HOW MATERNITY SERVICES ARE ORGANISED IN NORTHERN IRELAND
Revised June 2025
There are two main types of maternity care for women in Northern Ireland:
1. Midwife-led care with the woman birthing at home or in a midwife-led unit.
2. Consultant-led with the woman birthing in an obstetric unit (hospital).
There are 6 Health and Social Care Trusts in NI:
Belfast – Royal Jubilee Maternity Service The Royal Jubilee Maternity Hospital has 13 rooms in the delivery suite + 4 midwifery-led rooms known as the Active Birth Centre (ABC). There are 2 rooms with pools, one in the delivery suite and one in the ABC unit. A new maternity hospital has been built on site and is waiting to be opened.. There are approximately 5000 babies born in the Royal per year. The freestanding Midwifery Led Unit in the Mater Hospital has been closed to births since the beginning of the COVID-19 pandemic. https://belfasttrust.hscni.net/services/maternity/
Southern SHSCT Maternity Services– Craigavon Hospital has 8 birthing rooms in the delivery suite with one pool, and 8 rooms in the alongside midwifery-led unit with baths available for water births. Daisy Hill Hospital in Newry has 4 rooms in the delivery suite, and 2 midwifery-led rooms with pools.
A dedicated homebirth team, Birth at Home Team, was established in 2022, and despite excellent statistics, the service can be on hold due to staffing issues. There are approximately 5,300 babies born each year.
As soon as you have a positive pregnancy test, you can refer yourself: Self-referral form for Maternity Care
https://southerntrust.hscni.net/services/maternity-services/
South Eastern Maternity Ulster Hospital– The Ulster Hospital has 7 rooms with one pool in the delivery suite and an alongside midwifery-led unit (MLU) known as Home from Home, with 7 rooms and a pool in each room. The freestanding MLUs at both the Lagan Valley Hospital and the Downe Hospital have been closed for births since 2022. Antenatal care may be provided in the Midwifery-led unit in the Downe Hospital, Lagan Valley Birthing Centre in Lisburn, The Greenway Hub in Newtownards Hospital and Bangor Community midwives covering the Ards Peninsula. 4500 babies are born on average each year. https://setrust.hscni.net/service/maternity-2/ulster-hospital-maternity/
Northern Maternity Services - Northern Health and Social Care Trust - Antrim Area Hospital has 7 rooms in the birthing suite with one pool. A midwifery-led unit is currently being built on site.
Antrim Area Hospital maternity tour
Coleraine Hospital closed for births on 17th July 2023 and the site now facilitates the Causeway Maternity Hub outpatients services. Causeway Hospital virtual maternity tour
There is also a dedicated team of community midwives who provide a full range of midwifery care to women who live within the Northern Trust area. Approx. 4000 babies are born in the Trust each year.
Western Having a Baby in Altnagelvin Hospital Altnagelvin Hospital in Londonderry has 5 rooms in the delivery suite, plus an alongside midwifery-led unit with 8 rooms and 2 pools. Having a Baby in the South West Acute Hospital – South West Acute Hospital in Enniskillen has 5 rooms in the delivery suite, plus an alongside midwifery-led unit with 5 rooms, and 2 pools.. Approximately 3700 babies are born each year. https://westerntrust.hscni.net/service/maternity-services/maternity-services-tour/
Each of these Trusts has an allocated Consultant Midwife, Perinatal Mental Health Midwife and Continuity of Midwifery Carer Lead Midwife. There are continuity of carer teams throughout the province focussing on providing support to mothers with specific circumstances.
Maternity records are in the process of being digitalised with Encompass which provides a single digital record for each person for the whole of their life. The South Eastern Trust was the first to have Encompass implemented in November 2023, followed by the Belfast Trust. The Northern Trust went live in November 2024. The Western and Southern went live at the beginning of 2025. Each person can choose to access their personal information securely via a portal, My Care. The mother’s ‘green notes’ – her maternity file, allows her to easily transfer and choose to have her care in any Trust.
There is a Maternity Services Liaison Committee (MSLCs) or Maternity Voice Partnerships (MVPs) 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.
Northern Ireland Ambulance Service https://nias.hscni.net/ is one of the Health & Social Care Trusts.
In situations where mum has mental health issues, NI is the only country in the UK not to have a Mother-Baby unit, although there are ongoing discussions and campaigns to establish one.
There are no independent midwives in NI that can support intrapartum care. There are midwives who offer private antenatal and postnatal care independently.
Women can pay to have private antenatal obstetric care.
Experiences of maternity services can be shared at https://www.careopinion.org.uk/, or comments/complaints/compliments can be emailed to the Trust (contacts on the relevant website).
In December 2022 the Department of Health made the decision under coroner's recommendation to withdraw 2 regional guidelines on admission to Midwife-led units (MLUs) and support for home births, stating a number of clinically significant omissions and discrepancies when compared to the National Institute for Health and Care Excellence (NICE) Intrapartum care guidelines for healthy women and babies CG190. This means that women require more antenatal consultations if they choose to give birth under midwife-led care in NI, either in hospital or at home. As a result of the Covid pandemic and this more recent decision, all freestanding MLUs are now closed down in NI.
https://dhcni.hscni.net/digital-portfolio/encompass/?csrt=12749635264674566778
https://dhcni.hscni.net/digital-portfolio/encompass/my-care/
https://www.bbc.co.uk/news/uk-northern-ireland-63181565
Regional Quality Improvement Agency (RQIA) Guideline for planning to birth at home & Guidelines and Audit Network (GAIN) Guideline on admission to midwife-led units (MLUs) in NI.
https://www.nice.org.uk/guidance/cg190 published Dec 2014, updated Dec 2022 and revised publication due September 2023
Following on from this, the Department of Health commissioned a review into the maternity services by Professor Mary Renfrew which was launched in October 2024. The report details 32 recommendations alongside a 5 year programme for change, specifically calling for community midwifery hubs, midwifery units and home births to be fully supported and integrated into the wider maternity services.
Strategic direction for maternity care in NI
The Department of Health determines the maternity model of care in Northern Ireland, and in July 2012 launched the maternity strategy, adopting a health improvement approach:
give every baby and family the best start in life;
effective communication and high-quality maternity care;
healthier women at the start of pregnancy (preconception care);
effective, locally accessible, antenatal care and a positive experience for prospective parents;
safe labour and birth (intrapartum) care with improved experiences for mothers and babies; and
appropriate advice, and support for parents and baby after birth.
A Strategy for Maternity Care in Northern Ireland 2012-2018 (DHSSPS, 2012) places a strong emphasis on the normalisation of pregnancy and birth as a means of improving outcomes and experiences for mothers and babies. The strategy is overdue for renewal and there has been a call by the director of the Royal College of Midwives Northern Ireland for ‘The case for a new maternity strategy for Northern Ireland’ dated May 2021.
Maternity services in the UK have slowly been moving towards a more consistent model of care since the publication of Better Births in 2016. Research has shown that women have better outcomes if they have maternity care from the same midwife throughout their pregnancy, birth and postnatally. Up until recently, most women usually see numerous midwives, doctors, obstetricians at their appointments, during labour and birth, and in the postnatal period.
With the gradual introduction of the Continuity of Midwifery Carer (CoMC) model, women are assigned a named midwife at their booking appointment, who will be with them continually throughout their pregnancy journey, and on into the postnatal period. This model was launched in May 2023, with small teams in each Trust providing consistent care to those at higher risk of having poorer outcomes, eg living in under-privileged areas, smokers, under 20s, Black, Asian and mixed-ethnicity. As the roll-out continues, it should become available to more pregnant women in Northern Ireland.
Recent Developments in Maternity Care:
August 2020: Pilot scheme to introduce Continuity of Carer at the Causeway Hospital, Coleraine (Northern Trust)
2021: Regional group set up to begin a move towards transforming maternity care in NI
March 2022: RCM Blueprint for better maternity care in Northern Ireland
November 2022: RCM call for urgent start on review of maternity services in NI
NHS England (2016) National Maternity Review: Better Births – Improving outcomes of maternity services in England – A Five Year Forward View for maternity care. Available online at: www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf
https://www.health-ni.gov.uk/news/department-launches-new-model-maternity-care
www.rcm.org.uk/promoting/professional-practice/continuity-of-carer/
https://www.rcm.org.uk/media/5913/blueprint-for-better-maternity-ni.pdf
November 2022: Department of Health withdrew the Regional Quality Improvement Authority (RQIA) Guideline for Planning to Birth at Home (2019) and the Guidelines and Audit Network (GAIN) Guidelines for Admission to Midwife-led Units (MLUs) in NI (2016, updated 2018), on coroner's recommendation.
May 2023: RQIA issues Maternity Review Report - Review of governance arrangements in place to support safety within maternity services in Northern Ireland.
May 2023: Roll out of Continuity of Midwifery Care maternity model of care in all Trusts.
1st May 2023: The Department of Health commissions a new report into midwifery services in Northern Ireland ‘Enabling Safe, Quality Midwifery Services, and Care in Northern Ireland’ Prof Renfrew to develop recommendations for policy, practice, education and research in Northern Ireland. This is due to be completed in October 2023.
30th May 2023: ‘RCM The state of maternity services in Northern Ireland’ was launched at Stormont.
17th July 2023: Closure of Causeway Maternity Hospital, Coleraine.
October 2024: ‘Enabling Safe Quality Midwifery Services and Care in Northern Ireland’, Professor Mary Renfrew
22nd October 2024: Department of Health Press Release relating to maternity services: Nesbitt pledges maternity care improvement drive | Department of Health
Northern Ireland government and departments:
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. 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)
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 of 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
Resources:
Strategy for maternity care in NI 2012-2018 can be found at www.health-ni.gov.uk
State of maternity services report 2018: https://pre.rcm.org.uk/media/2825/state-of-maternity-services-report-2018-northern-ireland.pdf
Information and services on any government department and services: www.nidirect.gov.uk
NICE guidelines: https://www.nice.org.uk/guidance/ng235 (Sept. 2023)
Prepared by Anne Glover, NI volunteer representative on AIMS Campaigns Team. Anne is also the Doula UK Area Representative for NI, and she continues to support families across the province both as a birth and postnatal doula.