In March 2016, bump2babe sent a comprehensive survey to the 19 maternity hospitals/units and 2
midwifery-led units in Ireland. Responses were returned between March 2016 and May 2017. Here bump2babe
provides you with the opportunity to read the complete survey responses. In some instances, minor
modifications were made to the responses (e.g. replacing clinical terms with more user-friendly wording).
The information provided in this Guide is as was provided to us by the maternity hospitals and units but
please check with your caregiver to see if there have been any recent changes to services, polices or
practices.
Blank spaces indicate no information was provided by the maternity unit.
Unit: Cavan Midwifery Led Unit, Module: Early, Mid and Late Pregnancy Care Print Version
| Question | Sub Question | Answer |
|---|---|---|
| How do women access services? | Self referral | Yes |
| G.P. referral | Yes | |
| Other, please specify | Offered following Pre-assessment booking visit if eligible for Service | |
| Services provided for women in very early pregnancy (<12 weeks) - threatened miscarriage, history of miscarriage, medical conditions, hyperemesis etc. | N/A | |
| Midwife-led services available (please tick all that apply - please note the new definitions) | Midwifery-led unit (alongside) | Yes |
| Community midwives clinic - antenatal and postnatal care provided in woman’s home or at outreach clinic with option for home birth or birth in hospital attended by a Community Midwife. | ||
| DOMINO midwives clinic - antenatal and postnatal care provided in woman’s home or at outreach clinic with birth in unit not necessarily attended by DOMINO team midwife. | ||
| Public midwives clinic - antenatal care provided by midwives only | ||
| Other midwifery-led services, please specify | ||
| Obstetric-led services available (please tick all that apply) | Public clinic | |
| Semi-private clinic | ||
| Private clinic | ||
| Other obstetric-led services, please specify | ||
| Location of clinics (please provide details for those applicable) | Midwifery-led unit (alongside) | In the MLU at Cavan General Hospital and at St. Davnets Monaghan |
| Community midwives clinic (as per definition above) | ||
| DOMINO midwives clinic (as per definition above) | ||
| Public midwives clinic (as per definition above) | ||
| Other midwifery-led services specified by you above | ||
| Public clinic | ||
| Semi-private clinic | ||
| Private clinic | ||
| Other obstetric-led services specified by you above | ||
| Average gestation at a booking visit for the following clinics | Midwifery-led unit (alongside) | Less than 14 weeks |
| Community midwives clinic (as per definition above) | ||
| DOMINO midwives clinic (as per definition above) | ||
| Public midwives clinic (as per definition above) | ||
| Other midwifery-led services specified by you above | ||
| Public clinic | ||
| Semi-private clinic | ||
| Private clinic | ||
| Other obstetric-led services specified by you above | ||
| Information noted at booking visit | Ethnicity | Requested |
| Religion | Requested | |
| Marital status | Requested | |
| Sexual orientation | No | |
| Do women have the option of carrying their own notes? | Yes/No | No |
| Sometimes, please specify circumstances | ||
| Continuity of carer in the midwifery-led unit (alongside) | N/A | |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | Yes | |
| May see a different staff member every antenatal visit | ||
| Continuity of carer in the community midwives clinic - (as per definition above) | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in the DOMINO midwives clinic - (as per definition above) | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in the public midwives clinic - (as per definition above) | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in other midwifery-led services specified by you above | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in the public clinic | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in the semi-private clinic | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in the private clinic | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Continuity of carer in other obstetric-led services specified by you above | N/A | N/A |
| See the same person every antenatal visit | ||
| See one of team (8 people or less) every antenatal visit | ||
| May see a different staff member every antenatal visit | ||
| Approximate length of consultation with carer (in minutes) for each woman at her booking antenatal visit in the following clinics (where applicable) | Midwifery-led unit (alongside) | 1 hour |
| Community midwives clinic - (as per definition above) | ||
| DOMINO midwives clinic - (as per definition above) | ||
| Public midwives clinic - (as per definition above) | ||
| Other midwifery-led services specified by you above | ||
| Public clinic | ||
| Semi-private clinic | ||
| Private clinic | ||
| Other obstetric-led services specified by you above | ||
| Approximate length of consultation with carer (in minutes) for each woman at a follow up antenatal visit in the following clinics (where applicable) | Midwifery-led unit (alongside) | 30 minutes |
| Community midwives clinic - (as per definition above) | ||
| DOMINO midwives clinic - (as per definition above) | ||
| Public midwives clinic - (as per definition above) | ||
| Other midwifery-led services specified by you above | ||
| Public clinic | ||
| Semi-private clinic | ||
| Private clinic | ||
| Other obstetric-led services specified by you above | ||
| Average waiting times and facilities at the midwifery-led unit (alongside) if applicable. | N/A | |
| Waiting less than 30 minutes | Yes | |
| Waiting more than 30 minutes | No | |
| Play area for children | No | |
| Nappy changing facilities | Yes | |
| Sufficient seating for all women while waiting | Yes | |
| Sufficient seating for all partners while waiting | Yes | |
| Refreshments/drinking water | Yes | |
| Food vending machine | Yes in Hospital | |
| Cafeteria | Yes in Hospital | |
| Other, please specify | ||
| Average waiting times and facilities at the community midwives clinic (as per the definition above) if applicable. | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the DOMINO midwives clinic (as per the definition above) if applicable. | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the public midwives clinic (as per the definition above) if applicable. | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the other midwifery-led services specified by you above if applicable. | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the public clinic | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the semi-private clinic | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the private clinic | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Average waiting times and facilities at the other obstetric-led services specified by you above if applicable. | N/A | N/A |
| Waiting less than 30 minutes | ||
| Waiting more than 30 minutes | ||
| Play area for children | ||
| Nappy changing facilities | ||
| Sufficient seating for all women while waiting | ||
| Sufficient seating for all partners while waiting | ||
| Refreshments/drinking water | ||
| Food vending machine | ||
| Cafeteria | ||
| Other, please specify | ||
| Is combined care with their G.P. an option for women using midwifery-led services? | Yes/No | Yes |
| Additional comment | Care is shared with the GP | |
| Is combined care with their G.P. an option for women using obstetric-led services? | Yes/No | N/A |
| Additional comment | ||
| Is hospital-only care an option for women? | Yes, with midwives | |
| Yes, with obstetricians | ||
| No | No | |
| Additional comment | Combined with GP | |
| In the antenatal period, are mothers asked to state how they intend to feed their baby? | Always | |
| Mostly | ||
| Sometimes | ||
| Never | Yes | |
| Additional comment | ||
| In the antenatal period, please describe in detail how mothers are informed about, encouraged and supported to breastfeed? | Discussed at least 3 times antenatally. Offered to attend a prenatal breastfeeding workshop. Discussed at the antenatal class. | |
| Does the unit identify groups of service users who are least likely to breastfeed? | Yes/No | No |
| Additional comment (including how they are identified) | ||
| If service users are identified as least likely to breastfeed, how does the unit promote and support breastfeeding in those families during the antenatal period? | ||
| Information leaflets provided | Antenatal blood tests | Discussed and signed consent obtained |
| Healthy eating | Yes | |
| Smoking cessation | Yes | |
| Iron supplements | Yes | |
| Folic acid | Yes | |
| HIV testing | As Above | |
| Toxoplasmosis | ||
| Rhesus factor | Yes | |
| Pelvic floor exercises | Yes | |
| Vaginal birth after caesarean | ||
| Labour bag & hospital bag | Yes | |
| Signs of labour | Yes | |
| Labour and birth | Yes | |
| Pain relief options: pharmacological | Yes | |
| Pain relief options: non-pharmacological | Yes | |
| Caesarean birth | ||
| Breastfeeding | Yes | |
| Infant feeding | Yes for bottlefeeding | |
| Postnatal depression | Yes | |
| Postnatal care | Yes | |
| Car safety for babies | Yes | |
| Sudden Infant Death Syndrome | Yes | |
| Normal newborn characteristics | ||
| Neonatal screening | Yes | |
| Antenatal classes provided by hospital/unit | Prenatal breastfeeding workshop | |
| Independent antenatal classes in the community (e.g. Cuidiú classes) | ||
| Care plan (details of visits to GP and to chosen clinic) | Yes | |
| Contact details for support services - please give details | ||
| Other, please specify | ||
| Routinely tested at booking visit | Blood pressure | Yes |
| Urinalysis | Yes | |
| Weight | Yes | |
| Height | Yes | |
| Palpation/fundal height | ||
| Fetal heart rate | ||
| Ultrasound | Yes | |
| Full blood count | Yes | |
| Blood group & antibodies | Yes | |
| Rubella | Yes | |
| Chicken pox immunity | Yes | |
| H.I.V. | Yes | |
| Hepatitis B | Yes | |
| Syphilis | Yes | |
| Blood glucose | ||
| Hepatitis C | Yes | |
| Ferritin | ||
| Other, please specify | Hgb Electrophoresis for women of Asian and African origin | |
| Is there a smoking cessation programme provided? | Yes/No | Yes |
| Additional comment including details of availability, uptake and success rates | ||
| What nutrition services are offered to women? (Please include details of information provided to women, any access to a nutritionist antenatally/postnatally, and whether all or only some women are offered these services.) | None while attending MLU | |
| Please describe any services offered to women related to physical activity (including information, any classes, how physical activity is promoted etc.) | At booking women receive “Fit for Pregnancy’ leaflet. Physiotherapist attends and gives a talk at the antenatal class | |
| Which of the following scans are offered routinely? Where appropriate please include gestation. | Early pregnancy scans (< 12wks) | |
| Dating scans | Yes in the Ultrasound Department | |
| Anatomy/anomaly scans | No Discussed and leaflet given with Women at booking that this scan is not provided by the MLU | |
| Scans at routine antenatal visits | ||
| Please indicate any differences in number/frequency of scans depending on the type or care/carer chosen | 32 week scan preformed in the Ultrasound Department is offered to women attending MLU for placental location and growth scan | |
| What training do staff require to perform the following scans: | Early pregnancy scans (< 12wks) | |
| Dating scans | ||
| Anatomy/anomaly scans | ||
| Scans at routine antenatal visits | ||
| What is the unit policy on scans at maternal request? | Only Dating and 32 week scan are offered in the MLU. If mother requests further scans then the option to transfer to consultant led care is given. | |
| Do ultrasound scanning staff have any special training in communicating information to parents? | Yes/No | Yes |
| If Yes, please give details | ||
| Unit policy on changing due dates on the basis of ultrasound scanning of mothers | If less than 12 weeks and +/- 7 days will go with scan. If 12-24 weeks +/- 10 days will go with scan. | |
| Antenatal tests available | ||
| Test for full blood count | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for iron level | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for blood group | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for antibodies | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for rubella | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for varicella | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for hepatitis B | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for syphilis | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for hepatitis C | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for HIV | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for sickle cell | Routine/Non-routine/Available at maternal request | Non-routine. For women of Asian or African origin at booking |
| Additional information including indications and typical gestation where appropriate | For women of Asian or African origin at booking | |
| Test for thalassaemia | Routine/Non-routine/Available at maternal request | Non-routine. For women of Asian or African origin at booking |
| Additional information including indications and typical gestation where appropriate | For women of Asian or African origin at booking | |
| Glucose tolerance test | Routine/Non-routine/Available at maternal request | Non-routine |
| Additional information including indications and typical gestation where appropriate | For all women with recognised risk factors for gestational diabetes at 28 weeks | |
| Test for thyroid function | Routine/Non-routine/Available at maternal request | Non-routine |
| Additional information including indications and typical gestation where appropriate | ||
| Test for liver function | Routine/Non-routine/Available at maternal request | Non-routine |
| Additional information including indications and typical gestation where appropriate | ||
| Urine test - dipstick | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | ||
| Urine test - MSSU | Routine/Non-routine/Available at maternal request | Non-routine |
| Additional information including indications and typical gestation where appropriate | Assessed on symptoms and urine dipstick | |
| Test for group B strep | Routine/Non-routine/Available at maternal request | Non-routine |
| Additional information including indications and typical gestation where appropriate | ||
| Palpation | Routine/Non-routine/Available at maternal request | Routine |
| Additional information including indications and typical gestation where appropriate | Palpation and abdominal measurement performed each visit | |
| Electronic Fetal Monitoring | Routine/Non-routine/Available at maternal request | Non-routine |
| Additional information including indications and typical gestation where appropriate | ||
| Fetal heart rate (other methods) | Routine/Non-routine/Available at maternal request | Routine |
| Please specify method and any additional information | ||
| Anatomy/anomaly scan | Routine/Non-routine/Available at maternal request | No |
| Additional information including indications and typical gestation where appropriate | ||
| Triple test | Routine/Non-routine/Available at maternal request | NO |
| Additional information including indications and typical gestation where appropriate | ||
| Amniocentesis | Routine/Non-routine/Available at maternal request | No |
| Additional information including indications and typical gestation where appropriate | ||
| Chorionic villus sampling | Routine/Non-routine/Available at maternal request | No |
| Additional information including indications and typical gestation where appropriate | ||
| Other tests available | ||
| What immunisations are recommended to pregnant women and when? Who administers them? | Flu vaccination and whooping cough vaccination provided by GP | |
| In the antenatal period, is prophylactic anti-D routinely offered to Rh negative women? Please give details including gestation offered. | Yes to all Rh negative women at 28 weeks | |
| Is there an antenatal emergency drop-in/phone-in support service available? | Yes/No | Yes |
| If Yes, please give details | Can phone MLU any time 24 hours. | |
| Unit policy/guideline in relation to diagnosed breech presentation during pregnancy (please include any use of external cephalic version, moxibustion or other techniques to turn babies and mode of birth) | Transferred to Consultant Led Unit at 37 weeks gestation | |
| Under what circumstances are breech babies born vaginally? | Not in the MLU | |
| Number of breech babies born vaginally in 2014 and in 2015. Please specify how many were singletons. | 2014 | 0 in the MLU |
| 2015 | 0 in the MLU | |
| How are women who choose to have a vaginal breech birth supported in that choice? | Transferred for Consultant Led Care | |
| What additional supports are available to women with specific needs? Please provide details. | Multiple pregnancy | Not booked in the MLU |
| Previous Caesarean/VBAC | Not booked in the MLU | |
| Hypertension/ previous PE | Not booked in the MLU | |
| Assisted conception pregnancy | Not booked in the MLU | |
| Older mothers | >40 Not booked in the MLU | |
| Obese mothers | BMI>30 Not booked in the MLU | |
| Diabetes/Gestational Diabetes | Not booked in the MLU or transferred to CLU following abnormal GTT | |
| Hyperemesis | Transfer to CLU for severe Hyperemesis | |
| Intellectual disabilities | ||
| Teenage pregnancy | Referred to TUSLA | |
| Homelessness/other social issues including domestic violence | Referred to TUSLA | |
| Drug or alcohol abuse | Not booked in the MLU | |
| STDs | Not booked in the MLU if active STDs | |
| Other medical conditions | N/A | |
| Other special needs (visual/hearing impairment, mobility issues) | No | |
| Mental health issues or psychiatric disorders | Not booked in the MLU | |
| Non-English speaking or English as a 2nd language | Interpreter Service can be booked | |
| LGBT parents | No | |
| IUGR | Transferred to Consultant led care | |
| Preterm birth risk | Not booked in the MLU | |
| Stillbirth | Transferred to Consultant led care | |
| Known fetal anomalies | Transferred to Consultant led care | |
| Please describe how a woman's mental well-being is supported antenatally. | Postnatal depression is discussed at booking visit | |
| What supports are there for women experiencing antenatal depression or other mood disorders? | Discuss with GP and possible transfer to Consultant led care for psychiatric assessment | |
| Circumstances under which a woman would stay in hospital during the antenatal period | N/A | |
| Under what circumstances would a woman's antenatal care be transferred to a tertiary centre? | ||
| Unit policy/guideline on maternal request for caesarean birth | N/A | |
| Indications for birth by elective caesarean section | N/A | |
| In the antenatal clinic, how are women helped to understand and explore their options with regard to pharmacological and non-pharmacological methods of pain relief and methods of coping in labour? | Discussed and antenatal class available | |
| Unit policy/procedure if a mother requests a second opinion during the antenatal period | Can be transferred to CLU | |
| Unit policy/guideline on cervical sweeps (please include indications, contra-indications, gestation performed and by whom) | Sweeping of the membranes may be offered to women at term by the midwife. At 40 and 41 weeks nulliparous women should be offered a sweep. At 41 weeks parous women should be offered a sweep. Additional membrane sweeping may be offered if labour does not start ensuring a minimum of 72 hours between sweeps. Women receive an Induction of Labour leaflet. | |
| Unit policy/guideline on induction of labour for post-dates. | First-time mothers | Before term +12 |
| 2nd- & subsequent-time mothers | Before term +12 | |
| What are the options for women who decline induction for post-dates? | They are transferred to Consultant led care to discuss their options with a consultant. They are no longer eligible for MLU | |
| Indications for induction of labour (excluding post-dates) | First-time mothers | N/A |
| 2nd- & subsequent-time mothers | N/A | |
| What are the options for women who decline induction for the above indications? | N/A | |
| Education that staff in all antenatal care services undergo to promote, support and protect breastfeeding (please list topics, course duration, frequency of updates and specify staff who undergo this training (doctors, midwives, nurses, care assistants etc.)) | 20 hour breastfeeding course. 2 yearly 1 day refresher study day. | |
| Percentage of antenatal staff that have been educated in this way | Doctors | |
| Midwives | 100% | |
| Nurses | ||
| Care assistants | ||
| Others | ||
| Do antenatal staff rotate through all maternity services? | Yes, all do | |
| Yes, most do | Yes | |
| Yes, some do | ||
| No | ||
| Additional comment (including which staff rotate (doctors, midwives, care assistants etc.) | N/A |