High-Risk Pregnancy Care to Move from Portiuncula University Hospital

Expectant mothers with pregnancies deemed to be 'high risk' are to have their antenatal care moved from Portiuncula University Hospital to other locations. The development comes as a number of reviews into maternity care at the hospital in Ballinasloe, Co Galway continue. It is understood that the criteria for defining a high-risk pregnancy there is to be expanded. It will mean that expectant mothers with gestational diabetes, those with a high BMI, and those who have experienced difficulties during previous labors will now be scheduled to give birth at other maternity units in the region. Women considered likely to deliver before 35 weeks will also have their care moved.

Staff in Portiuncula have been briefed about the planned changes, and a meeting will take place later this afternoon to inform local elected representatives. They will be told that the measures are being taken to enhance safety, in light of the concerns that prompted the reviews of the unit. The HSE says it has committed to implementing all recommendations arising from the ongoing reviews. But the decision will significantly reduce the number of births at Portiuncula in the future. There were around 1,300 babies born there in 2024. That is expected to fall by three or four hundred when these changes are fully implemented.

Last January, external experts were appointed to oversee maternity services at Portiuncula University Hospital. The decision follows concerns about nine deliveries at the hospital since late 2023, two of which were stillbirths. A further three births since January of this year are now also subject to the ongoing review process. In many of the cases, babies experienced reduced blood flow to the brain around the time of their births. The medical definition for this is hypoxic-ischemic encephalopathy (HIE).

The Health Service Executive says the incidence of HIE at the Ballinasloe hospital is 'significantly higher' than that observed at other maternity units nationally or internationally. At this stage, five of the latest reviews have been completed. They have identified issues around clinical care, governance, communication, and infrastructure at the unit. Some of those concerns were raised seven years ago, at the conclusion of an earlier review into maternity care at Portiuncula.

The Regional executive Officer for the HSE West and North West said the measures were in part prompted by the ongoing reviews. Tony Canavan said the transfer of higher risk cases from PUH was an effort to improve patient safety. Those already booked into the hospital have been advised to continue with their arrangements. But in the future, 'categories of women' who would have otherwise attended PUH would now be cared for at University Hospital Galway, or at other maternity units in the region.

Around 1,300 births were registered in Portiuncula last year. Initially, the changes will result in the transfer of around 200 cases, but when fully implemented, that is expected to increase to between 400 and 500 patients annually. However, Mr. Canavan denied the move amounted to an orderly wind-down of the maternity unit in Ballinasloe. Instead, he described it as 'an orderly response to the safety concerns that had arisen, through these reviews'.

Mr. Canavan said he could not give commitments about the future plans in relation to any of the maternity services presently offered in the west and north-west. A commitment to review the existing maternity strategy at 19 units across the country is contained in the Programme for Government. Mr. Canavan said this would ultimately inform the provision of services nationwide. He went on to add that healthcare generally is inherently risky and maternity care, in particular, carried particular risks. In the latest reviews, some of the same themes that were identified in previous inquiries are starting to emerge again. Mr. Canavan said this was a concern and informed today's decision to transfer higher risk cases elsewhere. He said the unit in Galway was significantly better equipped in terms of obstetric and neonatal care, as well as from a staffing perspective. But he said it was also under pressure and this would have to be managed in line with the new arrangements.