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66 Maternity and Obstetrics started to provide the Outpatients Department a midwife for two set days a week from 4:30pm to assist in the evening booking clinics. These have proven popular for women. The mixed risk clinics are supported by Dr Venita Broderick and Dr Nita Adnan in Loughinstown, Bray, Arklow, Greystones and Wicklow Town. They were also challenged by the COVID-19 pandemic. The introduction of timed appointments became essential to ensure the guidelines of social distancing were met. These have proven remarkably successful. There is also a greater demand for these clinics as women preferred not to attend the hospital at this time. Other Developments The use of the debrief service offered by the Community Midwifery Manager has seen a large increase in demand with 28 women using this service. These appointments have received positive reports and whilst time consuming, are valued by the users. Two more midwives are trained in the examination of the newborn which provides a greater level of holistic midwifery care. Sinead Thompson, creator of the Labour Hopscotch Tool, was seconded to the National Women's & Infant Programme to roll out this initiative out nationally but this is currently on hold due to the COVID-19 pandemic. New Attended Follow Up Attended Total Attendances Greystones Health Centre 65 293 358 Leopardstown Primary Care Centre 104 540 644 St. Michael's Hospital 29 139 168 Pearse Street Primary Care Centre 95 485 580 Churchtown Primary Care Centre 108 466 574 Bray Primary Care Centre 71 339 410 Newtownmountkennedy Primary Care Centre 35 202 237 Consultant Clinic at NMH 0 255 255 Outpatient Checks at NMH 18 131 149 525 2,850 3,375 Planned Homebirth Actual Homebirth PRSOM Post Dates GBS Failure To Advance Maternal Choice Suspected Distress Other Care Giver Other Multip 60 32 3 1 3 1 2 2 11 5 Nullip 10 2 3 1 2 1 0 0 0 1 Reasons for leaving Domino Scheme 35% 30% 25% 20% 15% 10% 5% 0% Did not return for delivery Early transfer home High risk Transferred to independent Midwife Miscar- riage Transferred to Public Clinic Out of catchment area Transferred to private clinic Transferred to private midwife Transferred to semi private Termi- nation of pregnancy Twins 2020 | NMH Annual Rep t