It’s a busy morning in the Daisy Clinic and four pregnant women are sitting in the reception area as staff bustle around, offering patients tea, coffee and biscuits. Soothing jazz music plays quietly in the background, creating an aura of calm in this small building, hidden away in the Sophia Housing Association complex off Dublin’s Cork Street.
“People are nervous when they first come in but it’s important for us, regardless of background, that everyone is welcome,” explains Gillian Hill, co-ordinator of the Wisdom Centre which houses the clinic. “We don’t know where these women have come from, or where they’ll go after being here. But while they’re here, it’s a safe space for them.”
Established in response to the sudden increase in Ukrainian refugees, particularly women, arriving in Ireland in 2022, the clinic was modelled on a service set up by the Health Service Executive’s Response for Vulnerable People (RVP) team during the pandemic for the Roma community. While the number of Ukrainian women seeking pregnancy support has dropped, the clinic now operates as a satellite service connected to the Coombe, offering maternity and gynaecological care to pregnant women going through the international protection system.
A total of 130 pregnant asylum-seeking women have attended the clinic since June 2023, when data started being collected. Current patients are most likely to be from Nigeria, Jordan, Bangladesh or Somalia. Before the clinic existed, pregnancy care for an asylum-seeking woman was “very messy” and “fractured”, says lead community midwife Emer Shine. “These women would all be quite high-risk, just by the fact that they’re all in international protection. A lot have gestational diabetes and FGM [female genital mutilation] is definitely an issue.” The diet many of these women have while living in emergency accommodation is also concerning, she adds.
The arrival of the clinic means there is now “continuity of care” with “better links” for asylum seekers in Dublin. “The women have a phone number to call me and ask the things you might ring your mam about because some have no family here.”
Some women can still fall through the cracks. Shine recalls how a woman late in her pregnancy was recently transferred “in the middle of the night” from City Ark Hotel in Citywest to new accommodation in Tipperary. “It was only because she had my phone number that she could start calling us straight away. Eventually we got her transferred back to Dublin. She was 37 weeks pregnant [and also had]… a three-year-old toddler.”
Elanor Hale, the clinic’s senior medical social worker, agrees that the new system is “more co-ordinated and efficient” and “a lot easier for women to access”. It not only streamlines supports for pregnant women, but offers far more efficient interpretation services to help overcome communication barriers, she says.
However, she remains concerned about the “transient” nature of housing for these women. “They can be moved so quickly and without much notice. We’ve literally just had a case where a woman came in to deliver her baby, was living at one address and then was discharged to an alternative address.”
“These women are often confined to one room with more than one child and many are here on their own so it can be very isolating. Obviously childbirth and the postnatal period can be isolating for any woman, but this just exacerbates it.”
Women discharged to accommodation outside the capital often do not have health services “readily available”, she says. “If you’re discharging a mother and baby outside a major city you’re somewhat reliant on the goodwill of our universal services. You hope the public health nurse will take an interest.”
Maya*, who is 38 weeks pregnant and started attending the clinic in July, says she received no maternity care before arriving in Ireland. Her midwife has “supported me in every stage” which is “very important because this is my first pregnancy so I don’t know what’s going on and I needed her help”.
“We are here alone, we have no family,” says the young Bangladeshi mother-to-be as her husband nods his head. “My midwife is like my family now, she is so helpful, I can’t explain.”
“I can text her with any problem.”
Ola, who is 30 weeks pregnant, was recently transferred with her husband and children from the centre where she was living in the west of Ireland. “The place where we were living was too tight for a new baby, they wanted us to have more room.” While she has not yet attended the clinic, she has already been contacted via WhatsApp and is due to see a community midwife next week.
Before the clinic was set up, a pregnant asylum-seeking woman who was suddenly moved to a different part of the country would struggle to see a doctor quickly because transferring a GP card can take between six months to a year, says nurse and midwife Debbie Garry.
Now, the Daisy Clinic has created a system that’s “effective, productive and cost-effective for the hospital”, says Garry, noting that the Response for Vulnerable People team recently received a list from the International Protection and Accommodation Service (Ipas) of all pregnant women arriving in to Citywest for the first time. “That list makes life a lot easier for everyone – before the list we just had to go looking for these women.”
The 70-year-old midwife was appointed to the HSE’s social inclusion response for Roma women during the pandemic and oversees the care for pregnant asylum seekers in Dublin. Working with Roma and asylum-seeking women from certain countries “is almost like looking at Irish women 50 years ago, when women had no rights”. Many of these women do not have access to finances or even have their own phone, she says. Some cannot read or write and many of those who can, do not recognise the letters of the Roman alphabet. “You cannot assume that everybody can access or read a text from the hospital. Because of my age and experience I appreciate that these are women with no voice. And my age is an advantage to me, I’m like their grandmother You build up trust, you build up a relationship.”
“These are real people, these are real stories and you can see the trauma on their faces and in their body language. They’re not used to saying what they need.”
The clinic model now needs to be extended across the State, says Maxine Radcliffe, who leads the Response for Vulnerable People team and is in the final stages of establishing an outreach midwife clinic in Citywest.
“We’re seeing a lot of women at a very late stage antenatally. Imagine the journey some of these women have been on through Europe to get here. Many haven’t had any care at all. And that’s what we’re doing. These clinics need to exist.”
[ A Wicklow village is still divided, six months after anti-asylum seeker protestsOpens in new window ]
Asked if there were any plans to replicate the Daisy Clinic outside the capital, a HSE spokesman said pregnant asylum seekers were connected with a local GP and maternity services and were offered additional supports through the HSE’s migrant health teams.
A new “pregnancy protocol”, introduced in July 2024, required direct provision and emergency accommodation managers to notify Ipas when a woman was pregnant and required a transfer, said a Department of Integration spokesman. Under the protocol, any pregnancy-related accommodation transfers should “where possible, occur between 12 and 28 weeks which is generally accepted as the most stable period of pregnancy”, said the spokesman.
Ipas managers were “contractually obliged to meet the dietary and cultural needs of all residents” and when required, should also arrange transport for women to attend antenatal appointments, he said.
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