Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Deputy Cairns for raising this important issue and I acknowledge her ongoing work in the area of women's health. As the Deputy is aware, the HSE's national home birth service moved from community operations to acute operations within the HSE earlier this year. The home birth service is now being integrated into the maternity networks in line with the national maternity strategy. The core aim of that strategy is to provide safe, high quality maternity care to the women of this country. As part of this transition, the HSE's national women and infant health programme, NWIHP, was asked to provide more specific guidance at national level regarding the appropriate distance a woman should live from a maternity hospital while accessing home birth services and to make a recommendation on this issue.

Using both obstetric and midwifery expertise, the NWIHP issued national guidance on home births on 14 July recommending, from a clinical perspective, that it would be safest that all women accessing the HSE's home birth services would reside 30 minutes or less blue-light distance from their nearest maternity service.

When making this recommendation, the NWIHP took into account a range of factors, including the historic transfer rate into maternity units of mothers who laboured at home in the national home birth service, the primary reasons why women were transferred, the method of transfer, the need to factor in ambulance response times, the time needed to transfer the woman into the ambulance and the time until assessed upon arrival at the hospital.

The HSE's recommendation addresses the balance of risk that needs to be considered for home birth services. For example, if a woman has an emergency in a maternity hospital, and if a category 1 caesarean section is required, the woman must get to theatre within 30 minutes. In the event of a serious risk to a mother or baby in the HSE's home birth service being identified by the self-employed community midwife, this recommendation is designed both to ensure the best possible chance of getting to a maternity hospital in a timely manner to ensure the best outcome for mother and baby and to ensure that the clinical determination of the self-employed community midwife is acted upon in a safe and timely manner.

While I understand that the HSE's recommendation has caused concern for some, it is important to note that a geospatial analysis carried out by the HSE indicates that coverage will remain for 83% of the female population of childbearing age. While the home birth service represents only 0.7% of overall births, the HSE and NWIHP recognise that it is an extremely important pathway for women.

I would like to note that while choice for women is an integral part of our maternity services and of the national maternity strategy, the need to ensure safety must always be paramount. The objective of this measure is to enable the continuity of the home birth services whilst ensuring the best outcomes for mothers and babies in line with the objectives of the national maternity strategy.

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