If you have a low risk pregnancy, you may choose to have a home birth. The Health Service Executive (HSE) has a National Home Birth Service for eligible expectant mothers who wish to have a home birth under the care of a Self-Employed Community Midwife (SECM).
In some HSE areas the service may be available through a maternity hospital or a HSE scheme. However in other HSE areas, only private SECMs are available to attend a home birth – see ‘How to apply’ below.
COVID-19 and home birth
The information available about COVID-19 to date suggests that pregnant women are not a high-risk group. (RCOG, March 2020)
If you are pregnant and think you may have been exposed to COVID-19, contact your GP for advice regarding assessment and possible testing. Most women who test positive and have mild symptoms can safely self-isolate at home. Guidelines state that routine antenatal or ultrasound appointments should be deferred until after the period of self-isolation (14 days).
Pregnant woman who have COVID-19 should only attend the hospital if in need of urgent medical or obstetric care. Do not travel on public transport. It is important to phone the hospital in advance of coming to make sure you are seen at the right place by the right medical team.
If you are booked to have a home birth and you are worried about COVID-19, contact your self-employed community midwife or the maternity hospital where you are booked for antenatal care.
Check with your local hospital as many have suspended antenatal classes until further notice due to the coronavirus outbreak.
For more information on COVID-19 and pregnancy, the National Maternity Hospital has published Coronavirus and Maternity Advice (pdf). The Royal College of Obstetricians and Gynaecologists has also produced information on COVID-19 and pregnancy for women.
If you want to avail of the National Home Birth Service, you need to contact your Local Health Office. You will be put through to the designated official who is a qualified midwife. You will be sent an information pack.
You then contact a Self-Employed Community Midwife (SECM). An SECM has an agreement with the HSE to deliver the home birth service according to certain terms and conditions. You and the midwife should fill out an application form for the service. Your midwife will send the form to the HSE Designated Midwifery Officer (DMO) who will assess your eligibility for the service.
If your application is accepted, this entitles you to free care during your pregnancy, during labour and birth, and for up to 14 days after your baby is born. The HSE will provide you with a Home Birth Pack with all the information you will need for a home delivery. You can find more detailed information about the process in Appendix 4 Pathway of Care on hse.ie.
Your eligibility for a home birth is continually assessed right up until your baby is born. If, at any stage, you are assessed as not eligible to have your baby at home, your midwife and the DMO can help you to find a suitable maternity unit or hospital.
Alternatively, you can engage a SECM privately and your antenatal, delivery and postnatal care will be provided by them. If you enter into a private arrangement with a private midwife or an SECM for a home birth that has not been approved by the HSE Designated Midwifery Officer, it is the responsibility of your midwife to have appropriate insurance cover and you should be sure that such cover is in place.
If you are using maternity services provided by a hospital or HSE scheme, they are provided free of charge.
Many private health insurers provide a grant towards the cost of a home birth.
How to apply
If you wish to have a home birth, you need to decide this as early as possible in your pregnancy.