Midwives offered home-birth cover on HSE terms

SELF-EMPLOYED community midwives will be indemnified by the State Claims Agency to attend at home births only if they sign a memorandum of understanding with the HSE, an Oireachtas select committee has heard.

Minister for Health Mary Harney told the Select Committee on Health and Children she was a supporter of home births for “low-risk” women.

“Clearly home births have to be in the context of a community midwife signing the memorandum of understanding between the HSE and the midwife,” Ms Harney said.

“If something goes wrong, the Clinical Indemnity Scheme will provide indemnity as long as the midwife has signed the memorandum,” she added.

The committee was discussing amendments to the Nurses and Midwives Bill 2010 which has been controversial among supporters of home births. They say provisions in it will deny some women the right to have a home birth as self-employed community midwives will not be covered to attend at home births in some circumstances, and not at all if they refused to sign the memorandum.

Krysia Lynch, co-chairwoman of Aims Ireland, said the Bill was “taking away a mother’s human and constitutional right to choose where to have her baby, having informed herself of any risks”.

Ms Harney said yesterday the memorandum of understanding between self-employed community midwives and the HSE aimed to ensure midwives operated to the safest possible standards.

Among the issues covered by the memorandum are the qualifications a self-employed community midwife must have, their professional conduct, performance management and risk-management practices.

The reason for the new arrangements are the withdrawal by the former Irish Nurses Organisation of insurance cover from community midwives in 2008 as they were deemed too high a risk. This has been replaced in the interim by the State Claims Agency scheme.

A spokesman for the Minister said when the Bill became law the memorandum of understanding would mean women could continue to have home births by guaranteeing insurance was available to midwives who operated to the highest clinical standards and offered their services to women who were low-risk cases.

“A national steering committee on home births has been established by the HSE,” he said, “to review the implications of the memorandum of understanding between the HSE and self-employed community midwives on the provision of a safe, evidence-based home-birth service for low-risk women.”

Any midwife who attends at a home birth for reward, who does not have adequate clinical indemnity insurance will be guilty of an offence and could be subject to a significant fine, a period of imprisonment or both.