Dublin Hospital Transfers Women to Drogheda Amid Bed Crisis

Dublin’s Rotunda Hospital has begun transferring women in labour to Drogheda Hospital due to a critical shortage of neonatal beds. This significant issue was highlighted on a Monday evening in mid-December when a woman in labour had to be transported by ambulance to ensure her baby could be delivered safely. According to Prof. Seán Daly, master of the Rotunda, such transfers are becoming increasingly common as the hospital struggles to accommodate the rising number of births.

The demand for neonatal care has intensified at the Rotunda. Currently, the facility is preparing to open a new postnatal ward, designated as Ward 14, which will provide additional capacity for newborns. Daly expressed that the hospital is experiencing an exceptionally busy period, noting that in general, transfers occur when medical staff assess that delivery is imminent and space is essential for the newborn.

The hospital has recorded a 2 percent increase in deliveries year-on-year, with October 2023 marking the highest number of deliveries in a decade, totaling 804 babies. Over the first eleven months of the year, the Rotunda delivered 1,100 more babies than the National Maternity Hospital and nearly 1,700 more than the Coombe. The hospital anticipates delivering its millionth baby by 2026.

Daly noted that the complexity of cases has also risen. During a recent multidisciplinary team meeting, eight sets of twins were discussed, with some being delivered as early as 31 weeks. The increased incidence of twin births, approximately 140 sets annually, correlates with women having children later in life and the rise in assisted reproductive technology.

While advances in medical care have enabled the hospital to care for more vulnerable infants, this has added pressure to the existing neonatal facilities. Daly pointed out that babies born as early as 22 weeks are now considered viable, significantly increasing the demand for intensive care. “Twenty years ago, we didn’t consider babies viable unless they weighed more than about 700 grams and were 25 weeks or more,” he explained.

Concerns about the hospital’s current infrastructure were also raised. Daly criticized the existing neonatal unit, describing it as a “huge room” that lacks the necessary individual spaces for babies, increasing the risk of infection and limiting parental access. The hospital has sought planning permission for a new critical-care wing, but this request is currently under appeal.

Daly has reached out to 46 politicians, including Minister for Health Jennifer Carroll MacNeill, urging for changes in the planning process to address these urgent infrastructure needs. “This is national infrastructure,” he emphasized, noting that of the four level-three neonatal units in Ireland, none of the Dublin facilities are adequately designed for current demands.

“What will happen if the appeal doesn’t go the way he wants? There is no plan B,” he stated. He underscored the hospital’s strategic location in north inner-city Dublin, which allows it to collaborate effectively with nearby healthcare facilities like the Mater Hospital to meet population needs.

Additionally, the Rotunda has expanded its services beyond maternal medicine, now serving as a centre for benign gynaecological referrals in the area. The hospital receives approximately 1,400 referrals per month but can only manage 850 to 900 cases, resulting in lengthy waiting times. Daly acknowledged that the development of a surgical hub in north Dublin would help alleviate some of the capacity issues.

While conditions like endometriosis have gained public attention, Daly pointed out that many benign gynaecological issues also require improved services. “There is a whole cohort of women with urogynaecology difficulties,” he noted, emphasizing the need for prioritization of various conditions.

As he approaches the midpoint of his tenure, Daly remains committed to enhancing the hospital’s capacity and care standards. “It’s about developing the campus, getting more beds and taking better care of people,” he concluded. The challenges faced by the Rotunda highlight the pressing need for infrastructural improvements in Dublin’s maternity care facilities to keep pace with growing demand.