Supreme Court decision
highlights need for reform

Joint statement of the
National Birth Alliance
& Homebirth Association of Ireland

Today's Supreme Court decision may not be the end of women's entitlement to a free home birth service from the State. "Health boards have discretion in this area, and we are appealing to them to use it for the benefit of less well off women", said Krysia Lynch Rybaczuk, PRO of the Home Birth Association. "We have a Health Strategy that commits us to equity in health. Why should home birth be a choice reserved for the rich?"

Marie O'Connor of the National Birth Alliance blamed what she called "the medical empire in maternity care" for today's Supreme Court decision. "We live in such a deeply medicalised society that, like fish who can't see water, we find it difficult to see the monopoly that consultant obstetricians exercise over the services for birth".

The market for private maternity services is a highly lucrative one, worth an estimated e50m annually. "Average obstetric incomes are in the region of e500,000 yearly, and this is on top of a public salary that starts, in the eastern region, at e114,000. Obstetrics is a goldmine, and this goldmine is a huge barrier to reform".

Independent midwife Philomena Canning says that today's judgement under lines the need for a complete overhaul of our maternity care system. "Tomorrow sees the publication of a study showing that Caesarean rates in Ireland have trebled in the last 20 years. Our system has turned birth into an operation: two mothers in every five give birth by Caesarean, forceps or vacuum extraction".

These rates are not sustainable, O'Connor points out. "The cost to the State of the present doctor-driven system is astronomical. We are forcing women to have an excess of costly medical treatment, while at the same time denying them access to the midwifery model of care".

Given the Government's commitment to driving the Hanly agenda, the need for local services will become acute. "Here again, consultant obstetricians are blocking the development of the services. If they, or their representative bodies, have decided to pull out of eight or nine hospitals around the country, then they should move over and make way for midwives, and allow them to manage the services that they have been providing all along".

Many women want a birth that is low-tech and drug-free, options that in hospital are rarely open to them. Rybaczuk says that in today's overcrowded maternity units, active medical management is the rule. "The more doctors intervene, the more adverse outcomes occur, the more parents sue, the more doctors intervene. It is a vicious circle".

Canning makes the point that we have opted for a very expensive model of maternity care: "A normal hospital birth costs the State e4-5000, while home birth only costs e2000". Then there is the cost of obstetric insurance, currently costing e400,000 per consultant: "The taxpayer is picking up the tab for a model of care that is wasteful, expensive and unsustainable. Meanwhile midwives are leaving the services in their hundreds, and mothers are suffering from the iron rule of obstetrics in overcrowded labour wards".

For further details, please call:

Home Birth Association
Krysia Lynch-Rybaczuk
Telephone: 01 660 3499
Mobile: 087 754 3751

Independent Midwife ERHA
Philomena Canning
Telephone: 01 495 1902
Mobile: 087 290 0017

National Birth Alliance
Marie O’Connor
Telephone: 01 838 8168
Mobile: 087 918 2722