Further details surrounding the HSE home birth service are available on: https://www.hse.ie/eng/services/list/3/maternity/homebirth-services.html.
Contact a SECM in your area, details available on this website, to discuss your choices and gain what information you may need to support your decision about your preferred care and place of birth. Make contact with the Designated Midwifery Officer (DMO) who has governance over your geographical area. They will provide you with the necessary paperwork and supporting information for discussion when meeting with your midwife.
DMOs are the HSE support for the homebirth service. Their role is to guide you through the service, support the SECMs, provide governance of the service for the HSE and be the link between all the stakeholders.
Jo Delaney & Denise Malone
West Carlow/Kilkenny/South Tipperary
(Acting DMO) Dublin/Mid Leinster
Dunshaughlin, Co. Meath
Dublin North City, North Leinster
01 846 7159
087 945 7094
Carmel Cronolly McFadden
SECMs provide care from early pregnancy to two weeks after birth to you and your baby, available on call by phone 24 hours a day, seven days a week. They will inform you in advance of periods of leave etc. Visits may be in your home or a clinic provided by the midwife, this is individual to each SECM. Before, during and after birth, your midwife will liaise with any health professional if review or referral is required. In some instances, it may become necessary for your midwife to transfer your care to your obstetric team if there are concerns around the health of you or your baby. This should be in collaboration with yourself, respecting your input. Your midwife can be available to you to support you through this process if supported to by their DMO.
Your midwife will spend time learning about you, your family, your hopes for the pregnancy and your medical history. Your primary midwife is mainly responsible for providing care for you during and after labour. A second midwife will all be in attendance for the birth, mainly responsible for your baby after the birth but also to support you and your SECM. If your midwife has a student under her supervision, your midwife will ask for your permission to have the student present for your visits and your birth.
Your midwife will provide all your necessary care and support in the postnatal period. S/he will also organise the necessary notifications to your G.P., hospital, PHN, birth registrar etc. Your midwife will provide care for you and your baby until two weeks after you give birth where care is handed over to your PHN and G.P.
SECMs are covered for clinical indemnity insurance by the States Claims Agency (SCA/CIS) through their contract with the HSE to provide care to women deemed low risk. Ongoing risk assessment determines access for the mother and SECM to this insurance. Each SECM, also, has public liability insurance through this organisation.
Most SECMs provide an option for water birth service, discuss it with your individual midwife. There are circulating pools within the home birth community for loan or to be purchased in addition to liners etc. Your SECM does not have any responsibility for the provision of birth pools.
You may have whomever you like with you to support you during your labour and birth. Your primary midwife will be with you once you notify him/her with a second midwife also in attendance closer to the birth. You may not have met the second midwife prior to your birth.
Prior to 37 weeks gestation directions to your home will be entered onto the national ambulance database for easy access if needed during your labour and birth. Your midwife will be closely monitoring you throughout your labour and if there are any causes for concern, she may discuss transferring you into hospital for delivery. Your midwife will travel into the hospital with you and support you as needed and appropriate within the hospital setting.
All midwives are experts in supporting birth safely from qualification and registration. The continuity of care provided to you will support your SECM to recognise any deviations from the norm. SECMs are fully trained in dealing with obstetric emergencies that may occur in a home birth situation during labour, birth or the postnatal period. We do regular professional education and updates in maternal and neonatal resuscitation, emergency skills , supporting normal physiological birth and partake in peer review. Our outcomes and reviewed annually with ongoing feedback and learning opportunities. Our regional Designated Midwifery Officer (DMO) within the HSE ensures that we are competent and safe to practice and who also ensures that all our equipment is checked on a yearly basis.
Once you realise you are pregnant you will need to make contact with your G.P. to arrange referral to the hospital of your choice. This ensures that you have access to obstetric and midwifery support, blood tests and ultrasound if and when you may need it. At the same time you may be looking for a midwife with which to discuss homebirth as an option.
This booking appointment with your hospital typically occurs between 11 and 14 weeks. Most hospitals offer a dating scan at this time and a further detailed wellbeing/anomaly ultrasound is offered between 18 to 22 weeks of pregnancy. Bloods are obtained at your first visit to check for your blood group, iron levels and serology. A further blood test is taken to confirm your blood group and check your iron levels at 28 weeks of pregnancy approximately. Outside these appointments your midwife will discuss with you the need to attend for further hospital appointments depending on logistics, your schedule of care and the availability of your G.P.
A significant portion of G.P.’s in Ireland have an insurance policy which prohibits them from providing care to mothers who are choosing to birth at home. This has no implications for your maternity care until you have been confirmed by the Designated Midwifery Officer (DMO) as being accepted on to the HSE homebirth scheme. Typically this does not happen before 24 to 26 weeks of pregnancy. For the purpose of vaccinations, prescriptions and completing maternity leave documentation it is ideal to have this completed before confirmation of your homebirth eligibility is received by your G.P. Prior to this documentation you have the same access to your G.P. as any other pregnant person.
Some G.P.’s value the long relationship they have with you, their role within your family and the fact that they are in no way involved in the birth itself and will continue to offer their support as normal.
For most babies the early newborn check will be required to be done before 72 hours of age within the hospital where you were originally booked by a suitably qualified doctor or midwife with the relevant set of skills. Your midwife will arrange this for you both. The G.P. will resume care for the two and six week appointment once this check has been completed as stated within their insurance policy.