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Home Birth After Caesarean (HBAC) – Update

The window for Home Birth after Caesarean in Ireland has closed again for now. For a few weeks, UK Birth Centres/Neighbourhood Midwives had clinical indemnity to offer this option to women in a few locations in the country. However, the clinical indemnity enabling them to do so has been withdrawn preventing them from offering this option in the UK, NI and the Republic.

Two women were able to have a home birth after a caesarean with this model of care during the last month.Women with previous caesarean currently on the company’s books and availing of continuity of care throughout their pregnancy will be assessed on an individual basis to continue care. Women who were planning only 5- 6 weeks care with the company at the end of their pregnancy and are not yet receiving care will not be able to continue with their planed model of care, but will have to attend hospital services.

The company’s indemnity for other home birth clients remains in place and they state that they plan to continue to offer care to women who fall outside the HSE s rigid MOU criteria.

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Home Birth Services in Ireland

Home birth in Ireland is offered by :

(1) The HSE under the National Home birth Scheme,

(2) The HSE in selected hospitals 

(3) A private midwifery company.

Women seeking care from the HSE need to source a midwife, or a hospital based home birth scheme and then be assessed for eligibility. Only women with low risk pregnancies are considered suitable for home birth by the HSE in Ireland. Once accepted on the National Home Birth Scheme or on a hospital scheme women are visited at home during their pregnancy or they visit a midwives clinic.

Women seeking private midwifery care, will need to contact the private midwifery company  and be assessed for eligibility. Eligibility criteria are less strict than those set out by the HSE, and allow for more individualised assessment. Once accepted, women will need to arrange a payment plan and negotiate a date when private care with the company  will start. Until that time women will need to receive care from other sources; either public (GP or hospital), semi-private( hospital care) or private (hospital care).

In all cases women must also book in with a maternity unit or a maternity hospital so that their midwife can refer them in for more specialised care should the need arise. This will also be the unit that will take over the woman’s care should she or her baby require it. HSE patients are automatically treated as public patients in hospital care and codes of governance exist between the hospital and HSE home birth providers. Private midwifery patients can also choose to book in as public patients in the hospital.

The National Home Birth Service is a public service and consists of 10 visits with a midwife (taken during the antenatal and postnatal period) and the birth itself. The duration of care lasts from booking to 2 weeks postpartum. Extra visits during the pregnancy are taken with the GP  and are free of charge as they are covered under the Maternity and Infant Scheme. However, women may chose to avail of more visits with their midwife antenatally or in the postpartum via a private arrangement with their midwife. Many women, for example, wish to extend their care until 6 weeks postpartum when breastfeeding is more established. The service includes an anomaly scan taken at about 20 weeks and many midwives ask their clients to take a dating scan at about 12 weeks

When labour starts a woman will be attended by her midwife and by a second midwife if one is available. Most midwives offer the option of a waterbirth.  If you need to transfer to hospital care during labour your midwife may be able to continue care for you in a hospital setting, but equally may not be; it will depend on what local governance arrangements have been put in place.

After the baby is born the midwife will come and visit you for a period of two weeks. During this time you will also be required to have your baby checked by a GP or a paediatrician and you will also be offered the opportunity to have your baby’s hearing screened at a local hospital.

More information including a full list of practising midwives can be found on the HSE s home birth page  or here

Hospital home birth schemes are public services and are available via The National Maternity Hospital, Dublin, Waterford General Hospital and Wexford General. The service consists of  routine antenatal visits once a month until week 34, when visits for first time mothers may then be every two weeks (36 and 38 weeks). After 38 weeks women are seen weekly. The duration of care lasts from booking to 2 weeks postpartum. Extra visits during the pregnancy are taken with the GP  and are free of charge as they are covered under the Maternity and Infant Scheme. The service also includes an anomaly scan at 20 weeks and other early scans such as dating scans and nuchal scans if required.

When labour starts you will be attended in your home by two midwives. If you require transfer to hospital your midwives will continue to attend you and transfer with you. Hospital schemes do not tend to offer waterbirths, but do offer the option of labouring in water. After your baby is born, you will be attended at home for about 10 days, and you will have access to free hospital postnatal services such as lactation consultants, physiotherapy and baby massage classes.

Dublin (National Maternity Hospital, Holles Street) Domino Scheme, Phone 01 6373100

Waterford Domino/Home Birth Service Phone Janet Murphy 087 9243538

Wexford Maternity Unit Phone Sue Ryan 053 9153000

Private midwifery Services, Private Midwives Ireland  offers home birth to women in some areas of the Republic, notably Dublin, the North East and the Midlands at present. Their fees vary depending on when you start care and how many antenatal  and postnatal visits you decide to take on. They charge approximately €6,000 for a full midwifery service from early booking to 6 weeks postpartum. However, starting care at 20 weeks can reduce the fee to around  €5,000 and starting care at 35 weeks can cost as little as €3,500. This is a fully privatised service and women receive all their antenatal care at home or with their GP. Women can book in for an anomaly scan at about 20 weeks with their local unit, or arrange one privately.

Women can opt for this service having taken care in a hospital setting previously (usually publicly).

When labour starts you ill be attended at home by a midwife and a second midwife. Most midwives offer the option of waterbirth. If you need to transfer your care to hospital care during labour your midwife will not be able to continue care for you in a hospital setting but may by prior arrangement attend as your doula.

More information on Private Midwives Ireland can be found here 

Other home birth services may be offered locally. For more information contact the following.

Carlow/Kilkenny/South Tipperary  Phone Eithne Coen 056 7785619

Downpatrick Area Phone Assumpta Morgan / Alison McDaid 02844 616995