Sir, - Marie O'Connor (Features, April 11th) supports the view that "midwife-led care in planned home birth is as safe, or safer than obstetrically supervised hospital delivery" and quotes research from America in support of this view. At best, research on this subject in Britain, Europe and other developed nations is divided and gives no clear indication, even for women whose pregnancies have been identified as low risk.
In Ireland, the demand for home birth has become an issue in recent years but the community health services to provide for this are not developed. One cannot therefore compare the risk of a home birth in Ireland with the UK or other countries where services are in place to facilitate home births. While Ms O'Connor refers to Irish obstetricians cornering the market to share millions from private practice, she chooses to ignore that we in Ireland in recent years have benefited from the lowest maternal mortality and one of the lowest prenatal mortality rates in the world. Until such time as research shows that home births in an Irish setting can be achieved with equal safety to that existing in Irish hospital obstetric units it seems premature if not dangerous to encourage anything other than birth in hospital.
Providing for the care and safe delivery of mothers and their babies is an enormous responsibility for whoever embarks upon it. One needs only to glance at the statistics of as recent as 25 years ago to appreciate the improvements that have occurred. Most of these have arisen from closely audited and much improved hospital care. If there is a well-founded reason to deviate from this it behoves us as professionals working clinically in this field to ensure that it is primarily safe. - Yours, etc.,
Michael Mylotte, Obstetrician and Gynaecologist, Galway.