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BIRTH EXPERTS ARE warning of an increasing prevalence of women having babies at home without medical assistance.
Given the nature of unattended ‘free births’, data is unavailable on numbers opting for this, but those providing maternity services in the community told Noteworthy that they were coming across more year-on-year.
Aisling Dixon, community midlife in Ballinasloe and chairperson of the Community Midwives Association, said that she “noticed in the last 10-15 years that many more women are choosing home births because of a traumatic hospital experience”.
This contrasts to women’s reasons for homebirth in the early 2000s, when most opted for it for philosophical reasons as “they aligned to that pathway”, Dixon said.
This is significant as for some women, “their experience has meant that going back to hospital is too traumatic for them”.
In the absence of a home birth service, they are choosing to free birth.
Women need to meet strict criteria to avail of the HSE’s home birth service. Data from 2018-2020 shows over a quarter of women who wanted a home birth were referred back to a maternity unit and gave birth in a hospital. This does not include women transferred during labour.
Home births provided by the HSE have stricter criteria than other countries, such as the UK, or private home births for those able to afford the option of private midwives in Ireland. It is also limited to certain parts of Ireland due to the low number of available community midwives.
Free births were raised as a potential consequence of the controversial 30-minute ‘blue light’ ambulance distance limit recommended by the National Women and Infants Health Programme (NWIHP) last year. As part of this series, we reported that this controversial guidance “remains in place”, according to the HSE.
Minutes of the HSE Homebirth Oversight & Integration Steering Committee in October last year, obtained by Noteworthy though a Freedom of Information (FOI) request, noted that “concerns were raised that removal of the homebirth service would cause women to seek alternatives such as free birthing”.
We asked the HSE if an increasing number of free births was a concern. A spokesperson said that “the NWIHP is not aware of any formal reporting or data which evidences an increasing number of free births”.
“However, free births are acknowledged as an area of concern in general, given that ordinarily these births are unassisted and unattended by healthcare professionals,” they added.
Doulas, trained birth companions who offer non-clinical support, have noted a marked increase in this practice over the past year.
Anita Petry, chairperson of the Doula Association of Ireland, said that though they knew of this happening abroad, their association never had any interactions in relation to it.
“And last year it started,” said Petry. “I got a letter from one hospital, then I got a letter from another. Then a letter from a midwife.”
The Doula Association of Ireland always “discouraged doulas from attending free births as we felt the line between our scope of practice was quite thin and very easy to cross over”. This is because doulas are not midwives and do not offer medical advice or support.
However, Petry said that “in recent times, we have changed” as “it is also fundamental to the work of the doula to support women’s choice”.
“As long as the doula knows that their clients are well informed and understand the risks and benefits of the choice they are making, that doula will support them.” She clarified this by saying that she would not attend a free birth if she believed people were doing something harmful.
This week, she said, there is a doula, a member of the association, whose client was “dropped by her midwife and has extreme anxiety” about hospital care. The doula never had any intention of attending a free birth but now her client might refuse to go to hospital.
“We know that there’s emotional or psychological injuries and there’s a lot of women who really don’t want to go into hospital,” said Petry, also referring to the trauma that a lot of people in this position have experienced during a previous birth or births.
If they’re not given the option to stay at home, they might just do it themselves.
The observations of Petry and Dixon are backed by international research findings. Prior experience of trauma in maternity care as well as poor provision of maternity options were common themes across studies of free births.
Research from 2020 in Australia recommended “systematic improvements” to prioritise humanising maternity care as well as “the expansion of birth options” with midwifery-led care available for women of all risk profiles.
“It’s really difficult” to know how many women do this, said Dixon, as some stay in touch with maternity care teams but others don’t engage in any antenatal or other maternity care.
For those in the system, “once the baby is born, they’ll say the labour was quick and come into hospital”.
Because free births are becoming more common in Ireland, Petry is planning to organise a workshop for doulas and midwives. She hopes that this will increase the understanding of healthcare workers and also address some of the associated stigma.
When the association or doulas are contacted about free births by hospital staff, “there’s a lot that think that the doula is somehow acting like a midwife which she absolutely couldn’t do”.
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Read more articles in this series >>
Why does the Irish health service offer so little choice for expectant mothers?
By Maria Delaney of Noteworthy
Noteworthy is the crowdfunded investigative journalism platform from The Journal. This investigation was proposed and funded by our readers alongside direct support from our investigative fund.
What’s next? We also want to uncover how a broken system is detrimentally impacting women’s health. Help fund this work >>
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Time for another round on the E.U.
gravey train.
@Adrian: the world democracy is derived from a combination of the 2 Greek words for ‘power’ and ‘people’. To quote Abraham Lincoln ‘government of the people, for the people, by the people’. Western style democracy is more a system of control than self determination. It’s not for the people. In the case of the war in Ukraine it’s largely for the benefit of Washington, at the expense of the people. The power elite in every European country does the same. They follow orders, irrespective of what’s best for the country. They (the elite politicians) identify more with each other than they do with the citizens they are supposed to represent. That’s where we are now with the EU now I’m afraid.
@Ordinary Bloke: stunning, in-depth and nuanced analysis, complete with etymology lesson. Still, I’d say you’re probably better off sticking with the hurling.
@Ordinary Bloke: and there it is in a nut shell
Daly and Wallace could be making their exit from the train.
@Willie Marty: I hope they are both re-elected. Previously, neither of them would’ve been my (political) cup of tea. Claire, is a socialist. Mick, I’m not sure what ideology he has. It’s been a real eye opener for me in the last 18 months the huge importance of having MEP’s at times like this. I may not agree with their other positions but it’s critical that we have maverick politicians who aren’t afraid to call out the hypocrisy of the West in this Ukraine conflict. I’m immensely proud of Claire and Mick. They’ve won international praise for their anti-war stance and for (almost alone in Brussels) having the balls and gumption to call it for what it is. Claire is actually in my constituency. She’ll be my # 1 vote – something I wouldn’t have considered 5 years ago. Well done to both.
@Willie Marty: That would be progress and maybe bring Ming too!!
@Ordinary Bloke: I might add that as a man in his early 60’s, who has seen a lot and been through a lot, you are always learning. I’ll repeat, it has been a huge eye opener for me on the importance of having different and diverse voices (in your political representation) at different times. This never really occurred to me before. Ireland has a rich democratic tradition and I’m hugely proud of both of them.
@Ordinary Bloke: Amazing analysis!!
@Ordinary Bloke: Hopefully Moscow Mick and Kremlin Clare will be history after the next election. They are a disgrace and the sooner they are consigned to the dustbin of history the better. An example of how kremlin Clare thinks, she was recently on the Katie Hannon RTE program. She stated that all wars end with peace talks, rubbish the biggest and most destructive war of all time WW2 ended when the Nazis and Japanese were totally bombed out and smashed. Unconditional surrender. I would be amazed and saddened if any of them are re elected.
@Chris Gaffney: Ming is great craic, he shows up the dangle berries in FFG for what they are and upesets their little triggered support. Its a win win
@Ordinary Bloke: we’ll with any luck you’ll be on your own. They are both nothing short of a thundering disgrace to our country. They’ve changed sides so many time s it’s impossible to keep up. They always want something to protest and generally making a show of the Irish in the process. Nobody wants war but Moscow Mick is all for Ukraine rolling over and crawling to the negotiating table like cowards. All so the gravy train doesn’t get derailed. As for daly, for gods sake can someone sent her some samples of hair products. She always looks like she’s just woken up in a shrubbery after a hard night on the town and climbed in the bash room window. There is one person each of them is thinking about over there, themselves!
What’s worse than having 1 corrupt government? Having two, of course. Down with the EU.
@Brian: lol
elections? but I thought the EU was a dictatorship?
@087mail: Who is the dictator then?
I think p45s for Wallace and Daly would be a great result. SFs Chris MacManus will hopefully lose his seat too.
Europe for the people, that was called out as not true when the Euro currency was put ahead of the Irish people, because we bailed out the Euro and will be paying for this forever example the temporary USC tax.
Europe for the people not true considering gas is charges are linked to electricity charges where no gas is used. Europe has destroyed Ireland in its over reaching dictators who now want more votes. Get stuffed Italy might just follow the Britex module.
For those of you who still think the EU is run by unelected bureaucrats (as all brexiteers thought), here’s one of the two reasons why you are consistently wrong. And it’s possible you may have already voted for your own MEP in the past!!!
@Paul Furey: to be fair, it does appear and feel like it’s very remote and abstract. I get why people are cynical about it, it’s a big machine that takes a long time to turn. In my opinion it over reaches and doesn’t balance the cultures it represents.
@Sean McCarthy: there are 27 countries that need to agree on all legislation. The alternative isn’t the greatest.
Well, no one is voting for them would be a pretty good reason!!
Ireland needs to have MEP and TDs that are more representative of the diverse population.
Why no representation for Islam? According to census the Muslim population has quadrupled since 2016.
Where is the reprentation?
@Barry Donnelly: 1.3% of the population.
With 27 different countries u also have 27 different cultures, each country is a sovereign state they have their own Gov and whatever the EU proposes shud only be passed by the people of each country, it shudnt be the case that if they don’t concur with the national vote they order another until they succeed that is not democracy its dictatorship, they reduce State Gov to caretaker status and punish them if they don’t toe the line, European cities are turning into war zones, the migrant crisis!! No control, Nations being forced to take undocumented young men, some of their green initiatives are barmy, they sent Brian Lenihan to an early grave along with many others, the Germans had to approve our budgets, the bond holders had to be paid back and they approved Austerity to do it, not good
The level of blind ignorance
So our constituencies are Dublin, Munster and whatever is left over.
have your say