Antrim maternity pressures: missed staff breaks, delayed births and reduced gynaecology work

Sunday 08 November 2026

Midwives at Antrim Hospital have reported missing breaks, some inductions and caesarean sections have been delayed, and gynaecology work has been reduced to free consultant time for urgent antenatal assessment, Northern Trust leaders have told MLAs.

The Trust disclosed that it had faced 18 permanent midwifery vacancies — around 10% of posts — alongside significant sickness absence and maternity leave. Recruitment is intended to fill those permanent vacancies by March.

Officials also acknowledged pressure on consultant obstetricians despite all funded posts being permanently filled, with one consultant recently on sick leave.

Suzanne Pullins, the Trust’s interim chief executive, said consultants “definitely feel very under pressure”.

The evidence was given to the Assembly Health Committee on Thursday 5 November by Ms Pullins, director of operations Gillian Traub, director of finance Stevie Lennon, and director of surgery, women’s health and diagnostic services Lynne McCartney.

Midwives reported missed breaks and asked for independent input

Ms Pullins said vacancies had made conditions particularly challenging in a busy maternity unit. Staff had told management they were not getting breaks, and the Trust was working with employees and trade unions to improve their working environment.

Ms McCartney said directors began visiting the unit and speaking to staff when concerns emerged a few months earlier. Meetings with trade union representatives and different groups of midwives followed.

Staff wanted further opportunities to raise their concerns. Ms McCartney said they “would like to talk to us and they would like to talk to somebody independent.”

The work involves Ms McCartney, the director of nursing, a human resources colleague and an experienced midwifery professional from outside the Trust. An oversight group and work examining workforce and culture were bringing the issues together to develop an action plan.

Recruitment continues after 18 permanent vacancies

Ms McCartney described the staffing position the Trust had been working to address:

“We had 18 permanent vacancies and then on top of that we had significant sickness absence as well and some maternity leaves.”

Seven of those vacancies had been filled between June and October. The remaining recruitment timetable outlined to the committee was:

• Four midwives joining in November.

• Five new midwives joining in December.

• One joining in January.

• A further midwife, currently on maternity leave, expected in March.

Those appointments were expected to fill the permanent vacancies identified at the briefing. Sickness absence and maternity leave remained additional pressures, however, and officials did not suggest that recruitment alone would immediately resolve every staffing difficulty.

Ms McCartney said the Trust believed workforce and workload pressures were contributing to sickness absence, and that strengthening the team would help reduce it.

Inductions and caesarean sections delayed

Questioned about the impact of moving inpatient maternity services from Causeway Hospital to Antrim, Ms Pullins acknowledged that some inductions and caesarean sections had been delayed.

She said the Trust monitored those delays but did not have the figures available during the meeting, offering to provide further information in writing. No figures were supplied establishing how many women had been affected, the length of their waits or the clinical consequences of individual delays.

Following the transfer, the Trust introduced daily assessments of pressure in the unit. These initially used a red, amber and green system that considered conditions on the day, including whether inductions or caesarean sections had been delayed.

Ms Pullins said the assessment had subsequently been refined using the Birthrate Plus staffing model. The Trust had also developed services intended to reduce pressure on inpatient birthing facilities.

Gynaecology work reduced to release consultant capacity

Ms McCartney told members that Antrim had nine obstetricians and that all funded posts were permanently filled, although one consultant had recently gone on sick leave.

Ms Pullins intervened to make clear that this did not mean the workforce had enough capacity to meet every demand being placed on it.

Ms Pullins said the Trust had reduced some gynaecology work to free consultant capacity for antenatal triage — assessing pregnant women whose needs may be time-critical.

Around 9.5 consultant-programmed activities, or scheduled blocks of work, had been released each week.

The committee was not given a breakdown of the gynaecology appointments or procedures affected, or the impact on waiting times.

Consultants report longer clinics with electronic records

Ms Pullins said consultants had reported that Encompass, the electronic patient record system, was making clinics and appointments run longer because of the assessments and documentation they needed to complete.

Describing their feedback, she said “it has made their clinics run very long and their appointment times very long”.

She explained that consultants in busy antenatal clinics had previously been able to take files away and finish documentation later. Her understanding was that the electronic workflow required them to complete the record before closing it, although she expressly qualified that explanation as her limited understanding of the system.

Ms Pullins said difficulties with many workflows in other specialties had been worked through and resolved. She also identified scanning as a demand on consultant time, saying the Trust’s consultants undertook scans that would be carried out by sonographers in England.

Changing workload and a new midwifery-led option

The Trust described the challenge of caring for women arriving in spontaneous labour while also managing planned inductions and caesarean sections.

Ms Pullins said increased caesarean section rates and changes in how maternity care was delivered were adding to staff workloads. She explicitly acknowledged women’s right to choose and said she was not questioning that right.

Alongside the pressures, she confirmed that Antrim’s alongside midwifery-led unit had recently opened through a soft launch, providing a further maternity care option.

Trust defends Causeway transfer while acknowledging challenges

Asked directly whether moving inpatient births from Causeway to Antrim had been a success, Ms Pullins defended the change.

She said Causeway had not had a commissioned neonatal unit and had relied heavily on locum medical staff. Although she described the service there as safe, she said those circumstances created particular challenges when higher-risk patients required care.

Ms Pullins also pointed to positive recognition of Antrim as a training environment for doctors, while acknowledging continuing difficulties around recruiting and retaining midwives.

“I believe that it has been a success, but I believe that there are some challenges that we need to actively work through just now,” she said.

The Trust’s defence of the transfer sits alongside an unfinished programme of recruitment and improvements to working conditions. For women using its services, two important questions remain unanswered by the briefing: the scale of maternity delays and how much gynaecology care has been displaced to maintain time-critical antenatal assessment.