For centuries Irish women gave birth in the comfort of their home. In recent decades though, the maternity hospital has become the norm. But the homebirth tradition is now on the way back.
Jan Vanleevan (31) is expecting her first child in June. Originally from Holland but now living in Dublin’s Liberties, Jan is availing of Holles Street’s Domino homebirth scheme.
Staffed by a team of eight midwives, Domino provides care for women in their home from the early stages of pregnancy up to a week after birth. It is becoming increasingly popular.
Jan says she wanted to have her baby naturally. “I just wanted a non-medicalised birth without any drugs or epidural or that kind of thing. I don’t need any medical intervention,” she says. “I’m not sick, I’m pregnant.”
Hailing from Holland, where homebirths are far more common, also played a part. “In Holland it’s normal to have a birth at home. I presumed it was going to be the same here. But I found out it wasn’t going to be that easy,” she says.
Jan says her GP was “hesitant but supportive” when she told her she wanted to give birth at home. Not everyone was quite so understanding.
An obstetrician in the Coombe where she first attended said “the idea was mad and that he wouldn’t let his wife give birth at home. They basically said I was being an irresponsible mother.”
Determined to get a second opinion, she browsed the internet one evening and stumbled upon the Home Birth Association of Ireland (HBA). They put Jan in touch with the Domino scheme. “They were very helpful,” she says.
Rather than disparage maternity hospital birth, the association promotes choice. “It’s up to the woman to decide. What we want is choice,” says HBA chairperson Krysia Lynch.
She says numbers giving birth in the home are on the rise. “It has increased 60 per cent in the last 10 years.”
Lynch says the Domino programme is a step in the right direction, but points out that it’s only available to women who fall into the scheme’s south Dublin city catchment area. “What if you happen to live in the northside of the city?” she asks.
The Rotunda maternity hospital serves Dublin’s northside and provides no homebirth facility available here for expectant mothers. “I am definitely supportive of it. But we just don’t have the staff or resources for it,” says Rotunda Master Dr Michael Geary.
He explains that the Holles Street Domino scheme is a pilot project, and it has clear operational guidelines. “What we need is clear guidelines for midwives … and that’s one of the benefits of Holles Street.”
A report based on the Holles Street project is currently being assessed by the Department of Health and Children. A positive reception may result in homebirths being offered by maternity hospitals nationwide.
However, pending the outcome of the report, expectant mothers opting for a homebirth outside Holles Street’s catchment area will find an independent midwife is the only solution.
Midwife fees average €3,000, and this is well out of reach for many mothers. “Most health boards will refund 90 per cent of that,” advises Lynch.
If maternity hospitals provide their services free of charge why do mothers bother with the hassle and cost of a homebirth?
“In the hospitals there’s a policy that with each bed, there must be a rate of three births over 24 hours. It’s a conveyor belt system, get them in and get them out,” says independent midwife Philomena Canning. Choosing a homebirth allows mothers to take their time rather than be rushed into an inducement or caesarean.
While she promotes homebirths, she explains that homebirth is only suitable for ‘low-risk’ healthy mothers who are not in need of the services of a hospital should anything go wrong.
“Obstetricians agree that 90 per cent of childbirths are by healthy mothers. They’ll do better at home than in hospital. Women are more in control in their own environment. It takes the fear element out of it,” she says.
“I just want to give birth in the privacy of my own home, not in a hospital,” agrees Jan.
Demand for homebirths is on the rise as more and more mothers seek an alternative to the assembly line nature of maternity hospitals. Bringing a life into the world is one of the most spiritual and life-changing events a woman can have. To do so in their own home rather than a sterile hospital should be a right.
At present, only expectant mothers within Holles Street’s narrow catchment area and those with ready access to €3,000 to cover the upfront cost of an independent midwife can avail of a homebirth. A thumbs-up by the Department of Health on the Holles Street Domino scheme in the coming weeks may result in that choice being afforded to all mothers.
Judi Wyley, a 35-year-old from south Dublin, opted for a homebirth after her first child was born in a maternity hospital.
She recalls that the obstetrician was unhappy with the natural progression of the labour and performed a caesarean. “I felt robbed and degraded. And very sad I wasn’t able to give birth naturally.”
Pregnant with her second child Amy, Judi says she had no intention of returning to a hospital. “I didn’t want to go back. No way.”
She says a friend suggested a homebirth and she contacted an independent midwife who assisted in the birth.
There was a big difference with her experience in the maternity hospital, she says. “The contrast was poles apart. The drugs they gave me in the hospital made the pain terrible.
“But it’s so manageable when you go through it naturally. You just go with the contractions.”
So pleased was Judi she had her third child Tom through homebirth. But it was a little different this time. She gave birth in a waterpool with her two children and husband helping out.
“Jack helped Alan [her husband] fill the pool with water.” Her daughter, Amy, provided support. “She’d say ‘you’re doing great mum’ every time I had a contraction.”
With three children Judi has her hands full, but says if she has another child it will be a homebirth. “Without a doubt.”