To ask the Minister of Health (i) to detail the increased perinatal services available in Causeway Hospital since the maternity unit was moved to Antrim Area Hospital; and (ii) for his assessment of access to services for expectant mothers who must travel further since the move.

(i) Following our acute maternity services transformation work which saw births and inpatients consolidate onto the Antrim Area Hospital site, the Trust have worked to increase antenatal and postnatal services in the Causeway Maternity Hub by improving local access to antenatal and postnatal services for women within the Causeway locality. Complex antenatal clinics have been established in Causeway so as to mitigate the distance women have historically been asked to travel to receive this care.

These clinics include;

Perinatal Mental Health Clinic

There is a dedicated joint perinatal mental health and obstetric clinic. Since the reconfiguration of services, the community perinatal mental team now provide fortnightly clinics in the Causeway Maternity Hub. This has facilitated an improved pathway and increased co-ordination in care between the multidisciplinary teams and have reduced the need for women with perinatal mental health concerns to travel to Antrim as had been the case prior to the reform.

Social Complexities Antenatal/ Postnatal Clinic

There is a dedicated obstetric clinic with support from the Midwife specialist for Social Complexities.

Third trimester Midwifery Led Scanning Clinic

Weigh to Health Pregnancy Clinic for women with an increased BMI in pregnancy.

Specialist infant feeding clinic

The Trust also have a Maternity Care clinic, which is a dedicated provision for scheduled ambulatory care. Since the opening of this unit, until end of March 2024, 733 women have benefited from the utilisation of this service.

Scheduled Care provision

Examples of scheduled care provision includes iron infusions, caesarean section pre-operative care, screening tests, including those for diabetes and fetal and maternity wellbeing checks.

Being developed;

Gestational Diabetic Clinic

Pathways are currently being developed to provide to a cohort of risk-assessed women who present with gestational diabetes to receive antenatal care, thereby further increasing perinatal services to the woman in the locality of Causeway without the need to travel to the Antrim site.

Neurodiversity antenatal/ postnatal clinic

A further pathway currently under development is an antenatal space/clinic to provide women with a diagnosis of neurodiversity, that may find it difficult to attend a traditional antenatal clinic an alternative setting.

(ii) In relation to an assessment of access to services for expectant mothers who must travel further since the move, one of the concerns which had been expressed was that the change could result in additional babies born before arrival to hospital (BBAs). Since the consolidation of inpatient maternity services and births in Antrim Area Hospital, six women (accounting for seven babies as there was one set of twins) have experienced birth before arrival to hospital. Three women were within the Causeway locality and four resided closer to Antrim. There has been no significant increase in the average number of BBAs, which is approximately one per month.

Another concern was if mothers would present in labour at Causeway Hospital after the service change; however, since the maternity service reform, no women have presented in labour at Causeway Hospital.

Seven pregnant women (not in labour) have attended Causeway Emergency Department and appropriate pathways have been followed to ensure safe and timely care.

The change in configuration of Northern Trust inpatient maternity services was intended to address some significant concerns around the sustainability of the previous two-site model. Inevitably, this has resulted in some women having to travel further to give birth or to access unscheduled antenatal care, however local access to antenatal and postnatal care has been improved and the Trust is assured that the maternity service is now in a more stable, sustainable position.