Pathways to home birth services in Ireland

Home birth services in Ireland can be accessed via three pathways; in certain public hospitals provided by the HSE , under the National Home birth Service provided by self employed midwives engaged by the HSE, and with a private midwifery company provided by private midwives working outside the HSE.

Pathway 1 : Public Home birth Service through a maternity hospital

This is a fully public home birth service and is available through a few maternity hospitals / units in Ireland. Women book directly with the hospital and are assessed for eligibility based on personal and gynaecological history.  Individual hospitals will have varying eligibility criteria based on their own policies. Women will be usually seen in midwifery clinics either in the community or at their local hospital or maternity unit. Visits later on in the pregnancy  will usually be carried out at home. Women will usually be attended by a team of midwives and will usually get to know the midwives on the team during their pregnancy. Whoever is the midwife on duty when the woman goes into labour will be her attending midwife. The attending or primary midwife will always have a second midwife with her. An ambulance will be put on call as the woman approaches birth as a precautionary measure.

 In all cases if you need to transfer your care from the community to hospital, your midwives will transfer with you and will attend you in a hospital setting.

Hospital home birth schemes are available via The National Maternity Hospital, Dublin, Waterford General Hospital and Wexford General. Note the NMH scheme does not offer water births, but does offer labouring in water as an option.

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

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

Pathway 2 : The National Home birth Scheme provided by Self Employed Community Midwives

 Women need to source a midwife and then be assessed for eligibility. For a list of practising midwives see here. Only women with low risk pregnancies are considered suitable for home birth in Ireland. For a list of criteria defining eligibility to  home birth see here. Once accepted on the National Home Birth Scheme women are visited at home during their pregnancy or they visit a midwives clinic. There will be an initial booking in visit with your mdwife which for some women (CUMH) will be in a hospital setting, but for others will be in their home.

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. This is usually done at around 12 weeks and women will be offered a dating scan and bloods will be taken to screen for HIV, STDs and blood types amongst other conditions.

The National Home Birth Service is a public service and consists of 10 visits with a midwife (taken during the antenatal and postnatal period) plus an 11th visit for  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.

Most SECMs are happy to facilitate water births, and are also lactation consultants. If you need to transfer to obstetric or hospital care during your pregnancy your midwife will not be your attending midwife but may be able to accompany you in a doula capacity.

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

Pathway 3 : Fully privatised midwifery care

A newly founded private midwifery company, offers home birth to women in some areas of the Republic, notably Dublin and the North East at present. They charge approximately €6,000 for a full midwifery service from booking to 6 weeks postpartum. They also offer a home birth service without full continuity of care which starts at 36 weeks gestation and costs approximately €3,500. A mid way package starting with care at  20 weeks and finishing at 2 weeks postpartum is about €5,000. Package prices vary depending on how many antenatal visits and postnatal visits you chose. Most private health insurance companies will cover around €3,500 towards the cost of a home birth and fancier private health insurance policies will offer about €5,000 towards the cost of a homebirth, so if you have private health insurance, it might be time to put it to good work.

Please note that most health insurers will insure you for a private homebirth OR private hospital services and not for both. So whilst you are in the care of a private midwife you will be a public patient under the auspices of your local maternity hospital.

This service is open to women who have had a previous caesarean section, and to women who may not comply with the HSE’s rigid risk criteria as set out in the Memorandum of Understanding.

 For more information contact Private Midwives IrelandPhone : 1800 937 119 or email: info@privatemidwives.com