Support Services

Specialist Clinics

The Rotunda provides a number of specialist clinics for pregnant women in order to provide the best care during pregnancy.

The Rotunda provides a number of specialist clinics for pregnant women in order to provide the best care during pregnancy. Consultants and specialist registrars with an interest in the specific pregnancy-related condition run these clinics. They are supported by a midwife who has a wealth of knowledge to offer you during your pregnancy.

Cardiac Clinic

This clinic is a combined obstetric/cardiac clinic led by a consultant obstetrician, a heart specialist (cardiologist), anaesthetists and a consultant haematologist. Women with a known heart condition prior to pregnancy are referred to this clinic early in the pregnancy. The cardiac support midwife will arrange appointments for you to attend this service and will link up with the cardiac department in the Mater hospital for any tests you need during the pregnancy.

Diabetic Service

This is a combined obstetric/diabetic clinic led by consultant obstetricians and a consultant endocrinologist. Women with diabetes are asked to attend this clinic from early in their pregnancy. You may need to start taking insulin or, if you are already taking insulin, the dose may need to be adjusted regularly during your pregnancy. Good control of blood sugar levels is essential during pregnancy.

You will have close links with the diabetic midwives throughout your pregnancy as you will need to speak with them every week. You will also be seen by the dietitian. If you have diabetes or had pregnancy related (gestational) diabetes in the past, please contact the support midwife immediately you know you are pregnant to arrange an appointment. She may be contacted by phoning 087 – 683 2477 during office hours.

Dove Clinic

This service looks after the specific needs of pregnant women who have or are at risk of blood and sexually transmitted bacterial/viral infections.

For example you would attend the DOVE clinic if:

You or your partner are HIV positive
You or your partner are Hepatitis C positive
You or your partner are Hepatitis B positive
You or your partner have a history of drug addiction or drug abuse
You are on a prescribed methadone programme.
You are positive for syphilis infection.
You require management/treatment of vaginal warts, chlamydia, gonorrhoea or herpes.

While attending the DOVE clinic, you will receive care from a multidisciplinary team who will provide individualised care throughout your pregnancy and birth of your baby. At your clinic visits you will meet a consultant obstetrician, the DOVE liaison midwife, and/or the addiction liaison midwife as well as the DOVE clinic social worker. You may also be seen by a consultant in infectious diseases. After giving birth, your baby will be reviewed by the paediatrician from the DOVE team,.

It is important that you feel comfortable and can discuss issues openly with the team at the clinic and we hope that attending the clinic is a positive experience for you and your baby. You may contact the DOVE liaison midwife directly by phoning 087 – 415 1478 during office hours.

For further information on the DOVE clinic please see the DOVE clinic booklet.

Endocrine clinic

This service oversees the management of most endocrine conditions during pregnancy and is led a consultant endocrinologist from the Mater hospital. However, women with hypothyroidism have their condition managed between their GP and their obstetric team.

Epilepsy

Women with epilepsy should book their first visit as early as possible so that they can be referred to the consultant obstetrician who will care for them during their pregnancy. Epileptic seizures can increase during pregnancy or seizures can reoccur. Your medication may need to be adjusted. A plan to reduce the possibility of seizures during pregnancy and labour will be prepared for you.

Haematology clinic

This service is for women who have been diagnosed with a blood clot in this pregnancy or at any time in the past. It also provides care for women with a bleeding disorder (or a family history of bleeding disorders). The service is led by a consultant haematologist and midwife. You may be referred to this service following the review of your medical and family history at the booking visit.

High risk anaesthetic clinic

Consultant anaesthetists and specialist midwives provide this service to women who may require additional care or assessment, if an anaesthetic is required. This includes women with particular medical conditions or a musculoskeletal problem. You will be referred for review by your midwife or doctor.

Maternal medicine clinic

Consultant obstetricians and a midwife provide this service for women with pre-existing medical conditions, which require specialist care during pregnancy. You could be referred to this clinic from your booking visit or by your GP or medical team in a general hospital.

Medical hypertension/renal clinic

A specialist medical team led by a consultant nephrologist from Beaumont hospital and midwife provide this service for women with high blood pressure, kidney conditions and urinary tract infections. If you are already attending Beaumont hospital for any of these conditions, you will be transferred to the combined obstetric/medical service early in your pregnancy.

Multiple pregnancy

Women with a multiple pregnancy (twins or more) will be referred to this clinic after their booking visit. A consultant obstetrician and midwife lead this service. As part of your care you will have regular ultrasound scans to check on the growth, position and wellbeing of your babies.

Next birth after caesarean (NBAC)

The hospital and community midwifery team with an advanced midwife practitioner, provide this service for women who have had one previous caesarean section. Provided you meet certain criteria, you are referred to the midwifery-led NBAC clinic from your booking appointment.

You will either have an in-person or phone consultation with one of our midwifery team, between 16-22 weeks for your NBAC support visit. During this visit, your previous birth is explored with you and time is provided to answer any questions you may have.

Additionally you will provided with evidence based information and your options for this birth will be explored in collaboration with you. Following this appointment you are encouraged to engage with the NBAC antenatal education class, prior to your 36 week appointment with an advanced midwife practitioner.

You can attend the community midwifery team or the midwives’ clinic in the hospital for your ongoing antenatal care. The midwifery-led antenatal care pathway is supported by the team of Obstetric Consultants.

Perineal Clinic

The complicated postnatal care (‘perineal’) clinic provides care to women who have experienced anal sphincter injury during the birth of their baby, both in the immediate postnatal period or when women are pregnant again after a previous injury.

The clinic works closely with the physiotherapy department. An anal sphincter injury occurs when there is a tear from the vagina into the back passage. A third degree tear is where the ring of muscle around the back passage (anal sphincter) is damaged during birth. A fourth degree tear is where the tear goes as far as the anal canal (inside the back passage).

Other Complications

This clinic also provides care for women who have other problems after the birth of their baby, for example, perineal pain, dyspareunia (pain on sexual intercourse) or a perineal wound infection. Women are usually referred to this clinic from within the Rotunda, but GP referral for delayed postnatal complications are accepted.

The clinic also has links with the department of colorectal surgery in the Mater Hospital and the pain clinic in Beaumont Hospital for any women who require referral. The clinic also provides care for women who have experienced FGM and works in close collaboration with the HSE funded FGM clinic at IFPA .

FGM Information Leaflet

FGM Information Leaflet – English

FGM Information Leaflet – Arabic

FGM Information Leaflet – Somali

2 Weeks

Any women with a 3rd or 4th degree tear following birth will have been seen by the physiotherapist around 2 weeks after the birth. Further appointments with the physiotherapist will be arranged as necessary.

6 Weeks

These women are referred for a special review at this clinic around 6 weeks after birth to ensure that their recovery has been satisfactory. Their labour and the birth of their baby as well as planning care for any future pregnancies and births are discussed. The clinic is run by a consultant obstetrician & gynaecologist.

Preterm surveillance clinic

This specialist clinic, run by a consultant obstetrician, provides care to women who have had a previous preterm birth (before 34 weeks gestation), if they are considered likely to have another preterm birth.

You could be referred to this clinic from your booking visit and care is provided in the fetal medicine department.

Recurrent miscarriage

Women who have had three or more miscarriages in a row are referred to this clinic as soon as a pregnancy is confirmed. The clinic is run by a consultant obstetrician.

They will provide emotional and physical support during the early stages of the pregnancy, before transferring your care to the regular obstetric service.

Substance misuse

This service is available to women who are dependent on recreational drugs. The service is led by a constant obstetrician, a specialist midwife and medical social worker.

The addiction liaison midwife will also support you on a methadone programme, if it’s needed, during your pregnancy.

Teenage Pregnancy Service

The Teenage Pregnancy Service was established in 2005 and is run by a Consultant Obstetrician, Gynaecologist, and a Clinical Midwife Specialist, alongside a dedicated social worker. The service provides holistic, multi-disciplinary antenatal and postnatal care for those up to the age of 19.

We also offer care to some vulnerable young adults over the age of 19 (such as those with additional medical or social needs) who may benefit from the continuity of care of a dedicated obstetrician, midwife, and other supports that are available within our service.

In addition to weekly antenatal clinics, we run a monthly postnatal clinic, in which we provide contraceptive advice and long acting reversible contraception, if chosen.

Thrombosis Service

The service is led by a consultant haematologist. You may be referred to this service following the review of your medical and family history at the booking visit.

All these clinics take place within the main outpatients department. Appointments are arranged through the clerical staff in the outpatients department or by phoning them at 01 873 0596 or 01 873 0632. Support and advice is available through the assessment and emergency unit outside of clinic working hours.