Childbirth groups and midwives' organisations have warned the Nurses and Midwives Bill before the Dáil tomorrow will lead to a court challenge unless amended.
The Bill contains controversial provisions for home births in the State, including one that would make it compulsory for an expectant mother who wishes to have a home birth to go to hospital if her labour lasts longer than 24 hours. The midwife attending could face a fine or a prison sentence if they do not comply.
Moreover, self-employed community midwives would be indemnified by the State Claims Agency to attend at home births only if they sign a memorandum of understanding with the HSE.
Advocates of home births say provisions in the Bill 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.
"This Bill will be challenged in the High Court as soon as the ink is dry on the President’s signature," said Marie O'Connor of the National Birth Alliance.
She said the Minister for Health, Mary Harney, had "been put on notice" the legislation was facing a legal challenge on a number of possible grounds.
She said a challenge was likely to come from a woman using the midwifery service but added that midwives are considering a case due to the threat to their economic rights as independent professionals with the right to act autonomously.
Ms O'Connor said midwifes would only be indemnified when "when participating in very narrow HSE home-birth scheme," which, she said, "completely cuts the options for women". She said the Bill would contravenes a 2005 EC directive that guarantees the right to pursue a profession, such as midwifery, in a self-employed capacity.
Ms O'Connor accused the HSE of "micro-managing midwifery", adding: "The whole Bill is virtually inoperable. It seems to legislate for every twist turn of labour, restricting midwifery autonomy to make clinical decisions on site - and potentially threatening public safety."
The Home Birth Association of Ireland, the Community Midwives Association (CMA) and Association for Improvements in Maternity Services Ireland (AIMSI) are among the groups lobbying for changes to the Bill. They are calling for mandatory insurance to be dropped and argue criminalising uninsured practice when midwives have no access to indemnity as of right is "manifestly unjust".
Bridget Sheeran of the Community Midwives’ Association (CMA) said: ‘Section 40 effectively criminalises clinical decision-making, makes private practice unlawful and will leave vulnerable women and their babies without care. This Bill is a threat to public safety, as well as a denial of human rights. It also denies midwives their rights as service providers".
Krysia Lynch of AIMSI said giving midwives access to indemnity on the same terms as consultant obstetricians would promote the development of community midwifery services .
Liam Doran, general secretary of the Irish Nurses and Midwives Organisation, said his organisation had submitted amendments aimed at securing a service that satisfied mothers and midwifes, with best standards being of paramount importance.
He noted, however, there was "very significant unrest among midwives' groups.
However, the Ms Harney has said the memorandum of understanding between self-employed community midwives and the HSE aimed to ensure midwives operated to the safest possible standards.
A spokesman for the Minister said when the Bill became law, that memorandum 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.
