How Maternity Services are organised in Northern Ireland

There are two main types of maternity care for women in Northern Ireland:

Midwife-led care with the woman birthing at home or in a midwife-led unit.
Consultant-led with the woman birthing in an obstetric unit (hospital).

Recent intrapartum care guidelines and an intrapartum care quality standard from National Institute for Health and Care Excellence (NICE, 2014; NICE, 2015) also highlight the importance of women with a low risk of complications during labour being given the choice to birth in any of the four different birth settings. These include: home, freestanding midwifery unit, alongside midwifery unit or an obstetric unit.

There has been on-going growth in the provision of a network of midwife-led units (MLUs) throughout Northern Ireland (NI) as supported by the Maternity Strategy Implementation Group.

There are 9 MLUs in NI, 6 alongside units (AMU) and 3 freestanding (FMU). There is currently no MLU in the Northern Trust.

There are 6 Health and Social Care Trusts in NI:

Belfast – Royal Jubilee Maternity Hospital AMU & Mater Hospital FMU (currently closed to maternity services due to COVID-19) www.belfasttrust.hscni.net

Northern – Antrim Hospital and Causeway Hospital in Coleraine www.northerntrust.hscni.net

Western – SWAH (Enniskillen) AMU and Altnagelvin Hospital AMU www.westerntrust.hscni.net

Southern – Craigavon Hospital AMU & Daisy Hill AMU www.southerntrust.hscni.net

South Eastern – Ulster Hospital AMU, Lagan Valley FMU, Downe Hospital FMU www.setrust.hscni.net

There are currently only 2 Consultant Midwives in NI – one in Northern Trust and one in Belfast Trust.

The mother’s ‘green notes’ – their maternity file - allows to easily transfer and choose to have their care in any Trust.

There is a Maternity Services Liaison Committee for each Trust. The forums are made up of local maternity service users and representatives of organisations who work with the maternity services. The aim is to work together and improve services in response to the needs of women.

There are no independent midwives in NI.

Women can pay to have private antenatal obstetric care.

In 2018, there were 22,833 births recorded in Northern Ireland (NI) (Northern Ireland Statistics and Research Agency - NISRA, 2019).

In situations where mum has mental health issues, NI is the only UK country not to have a Mother-Baby unit.

The NI Assembly is the devolved legislature for NI, responsible for making laws on transferred matters [eg health,] and for scrutinising the work of ministers and NI government departments www.niassembly.gov.uk

NI Executive

Comprises First Minister, deputy First Minister and 8 departmental Ministers, one of which is the Health Minister, currently Robin Swann. www.northernireland.gov.uk

NHS in NI

In NI, the NHS is referred to as HSC – Health & Social Care

www.health-ni.gov.uk

It is the publicly funded healthcare system in NI, and one of the 4 systems which make up the National Health Service in the UK (NHS England, NHS Scotland & NHS Wales).

Resources:

Strategy for maternity care in NI 2012-2018 can be found at www.health-ni.gov.uk

COVID-19 advice for pregnant women and parents in NI (PHA) www.ni-maternity.com

State of maternity services report 2018 https://www.rcm.org.uk/media/2825/state-of-maternity-services-report-2018-northern-ireland.pdf

Guidelines & Audit Implementation Network (GAIN) Guideline for admission to Midwife-Led Units in Northern Ireland and Northern Ireland normal labour and birth care pathway (updated September 2018)

RQIA Planning to Birth at Home (Woman & Partner’s Information Booklet) 2019. You can access this document by logging onto this website www.rqia.org.uk

COVID-19 - Health Committee updates: http://www.niassembly.gov.uk/assembly-business/committees/2017-2022/health/forward-work-programme/

Key:

HSCB: Health & Social Care Board – commissions services, manages resources & performance improvement

LCGs: Local Commissioning Groups, one for each trust, responsible for the commissioning of health and social care by addressing the needs if their local population. www.hscboard.hscni.net

HSC Trusts: Provide health and social services across NI www.online.hscni.net

PHA: Public Health Agency, major organisation in NI for health improvement and health protection www.publichealth-hscni.net

RQIA: Regulation and Quality Improvement Authority is the independent health and social care regulatory body for NI www.rqia.org.uk

Prepared by Anne Glover, NI volunteer representative on AIMS Campaigning Committee. Anne is also the Doula UK Area Representative for NI, with over 5 years’ experience, and has to date supported over 60 births.

How Maternity Services are organised in Northern Ireland

There are two main types of maternity care for women in Northern Ireland:

Midwife-led care with the woman birthing at home or in a midwife-led unit.

Consultant-led with the woman birthing in an obstetric unit (hospital).

There has been on-going growth in the provision of a network of midwife-led units (MLUs) throughout Northern Ireland (NI) as supported by the Maternity Strategy Implementation Group.

​

There are 9 MLUs in NI, 6 alongside units (AMU) and 3 freestanding (FMU). There is currently no MLU in the Northern Trust.

​

There are 6 Health and Social Care Trusts in NI:

​

Belfast – Royal Jubilee Maternity Hospital AMU & Mater Hospital FMU (currently closed to maternity services due to COVID-19) www.belfasttrust.hscni.net

​

Northern – Antrim Hospital and Causeway Hospital in Coleraine www.northerntrust.hscni.net

​

Western – SWAH (Enniskillen) AMU and Altnagelvin Hospital AMU www.westerntrust.hscni.net

​

Southern – Craigavon Hospital AMU & Daisy Hill AMU www.southerntrust.hscni.net

​

South Eastern – Ulster Hospital AMU, Lagan Valley FMU, Downe Hospital FMU www.setrust.hscni.net

​

There are currently only 2 Consultant Midwives in NI – one in Northern Trust and one in Belfast Trust.

The mother’s ‘green notes’ – their maternity file - allows to easily transfer and choose to have their care in any Trust.

​

There is a Maternity Services Liaison Committee for each Trust. The forums are made up of local maternity service users and representatives of organisations who work with the maternity services. The aim is to work together and improve services in response to the needs of women.

There are no independent midwives in NI.

​

Women can pay to have private antenatal obstetric care.

​

In 2018, there were 22,833 births recorded in Northern Ireland (NI) (Northern Ireland Statistics and Research Agency - NISRA, 2019).

​

In situations where mum has mental health issues, NI is the only UK country not to have a Mother-Baby unit.

The NI Assembly is the devolved legislature for NI, responsible for making laws on transferred matters [eg health,] and for scrutinising the work of ministers and NI government departments www.niassembly.gov.uk

NI Executive

Comprises First Minister, deputy First Minister and 8 departmental Ministers, one of which is the Health Minister, currently Robin Swann. www.northernireland.gov.uk

NHS in NI

In NI, the NHS is referred to as HSC – Health & Social Care

www.health-ni.gov.uk

It is the publicly funded healthcare system in NI, and one of the 4 systems which make up the National Health Service in the UK (NHS England, NHS Scotland & NHS Wales).

​

Resources:

Strategy for maternity care in NI 2012-2018 can be found at www.health-ni.gov.uk

​

COVID-19 advice for pregnant women and parents in NI (PHA) www.ni-maternity.com

​

State of maternity services report 2018 https://www.rcm.org.uk/media/2825/state-of-maternity-services-report-2018-northern-ireland.pdf

​

Guidelines & Audit Implementation Network (GAIN) Guideline for admission to Midwife-Led Units in Northern Ireland and Northern Ireland normal labour and birth care pathway (updated September 2018)

​

RQIA Planning to Birth at Home (Woman & Partner’s Information Booklet) 2019. You can access this document by logging onto this website www.rqia.org.uk

​

COVID-19 - Health Committee updates: http://www.niassembly.gov.uk/assembly-business/committees/2017-2022/health/forward-work-programme/

Key:

HSCB: Health & Social Care Board – commissions services, manages resources & performance improvement

LCGs: Local Commissioning Groups, one for each trust, responsible for the commissioning of health and social care by addressing the needs if their local population. www.hscboard.hscni.net

HSC Trusts: Provide health and social services across NI www.online.hscni.net

PHA: Public Health Agency, major organisation in NI for health improvement and health protection www.publichealth-hscni.net

RQIA: Regulation and Quality Improvement Authority is the independent health and social care regulatory body for NI www.rqia.org.uk

Prepared by Anne Glover, NI volunteer representative on AIMS Campaigning Committee. Anne is also the Doula UK Area Representative for NI, with over 5 years’ experience, and has to date supported over 60 births.