Our aim is to ensure you receive maternity care in the right place, with the right people looking after you and your baby. We would advise you to read the Public Health Agency (PHA) Pregnancy Book Pregnancy Book 2025.pdf, Section 2, Page 16; Where to have your baby. This will discuss the current birth place options available to you within Northern Ireland.
You can now self-refer to Belfast Trust maternity services using the form below as soon as you have a positive pregnancy test.
If you have any difficulty completing the form below or you get an error message, please download and complete this self-referral form and return by email to: maternityreferral@belfasttrust.hscni.net
Please only complete the self-referral form if you want to give birth in the Royal-Jubilee Maternity Hospital in Belfast.
Use this self referral form to access RJMH Maternity and Continuity of Midwifery Care (CoMC) services.
If you are completing this form on behalf of someone else please answer as best you can with the information available to you.