'It was the most natural, joyous journey a human could have' - birthing at home in Ireland
For low-risk, healthy pregnancies, a home birth is a safe option, according to the Health Service Executive. But it is relatively uncommon in Ireland.
Between the years of 2013 and 2016, between 190 to 260 women per year registered onto the HSE national home birth service.
By contrast, in the Netherlands, which has the highest percentage of home births in the western world, around 17pc of births take place at home.
For some women, home is where they feel safest for the birth of their baby. Both the midwife-led care and the post-natal care, in the form of home visits for up to seven days after the birth, are attractive options, as well as the avoidance of a hospital.
Two midwives tend to mother and baby during labour and the birth at home, while one midwife stays behind afterwards until it’s clear that mum and baby are doing well at home, that baby is feeding well, and that mum has showered and eaten. The midwife carries out physiological checks on both mum and baby to ensure that they’re both doing well.
In the National Maternity Hospital in Holles Street, there are 40 home births a year.
While many more women register for a home birth every year at the hospital, the main reasons why these births don’t take place at home in the end is because the waters might break but no labour happens, or the woman is 14 days overdue and labour needs to be induced.
Teresa McCreery, the hospital’s community midwifery manager explains: “The benefits are that you have continuity of care, and you know the philosophy of the midwifery care around the time of the birth. Evidence demonstrates that you are more likely to have less interventions and that the birth experience is better.”
“There’s a lot of fear around birth, I think women psychologically must be of the mindset that this is right for them. For some reason it’s not right for other women and that’s OK too. Historically birth can be portrayed in the media as something that’s very frightening, and a woman might think [a home birth] isn’t something for me.”
“A lot of people perceive it as messy – and they often ask ‘what about all the blood?’ In reality it’s very well-contained.”
A midwife also visits mum and baby for up to 7-10 days after the birth, and there are no hospital queues to contend with for check-up appointments.
“Midwives have extended their role and can do the examination of the newborn in the postnatal period, so women no longer need to go the hospital or the GP to have that done,” Ms McCreery explains.
“Assuming all is well, the only time that the woman needs to go to hospital is at around 22 weeks of pregnancy (for a scan). The rest of the appointments are all in clinics.”
Cookbook author Susan Jane White gave birth to her two boys Benjamin and Marty at home, and she knew instantly that a home birth was the right option for her.
“I absolutely knew I was not the type to relax in a hospital setting. My late father spent much time in hospital, and I too spent miserable bouts in my mid-twenties so my association with hospital settings was at best fearful, and at worst, calamitous.”
“I wanted to give birth at home, or at least somewhere calm without the visual reminder of medicalising the birthing process.”
“Most people are supportive of this view, even if they don’t hold such opinions themselves. I was 100pc certain I wanted a home birth. In contrast, I have good friends who want to be surrounded by doctors and nurses, in a clinical setting, with lots of pain killers. It’s important to know what you want and need – meeting these expectations is a very personal decision and will help to ensure that both mum and baby thrive during and after labour.”
Homebirths in Ireland are currently available under three pathways: the HSE national home birth service; private midwifery agencies; and at three maternity hospitals – the National Maternity Hospital in Dublin, Wexford General Hospital and University Hospital Waterford.
Bernadette Parte had her three babies at home in south Dublin, as a patient of the NMH Holles Street. Nora was born in July 2003, Michael in December 2004 and Sarah in June 2007.
She explains: "I had always been nervous about going into hospitals, not for any particularly good reason, but when I heard that it was possible to have a home birth, I was very open to the idea. Provided that I was a good candidate for home birth, verified by the community midwifes in Holles Street, I felt that it would be my first choice and my husband, Paddy, supported me in this.”
“I had complete faith in all the community midwives that I met – Niamh, Clodagh, Theresa, Margaret, Caroline, Roisin, Kate and Sinead. I was very clear from the outset that if they asked me to go into the hospital, I would do so.”
“During the course of the pregnancies, we got to know them well and, while they all had different personalities, they were equally knowledgeable and inspired confidence. I was able to have my ante-natal checks at home and by the time I was expecting number three, Nora and Michael could hear the baby’s heartbeat in our kitchen. We enjoyed many a good laugh and I couldn’t thank them enough for the hard work and long hours they put in, both in the hospital and in homes.”
The HSE says the National Women and Infants Health Programme (NWIHP), in partnership with maternity services, will be working towards an expansion of direct provision of homebirth services by public maternity services.
A HSE spokesperson said: “The National Maternity Strategy recommends the availability of homebirths as very much a core component of the supported care pathway for women as part of the strategy’s model of care."
Bernadette and Susan Jane both say that exercise and reading were key for them as preparation for their births at home.
“I love reading and I had a library of books on everything baby-related,” says Bernadette. “The whole subject fascinates me, from the moment of conception up to birth and beyond, and I read extensively about the life of the baby in the womb, if they dream (they do!), what affects them, the best conditions for labour etc. I hoped that the more I knew about the process, the better prepared I would be for the birth. Of course, there is nothing quite like experience – and nothing can truly prepare you for the magic of childbirth.”
“When expecting our first baby, Nora, I attended pilates classes aimed at pregnant mums, which I found very relaxing and I used my physio ball during labour to great effect.”
"If someone is considering a home birth, is having a straightforward pregnancy and, in my opinion, is under the care of a team of midwives attached to a maternity hospital, home birth can be a wonderful experience. A supportive partner is also essential. However, I would advise any expectant mother not to become too fixated on a specific birth plan because giving birth involves letting go of control and allowing your body to deliver the baby. If this requires medical intervention, so be it, as ultimately what every mother wants is to have a good experience and a healthy baby in her arms at the end of it, whether or not that is at home or in a hospital. I am just glad that for us home birth was an option.”
Susan Jane "adored" every moment of her births, feeling very supported by her midwife at home, she explains.
“I had a strong desire to experience a drug-free, naturally-paced ‘canal’ birth without being induced or manipulated onto what I saw as a birthing conveyor belt.”
“If, at 39 weeks, or indeed during labour, my midwife wanted to transfer me to a hospital setting, I would have submitted to the sudden change of experience and embraced it fully. That’s a different situation. Why? Because that would have been a medical decision based on concern for my pregnancy. I feel it’s important to communicate that safety was at the forefront of my mind at all times – both for my body, and for my baby. I was a “low risk” pregnancy. Natural, drug-free home-birthing was the safest option for me. I adored every moment of birthing. It was surreal. My midwife, the late, very brilliant Philomena Canning, was by my side for every breath. Both my boys were calmly pushed into the world, in the centre of our family home, at my own rhythm, without a tear or a bruise for mum and baby."
"It was the most natural, primal, joyous journey a human could have.”