, Maternity Care Options- CORK

Living in Cork, you might think what options?! We have only one maternity hospital so what other options do we have for maternity care?

While our options are undoubtedly limited, there are a number of choices for you to consider, when deciding what type of maternity care to choose during your pregnancy and for the birth of your baby.

From the moment you become pregnant there are so many decisions to make and I thought it would be helpful to have all the options in one place. There is very little information out there, that is relevant to Ireland, let allow Cork and a lot of the information is subjective and based on the experiences or opinions of individuals. So I wanted to reach out and provide some information to make it easier for new moms- to-be. It can be quite confusing to know where to turn at the beginning of your pregnancy.

  • Visit your GP

The first step is to visit your GP who will confirm the pregnancy for you, which is important if you need to hear it out loud from someone else to make it all feel real! (I personally also needed confirmation that I was not having a heart attack!).

What else to expect at your visit?

Your GP will register you for the Maternity and Infant Care Scheme which allows you 5 free (pregnancy related) GP visits until the birth of the baby and 2 visits after having your baby – the visit at 2 weeks after the birth is a health check for the baby and the visit at 6 weeks after the birth of your baby is for you.

Your GP visits will alternate with the hospital visits or home midwife visits, or consultant visits, depending on what you choose. This is also known as Combined Care. All women are entitled to free maternity care which includes all of the options below, with the exception of the Private Consultant led clinics, and includes the hospital accommodation before and after the birth of your baby.

At your first GP appointment, your GP will carry out some basic health checks, like blood pressure check, urine test and will book you in for some routine blood tests. Most GP clinics have a midwife who will see you at most of your appointments instead of the GP.

Your GP will usually ask you if you have Private Health Insurance and if you do, they will advise that you can consider private consultants and if you don’t have private insurance, they will automatically refer you to the public clinic in CUMH.

There are a few more options to consider besides going Public or Private which I will outline.

  • Consultant Led Public Clinic:

Who will provide your care during your pregnancy?

Attending the Public Clinic in CUMH means that you will attend a Consultant Obstetrician clinic for your antenatal health checks including blood pressure checks and urine checks (you will quickly get used to peeing into those tiny bottles!) and also for the ultrasound scans to check on your baby. While you will attend a consultant’s clinic, it is unlikely that you will actually meet the Consultant. A midwife will carry out the blood pressure checks and see how you are generally doing and one of a team of hospital doctors – Consultant Obstetrician, Registrar or Senior House Officer will carry out the scan. You will be offered approximately 3 scans (12 weeks, 20 weeks and another closer to the birth).

Who will take care of you during the labour and Birth of your baby?

During the labour and birth of your baby you will be cared for by a team of midwives and if there are any concerns then one of a team of hospital doctors under the Consultant or the on call doctor will be of assistance.

  • Midwifery Led Clinic

Who will provide your care during your pregnancy?

Midwifery delivered clinics are held in CUMH Outpatients department and at your first visit at the hospital. as a public patient, this option maybe offered to you. You will be seen only by one of the midwives and there is a greater chance that you will meet the same midwives throughout your pregnancy. If special circumstances present themselves during your pregnancy the midwife will refer you to the Consultant obstetrician as required. The midwifery clinics tend to be a little bit less busy and you may also get a little bit more time with the midwife.

Who will take care of you during the labour and Birth of your baby?

A team of hospital based midwives will support you during the labour and birth of your baby. If required the on call doctor will be also be available.

  • DOMINO Clinic: Maternity Led Clinic:

Who will provide your care during your pregnancy?

The DOMINO Clinic is Completely Midwifery Led meaning that at your antenatal visits you will see only a Midwife who will carry out all health checks and scans. If a special circumstance presents itself, then the midwife may call a hospital doctor to see you as necessary.

Who will take care of you during the labour and Birth of your baby?

During the labour and birth of your baby, you will be cared for by the same team of midwives that you would have met during your antenatal appointments. You will also be able to avail of the “Home from Home” birthing suite and you will be able to go home from six hours after giving birth. Furthermore the DOMINO midwife will visit you and your baby at your own home up to five days after giving birth. They will be able to check on the health of you and your baby as well as support you with breastfeeding.

Unfortunately the scheme is only available to women living within a five mile radius of CUMH.

  • Cois Tí (Cork University Maternity Hospital’s outreach clinic initiative)

At your 20 week appointment, you may be offered the option to attend the outreach clinics if you live near one of the outreach clinics and are considered low risk.

There are five outreach centres available in the following areas:

  • Mallow
  • Mitchelstown
  • Bantry
  • Mary’s Health Campus
  • Finbarr’s Hospital

The outreach clinics are mostly midwifery led clinics. The benefits of these clinics are that the waiting time is shorter and of course you will have a shorter distance to travel.

  • Home Birth (National Home birth Scheme provided by Self Employed Community Midwives)

Who will provide your care during your pregnancy?

The first step to make, if you are interested in a Home Birth, is to contact a Self Employed Community Midwife in your area. You will need to be assessed for eligibility before being accepted on the National Home Birth Scheme. This is a public service and although the midwife is self employed she is paid by the HSE.

You will need to source the midwife and then be assessed for eligibility. The list of available midwives is accessible on . When you are accepted on the National Home Birth Scheme you will have an initial appointment in CUMH.

Your GP will still need to register you under the Maternity and Infant Care Scheme and with CUMH. If you needed more specialised care during your pregnancy, you could be referred to the hospital; therefore you need to be registered with them.

You will be entitled to have 10 visits with your midwife during your pregnancy and up to 2 weeks after the birth, plus an 11th visit for the birth itself. Some of these visits will be at the midwife’s own clinic and some may be in your own home.

As you will also be covered under the Maternity and Infant Care Scheme, you will also have free visits to your GP in between the visits with your midwife.

Who will take care of you during the labour and Birth of your baby?

Your midwife will continue to care for you during the labour and birth of your baby and will also arrange for another midwife to be present. The home birth midwife usually offers a birthing pool for the birth. If for any reason you need to be transferred to the hospital for the birth of your baby, your midwife could still attend but in the capacity of a doula.

  • Private Consultant Led Care

Who will provide your care during your pregnancy?

If you choose a private consultant, you will need to have private health insurance and also willing to pay additional fees of around €3,000. You will need to choose your consultant and give them a call to book in and see if they are taking patients. You may ask your GP for some recommendations, conduct a little bit of research online or take recommendations from friends and family.

You will be given your first appointment at around 14 weeks. This appointment will involve seeing a midwife first, who will take your history and routine health checks and then you will meet your chosen consultant who will carry out the ultrasound and confirm the baby’s estimated due date.

You will continue to meet with your consultant and the midwife on the team at each of your antenatal appointments. Usually the consultant will request to see you every 4 weeks up until 32 weeks gestation, and then fortnightly or weekly until the birth. You will be scanned at each visit.

Who will take care of you during the labour and Birth of your baby?

When you go into labour you will meet with one of the team of midwives in the same way as a Public patient. Your consultant will be informed that you are in labour and will check in on you and your progress throughout the labour and offer instruction to the midwife as appropriate. The consultant will be called upon in order to be present for the birth of your baby and will provide the relevant care that may be required during and after the birth. Your consultant will normally visit you in the postnatal wards also.

  • Once you have chosen your maternity care option, what next?

As early as possible book into the antenatal classes and breastfeeding classes in CUMH, as they get booked up really quickly.

Alternatively you can book private antenatal classes and there are also plenty of private breastfeeding classes available.

And finally, book you and your partner on a HypnoBirthing course to ensure you feel completely prepared for the birth of your baby.