Arranging a Home Birth
1. You do not need permission from your doctor, the Health Service Executive or anyone else to have your baby at home.
2. Birth Attendants - Midwives
Midwives are professionals in their own right and are qualified to practice independently in providing all services to those who opt for home birth. They are the only people whose training is concerned solely with maternity care and normal pregnancy and birth.
They are the specialists in normal maternity care (obstetrics is the study of abnormal pregnancy and labour). It should be noted that a midwife will not deliver at home if you go into labour before thirty six weeks.
A midwife can provide full antenatal care; labour and delivery; and postnatal care up to and including a six-week check up. The midwife can also conduct the regular paediatric newborn checks and the P.K.U. (heel prick test) on the baby.
When it comes to establishing breast-feeding, she will provide the best of encouragement and support. Midwives provide a very personalised service and will answer any questions you have about the services they offer.
Fortunately, there are a number of independent (private) domiciliary midwives in Ireland (see list). Most of the 350 home births per year in Ireland are attended by them.
(i) A homebirth with independent midwives provided directly by the HSE.
The HSE provide a direct homebirth service in County Kerry and County Cork using the services of the independent midwives. If you are eligible (no previous Caesarean Birth), you will be attended by an independent midwife throughout your pregnancy.
For further details contact Jo Delaney on 021-492-3935
(ii) A homebirth with a privately engaged independent midwife
For all Health Areas outside counties Cork and Kerry if you wish to avail of the services of an independent midwife, you will need to engage him / her privately. You will receive a grant towards the fee (see homebirth costs) from your Health Area if there is no other clear pathway to home birth care, but this may not cover the full cost. Private insurance will usually also contribute. (See homebirth costs). For those women with previous ceasearian births in counties Cork and Kerry, whilst you may not be entitled to avail of the free scheme, you an of course hire a midwife privately, however, because there is already a clear pathway to care within the HSE provided service you may not be eligible for the grant. This point may also apply to women in the catchments of the schemes provided by the Maternity Hospitals in Waterford and NMH Holles St. See below. The one possible exception being if the schemes are full.
(iii) A Homebirth with a team of community midwives working out of a maternity hospital
Two such schemes are currently in operation in The Republic; one in The National Maternity Hospital Holles St., Dublin and one in Waterford General, serving parts of Kilkenny and Wexford too. The service is usually provided by a team of midwives, so although you will meet all the midwives during your antenatal period you will not be able to guarantee who you will get on the day. The service is free of charge. Some of your antenatal visits will take place at the Maternity hospital, some at home and some at outreach clinics.
Weford/ Killkenny/ Waterford:
contact Ethne Coen on 056-7720400
Dublin (NMH)
contact Community Midwives on 01-6373100
There is also a limited service provided in NI DownPatrick contact Assumpta Morgan or Alision McDaid 02844 616995
3. Birth Attendants – Doctors
G.P.s may be unwilling to be involved in home births because of several reasons - high insurance premiums, lack of up-to-date information and or experience in the area of childbirth and the extra demands of being on call. However, some may be willing to support you in some aspects of your antenatal and post natal care.
If your own G.P. is not supportive of home births you could begin by obtaining a list from your local Health Board of those doctors providing antenatal care. You can ring all doctors within a reasonable radius and make personal calls on those that sound interested. You stand a much better chance if you present your case in person, and have a good knowledge of your rights, the advantages of home birth and the reasons for your choice. Whereas s/he may have found it easy to dismiss you over the phone, in the surgery s/he will have to at least consider the issue before deciding.
To save paying for the visit, you could make it clear from the outset that you are only seeking information about her/his services.
The Home Birth Association and our regional contacts may have information about supportive doctors in your area
Some Health Areas insist that a doctor must be involved, knowing that very few will agree to do so.
There is no statutory requirement for a doctor to be present at a birth, at home or in hospital.
4. Finally
If you engage a midwife or doctor privately you are not obliged to notify the Health Board of your intention to have a home birth. However, by notifying the Health Board by letter, you are providing a truer picture to them of the demands for home births and you will be eligible for the €1,500 grant payable to all eligible women.
While we can appreciate the frustration felt by parents who want to have their babies born at home, we in the Home Birth Association do not support unassisted births. That is the decision to go ahead with the delivery with no trained medical attendants.
Low tech alternatives include the Community midwives DOMINO scheme in Holles St and the Rotunda and the pilot Midwifery Led unit in Our Lady of Lourdes, Drogheda.
You may seek a home delivery up to 36 weeks, however, the earlier in your pregnancy that you make preparations, the more likely it is that you will give birth in the place of your choice, with the birth attendant[s] of your choice.
Once you are happy with your decision about where your baby will be born, you will be able to settle into that serene confidence which is so valuable during pregnancy, childbirth and the period of early parenthood.
