Dear Editor,
In response to City Councillor Mary Leahy raising concerns over the rules governing the availability of private beds in public maternity hospitals, the Irish Hospital Consultants Association (IHCA) state that consultant-led maternity services came about through mothers exercising freedom of choice and an absence of demand for midwifery-led services (Galway Independent, 17 October 2007).

Neither of these statements is true. Firstly, most women in Ireland do not have access to the full range of options regarding their maternity care that should be provided if our services are ever to conform to international best practice. Thus, many women are unable to make a truly 'informed choice' about care. We also know that women recognise continuing problems in the maternity services, such as acute overcrowding, and that they are deeply dissatisfied, as revealed by national survey data such as that published in 2006 by the Irish Examiner/Lansdowne Market Research.

Secondly, there is no evidence to support an absence of demand for midwifery-led services in Ireland. On the contrary, examples from the two pilot midwifery-led units in Cavan and Drogheda show that up to 50 per cent of all eligible women would choose midwifery-led services. Other such initiatives in Cork and Dublin also demonstrate strong demand, a demand that is also evidenced in surveys of women's views in the West of the country.

Furthermore, many local, regional and national women's groups, including Cuidi?: The Irish Childbirth Trust, the association for improvements in maternity services Ireland, and the Irish Homebirth Association, have and continue to emphasise that demand from women for such services outstrips their availability.

Nevertheless, we are delighted that the IHCA see nothing to prevent the re-introduction of midwifery-led services other than an absence of demand. Given that the demand is clearly there, we look forward to the support of our consultant colleagues in the provision of additional models of maternity care, thus providing choice for the women of Ireland.

Sincerely, Declan Devane
Lecturer in Midwifery

and

Dr Jo Murphy-Lawless
Lecturer

For and on behalf of the

Midwifery Forum,
School of Nursing and Midwifery,
Trinity College Dublin

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