Portiuncula University Hospital Shifts High-Risk Pregnancy Care

Portiuncula University Hospital (PUH) in Ballinasloe, County Galway, has announced a significant policy change regarding the management of high-risk pregnancies. Effective immediately, expectant mothers categorized as having high-risk pregnancies will have their antenatal care relocated to other medical facilities in the region. This decision is part of ongoing efforts to enhance maternal and neonatal safety following a series of concerning incidents at the hospital's maternity unit.

The Health Service Executive (HSE) has stated that the criteria for identifying high-risk pregnancies will be broadened under this new policy. Expectant mothers with gestational diabetes, elevated Body Mass Index (BMI), and those who have faced complications in previous deliveries are now included in this category. Furthermore, women at risk of delivering prior to 35 weeks will also be transferred to alternative maternity units. This change is anticipated to significantly reduce the number of births at PUH, which recorded approximately 1,300 deliveries in 2024. Experts estimate that this figure may decrease by as many as 400 births annually due to the relocation of high-risk cases.

The decision arises in response to ongoing reviews of maternity services at PUH, prompted by alarming data regarding neonatal outcomes. Notably, reports indicate that the incidence of hypoxic-ischemic encephalopathy (HIE)—a condition characterized by reduced blood flow to the brain during birth—at PUH is significantly higher than the national and international averages. According to the HSE, this issue has been under scrutiny since late 2023, with a total of nine problematic deliveries, including two stillbirths, raising serious concerns about clinical governance and infrastructure at the hospital's maternity unit.

Dr. Emily Fitzgerald, a consultant obstetrician at Galway University Hospitals, highlighted the importance of the move in ensuring that expectant mothers receive appropriate care tailored to their specific health needs. "The safety of both mothers and babies is paramount, and these changes are aimed at addressing the risks associated with high-risk pregnancies in a more effective manner," stated Dr. Fitzgerald during a recent press briefing.

In response to the troubling findings, the HSE had previously appointed external experts to oversee maternity services at PUH. Their reviews have revealed long-standing issues within the unit, echoing concerns raised in a 2014 investigation known as the Walker Report. This earlier examination followed multiple cases of oxygen deprivation during childbirth, which resulted in serious harm to newborns and highlighted deficiencies in staffing and resources.

The Walker Report concluded that systemic failures were to blame for the adverse outcomes, leading to a series of recommendations for improvement. While the HSE has claimed that all recommendations from previous reviews had been implemented, the recent spike in incidents suggests that further action is necessary.

Local elected representatives have been briefed on the planned changes, with a community meeting to discuss the implications of these modifications scheduled for later this afternoon. The HSE has assured the public that the safety of maternity services will remain a priority, as it continues to fulfill commitments to improve the quality of care.

In the broader context, the shift in high-risk pregnancy care reflects ongoing challenges within Ireland's maternity services, which have faced heightened scrutiny in recent years. The growing demand for safe and effective maternal healthcare has brought the issue of resource allocation to the forefront of public discourse, prompting calls for comprehensive reform.

Moving forward, stakeholders will remain vigilant, ensuring that both the quality of care and the safety of mothers and their children are prioritized in every decision made. As the HSE moves to implement these changes, the long-term implications for maternal healthcare in Ireland remain to be seen, but the commitment to safety and improvement must continue to guide future actions.