The Irish Nurses Organisation (INO) is to withdraw indemnity insurance cover from independent community midwives.
In a letter to all 19 independent midwives operating in the State, the INO said it was "not sustainable" for it as a union to continue providing cover for them and its service will be discontinued from September.
Currently, independent midwives pay for indemnity through their union subscriptions. A request by the INO's underwriter, Lloyds, that the union pay €1,000 towards the insurance of each of the independent community midwives was rejected by the INO executive last month.
Midwives, covered by the INO, have warned that the decision could spell the end of independent home births in Ireland. Independent community midwives are responsible for all but about 40 of the 350 home births which take place on average in Ireland every year.
Two pilot schemes involving community midwifery services attached to Holles Street and Waterford Regional Hospitals are covered by the hospitals' own insurance.
Colm O'Boyle, an independent midwife and lecturer in midwifery at Trinity College Dublin, said the withdrawal of indemnity insurance would make it impossible to carry on their home birth service.
"The INO has told us they can't afford it. Individual insurance is almost impossible to get and the price is likely to be very exorbitant at anything between €10,000 and €50,000 a year. If not, I could lose my home. When the Royal College of Midwives in the UK decided to do something similar, the number of home births dropped dramatically."
Dublin-based independent midwife Philomena Canning said they would be happy to pay the €1,000 themselves, but were being denied that option by the INO.
"It is a package that seems to be reasonable to us. It beggars belief that they would write this letter when we have offered to pay and it doesn't affect the other members. It doesn't make any sense that the underwriters are making this offer and the INO is not delighted to accept it on our behalf.
"Self-employed midwifery is the trend internationally and it won't develop in Ireland if this continues. If it were to go ahead, mothers in Ireland would lose a fundamental choice that women in Europe take for granted.
"It means that women who want a home birth will have to go back into the system again and that creates extra pressure."
INO general secretary Liam Doran said it planned to meet the independent midwives and the Health Service Executive (HSE) in the coming weeks to discuss the issue, but the union was pressing for the HSE to indemnify the midwives in the same way that hospital consultants were indemnified.
"If the HSE is referring women to independent midwives or if the Government says that independent midwifery is a good thing, the Government or the HSE is going to have to create the insurance environment to ensure that will happen," he said.
