D uring her first pregnancy Maria would spend a long time waiting for her appointments at the Rotunda , one of Europe’s busiest maternity hospitals . Even when she was further along in her pregnancy , she wouldn’t always get a seat while waiting. It had never occurred to her to go private.
“I’m not sick. I don’t need to see a doctor. I’ll just go public, right?” says Maria, who does not want to share her surname.
During her first pregnancy, she was diagnosed with placenta previa – a condition where the placenta can block the cervix – at about 17 weeks. Maria was concerned when it had not moved by 34 weeks. She had researched about the risks from the condition in the third trimester, but says her worries were dismissed.
It was normal for her to see different staff at every antenatal appointment and another clinician was shocked to discover at 36 weeks that she had not been referred to a consultant over the condition.
“If I had gone into labour, I would have haemorrhaged,” she says.
Maria’s baby boy was born at 37 weeks, and spent 10 days in the neonatal intensive care unit (NICU). It was an extremely stressful experience for Maria.
“Having to leave my six-day-old son in hospital while I drove home, still for all intents and purposes appearing pregnant with a floppy empty belly, was the hardest thing I have ever done,” she says.
Three years later, when pregnant again, she shared some of her anxieties with her GP who suggested she go private, if she had the health insurance and the finances.
[ I had no choice but to seek private care at the Rotunda after years of misdiagnosis Opens in new window ]
Maria spent a lot of time researching private care, “including whether my family could afford this”.
“I don’t [spend] four grand at the drop of a hat; I’m not quite in that socioeconomic space,” she says, referring to the estimated cost of private maternity care.
She had to consider her family’s mortgage payments, car payments and the €1,500 a month they spent on childcare fees for their eldest.
“Just because I had the money in my savings doesn’t mean that it’s something I was able to part with willingly,” she says.
“I just felt like when I was public, nobody had my back, and I had no one central point of contact. I didn’t have one consultant looking after me that I could ask all these questions to – whereas when I was private and my daughter was in the NICU, my consultant popped in every morning and asked me how things are going, how I was feeling, how is my daughter.”
Her second baby, a girl, also had to be treated in the NICU but for different reasons. This time, Maria’s consultant and her midwives advocated for her to be able to hold and feed her baby, something she did not get to do for her firstborn.
The Rotunda Hospital in Dublin, one of the busiest maternity hospitals in Europe. Photograph: Sam Boal/Collins
“It was the best money I spent,” Maria says.
The differences between public and private maternity care have been brought into sharp focus in the recent dispute between the Rotunda and the Minister for Health , Jennifer Carroll MacNeill.
Within the next decade, private care in maternity hospitals will start to be wound down and the only option for pregnant women such as Maria will be public care. This policy decision was taken three years ago, but most people only became aware of the change over the past two weeks due to the public dispute.
It’s difficult to predict when private care in maternity hospitals will end, as it will depend on the retirement rate of obstetricians who are currently on public-private contracts. Contracts for new consultants have been all public-only since 2023, meaning they cannot offer private maternity care.
Some within the maternity service expect private care to have between 12 and 15 years left, but many anticipate that semi-private care will end sooner.
As private care is wound down, the fewer women who are able to avail of it may face much higher fees as demand starts to outstrip supply.
Health Minister Jennifer Carroll MacNeill speaks to the media outside Government Buildings in Dublin this week about the dispute with the Rotunda Hospital over the provision of private maternity care. Photograph: Grainne Ni Aodha/PA
Maria represents many women who feel that a better model of maternity care is now being taken away from them, even with the recognition that more consistent pregnancy care should not only be available to those with means.
Two of the State’s biggest maternity hospitals – the Rotunda and the National Maternity Hospital – are now calling on the Government to exclude maternity care from its plan to remove all private care from public hospitals.
Private care is more than a private room, which may not even be available for fee-paying patients, depending on the capacity of the hospital. The main benefit is that a woman sees the same clinician throughout her pregnancy, and feels that there is a named person who is responsible for her care.
Anecdotally, private patien…
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