A PREGNANT WOMAN will find out in a fortnight if she is allowed to have a home birth, following a hearing at the High Court today.
Aja Teehan, who is 29 weeks pregnant and lives in Co Kilkenny, applied to the Health Service Executive (HSE) to have a home birth for her second child.
Teehan had a caesarean section on her previous pregnancy and said she was told this makes her ineligible for a home birth with a self-employed community midwife working for the HSE.
The issue centres on her suitability for a home birth under HSE guidelines, and the indemnity cover for self-employed community midwives.
The judge in the case is due to give a verdict on 13 August, two months before Teehan is scheduled to give birth.
Ireland has a National Domiciliary Midwifery service, which offers home birth service under the care of a self-employed community midwife (SECM). This service is provided by the SECM on behalf of the HSE.
Only women who are eligible can avail of the home birth, and a number of tables set out the conditions for eligibility.
Table two names Caesarean section under ‘previous pregnancy complications’. Philomena Canning, a SECM with the HSE, said that midwives are informed that women who come under tables one or two are ineligible for a home birth.
“The scheme is a full HSE scheme and the midwife is merely engaged by the HSE to provide the clinical service on the terms laid down by the HSE.”
Teehan said a letter received from the HSE’s National Lead Midwife stated: “You have a right to have the baby wherever you wish but the HSE however would not be in a position to provide the service in this instance or provide indemnity cover for the midwife”.
Midwife Philomena Canning said that there is no access to insurance on the open market for any providers involved in maternity care, and that Section 40 of the Nurses and Midwives Act 2011, when enacted, would mean that a SECM attending a home birth without clinical indemnity insurance from the HSE would be doing so illegally and could be prosecuted.
The Department of Health said that there are plans to enact Section 40 of the Nurses and Midwives Act 2011, but no specific date has been set yet.
RTÉ reports that counsel for the HSE, Paul Anthony McDermott said that the HSE is entitled to its policy on which the decision about Teehan was made.
Outside the court this morning was a group of mothers and their children, brandishing signs saying they supported Teehan in her claim.
Some of the women outside the court this afternoon. Pic: Aoife Barry
Jean Kelly from AIMS Ireland, who was one of the people outside the court, told TheJournal.ie about the case:
“From an AIMS perspective it is about self determination, deciding the circumstances of becoming a parent, how and where you give birth, with a doctor or midwife, whether in hospital, stay at home, have an epidural or not, it’s completely your choice. We feel the HSE can guide you and give recommendations, but it is up to each person to make the ultimate decision.
Teehan believes that the statistically high levels of safety associated with VBAC (vaginal birth after caesarean) mitigate against the risk of uterine rupture, and that the home setting offers advantages in minimising any risk even further.
She told TheJournal.ie:
It is not that I am determined to have a home birth regardless of consequences – if I thought there was anything going wrong with my labour I would be the first one calling the ambulance. I just want the option of a trial of labour in my home.
The HSE said it would be inappropriate to comment on the case as it is before the court.
First published 4.35pm