Sir, - It is regrettable but not surprising that it has taken High Court action by An Bord Altranais against a domiciliary midwife to put a spotlight on home births in Ireland (The Irish Times, September 13th).
The 1970 Health Act legally obliges the health boards to provide free midwifery services to all women, even when women choose to give birth at home. Twenty-seven years later one can only wonder why it is so difficult to obtain a home birth.
In December 1996, the Ombudsman advised me that the Department of Health was aware that there was a practical difficulty in providing a home midwifery service due to the decline in the number of midwives with the relevant skill and experience who were prepared to undertake a home confinement. Also, that the Department of Health was aware there was a statutory obligation on health boards to provide such a service. The Department has advised that the issue will be positively addressed by the Minister for Health in the forthcoming policy document "Women's Health Plan". Finally, the Ombudsman stated that as an interim measure each health board has agreed to provide two-thirds of the cost of a home birth, up to a maximum of £400, to applicants who contract private midwives, where no Health Board midwife is available. Why are women paying for this service? Why do some health boards fail to provide any domiciliary service at all?
These issues and many others surrounding home birth must be dealt with properly now to ensure an effective, safe service for women and midwives. - Yours, etc.,
From Sally Millar (midwife)
Peterswell, Co Galway.