An evaluation of midwife-led, DOMINO and home birth services at the National Maternity Hospital, Dublin

DOMINO and home birth midwife-led services are provided by midwives attached to an urban maternity hospital in the Republic of Ireland. To obtain an understanding of women's experiences of using these midwife-led modes of care a cross-sectional survey design study was undertaken. Data was collated via a piloted, unstructured self-completion questionnaire disseminated to 151 maternity care users, with 116 participants returning the completed questionnaire (77% response rate). Data analysis was predominantly undertaken using descriptive statistics via SPSS V22, with iterative content analysis of the data generated from the open questions. Finding illuminated the aspects of care the maternity care users valued including: continuity of care, provision of choice and control and early discharge home with community postnatal care from the midwifery team. The women expressed how they had experienced and valued the provision of thorough and competent care by skilled experienced midwives, with 97% rating their experience as highly positive. The findings also highlighted how the cultural norms within the maternity hospital can influence the provision of midwife-led care e.g. admission electronic fetal monitoring. Recommendations included: expansion of the current provision of the DOMINO and home birth services for women outside the catchment area and across Ireland.