Different types of maternity services in Ireland

Introduction

Hospitals in Ireland now offer more flexibility in their maternity services.

Most women choose to get combined care (also known as shared care) which is a combination of maternity care from their GP and their local maternity unit or hospital.

However, if you have a normal-risk pregnancy, you can choose midwifery-ledcare instead. This can be provided to you in hospital, at home, or in a midwifery-led clinic. You may also choose to have a home birth, rather than deliver your baby in hospital. If you do have your baby in a hospital, you may be allowed to get discharged early.

This document explains the variety of maternity services available in Ireland. For information on the differences between public, semi-private and private maternity care, read our document on Choices in antenatal care.

The Maternity and Infant Care Scheme

If you live in Ireland (or if you intend to live here for at least 1 year), you can get free maternity care through the Maternity and Infant Care Scheme. This covers antenatal visits, labour, delivery and postnatal care. You do not need a medical card or a GP visit card to use this scheme.

Most women choose to split their care between their GP and a maternity unit/hospital. This is known as combined care or shared care. Alternatively, you can choose to get all of your care at the hospital's antenatal clinic. This option is available in all maternity units and hospitals in Ireland.

You will be asked whether you want to be a public, semi-private or private patient when you ring to make your first appointment. If you decide to be a private patient, you will be liable for the full range of in-patient charges.

Read more about what is covered under the Maternity and Infant Care Scheme.

The Domino Scheme

The Domino Scheme (also known as the Domino Service) is a midwife-led maternity service. It is only available:

• To women with normal-risk pregnancies (no pregnancy complications)
• In certain areas
• From certain maternity hospitals and maternity units

On the Domino Scheme, you will be cared for by experienced community midwives throughout your pregnancy, during your labour and for the first week after your baby is born. This midwife-led care is combined with care from your GP.

You will also be given the opportunity to leave the hospital early (early discharge). You may be able to go home as soon as 6-12 hours after your baby is born.

Women using the Domino Scheme are often encouraged to use natural birthing methods. You will be supported through this by your Domino midwives.

If you are interested in using the Domino scheme, contact your local maternity hospital or maternity unit to see if it’s available in your area.

Community midwives

Community midwives are self-employed and for this reason, their service is only available in particular areas when the midwives have availability.

If you have a normal-risk pregnancy (no complications), community midwives can:

• Provide your antenatal visits, either in a local clinic or your home
• Deliver your baby either in hospital (Domino Scheme) or at home
• Provide postnatal care (care after your baby is born)

Answer any maternity questions you may have by phone, 24 hours a day, 7 days a week

If you choose to be cared for by community midwives, you will need to have a routine scan at around 18-22 weeks and a full physical examination to assess your suitability. If you experience any problems during pregnancy or labour, you will be immediately transferred back to full hospital care.

You can find contact details for local community midwives on the Community Midwives Association website.

Home births

While most women deliver their babies in hospital, you can choose to have your baby at home. This is called a home birth.

During the home birth, you will be supported by 2 self-employed community midwives on behalf of the HSE. You do not have to pay for this service.

Home births are only suitable for women with normal-risk pregnancies. If you or your baby develop health problems, you will need to deliver your baby in hospital, under the care of an obstetrician (a doctor who specialises in pregnancy and labour).

If you want to have a home birth, contact your GP and your local designated midwifery officer as early as possible in your pregnancy to discuss if it is a safe option for you and for more information.

Midwifery-led clinics

Some women choose to get maternity care from experienced midwives in a midwifery-led clinic. This clinic is usually based in the hospital, and is provided alongside care from your consultant.

You can give birth in a uniquely designed birth room, where you can avail of facilities such as music and supportive aids (for example, a gym ball or bean bags) if required.