The Northern Health and Social Care Trust has published a sixth-month review following amalgamation of maternity services at Antrim Area Hospital.
All hospital births in the Northern Trust have taken place at Antrim Hospital since July 17th 2023 after an end to deliveries at Causeway Hospital in Coleraine.
Following the reorganisation, there were 323 births in Antrim Hospital and 33 in Causeway last July; 321, in Antrim, in August; 286, September, 308, October, 261, November and 284, December.
During the same period the previous year, there were 71 births at Causeway Hospital and 241 in Antrim in July 2022; in August, 74, Causeway, 241, Antrim; September, 86, Causeway, 277, Antrim; October, 83, Causeway, 252, Antrim; November, 71, Causeway, 227, Antrim; December 69, Causeway, 237, Antrim.
Last year, the overall number of births in the Northern Trust was 3,484.
The report says since the consolidation of in-patient maternity services and births in Antrim Area Hospital, six women (seven babies, including a set of twins) have experienced birth before arrival at hospital. Three women were within the Causeway locality and four resided “closer” to Antrim.
It states there has been “no significant increase” in the average number of births before arrival which is approximately one per month.
“Since the maternity service reform, no women have presented in labour at Causeway Hospital. Seven pregnant woman (not in labour) have attended Causeway Emergency Department and appropriate pathways have been followed to ensure safe and timely care,” the report notes.
Between July 17th 2023 and January 31st, fewer than five Northern Trust residents gave birth in the Western Trust and 21 in other Trusts. None were from the Causeway area.
The report also says there has been “no significant increase” since the service change in intervention rates of instrumental birth and caesarean sections in the Northern Trust. The number of home births in Causeway has decreased.
The Trust says during times of increased activity within any maternity unit, it is “part of normal operational management” for scheduled births to be delayed if “appropriate and safe to do so to ensure safety and ability to provide one-to-one midwifery care for women in labour”.
During the six-month period, scheduled inductions of labour were delayed for reasons related to capacity, demand and staffing levels by 12 hours or less on 14 occasions last July; 37, in August; 23 in September; 26 in October; seven in November; five in December and eight in January.
Caesarean sections were delayed for more than 24 hours on eight occasions last August, four in September, one in November, two in December and two in January due to strike action.
Issues highlighted on a patient feedback platform were a need for more practical and emotional support for first time mothers, perceived lack of staff, space and privacy, noise and poor communication. Some felt they had been discharged too soon.
Of 75 replies to a patient survey, 37 were very satisfied, 20 were satisfied, seven were neutral, five were dissatisfied and four were very dissatisfied.
The Trust says the reorganisation has “increased some of the pre-existing challenges Antrim maternity has faced with regards to space, workload and time”.
“After six months, the Trust is assured that the change has been made safely and successfully, and that the maternity service is now in a more stable, sustainable position,” the report continued.
“The feedback received indicates that some women find the environment at Antrim challenging with respect to noise and privacy. It is acknowledged that further development and enhancement of the environment is required.
“Therefore, the Trust continues to work hard to plan and commission the build of an interim three-bedded midwifery led unit at Antrim Area Hospital which we expect to be operational in 2025, in advance of the new-build women and children’s Unit.
“The Northern Trust are assured that the transition to the new maternity services model has proceeded as planned and the resultant service model is a safe and sustainable one.”
It has also stated it is “committed to enhancing the Causeway Maternity Hub by improving local access to antenatal and postnatal services for women within the Causeway locality.
“Complex clinics established in September 2023 are a third trimester midwifery led scanning clinic and for women with increased BMI in pregnancy. The development of local services in the Causeway Maternity Hub for women with gestational diabetes is underway.”