Woman seeks orders compelling HSE to grant her a home birth

Aja Teehan wants her second child to be born in her Co Kilkenny home

A mother has asked the High Court for orders compelling the HSE to grant her application for a home birth.

University lecturer Aja Teehan, whose second child is due on October 13th, wants to have the baby born at home in Thomastown, Co Kilkenny, assisted by a midwife.

She alleges the HSE is operating a “blanket policy” of refusing to cover home births for women who previously had Caesarean Section births and that alleged policy means she cannot have her baby at home as a midwife will not get indemnity cover to attend on her. Ms Teehan has a six-year-old daughter born after a Caesarean Section.

Matthias Kelly SC, for Ms Teehan, told Ms Justice Iseult O’Malley his client was not trying to be “some sort of martyr” but was trying to minimise the risk for herself.

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She was acting as a perfectly responsible mother and had asked the HSE to look at the evidence in her case but there was “no engagement” by the HSE, just a repeat of a “mantra” when declining her application.

In her action against the Minister for Health and HSE, Ms Teehan who was accompanied in court by her husband Charles Brand, wants orders quashing the HSE’s refusals in May and June of her application for a home birth.

She claims the HSE has unreasonably and unlawfully refused to consider the merits of her application in that it is applying a blanket policy fettering it’s discretion. The HSE’s refusal breaches her rights under the Constitution and European Convention on Human Rights, she also alleges.

Mr Kelly said, having carried out extensive research and discovering there was a high level of safety associated with vaginal birth after a caesarean section, she and her husband decided to have a natural birth at home as opposed to delivery in a hospital. When she made preliminary enquiries about HSE home birth services, she was informed expectant mothers with previous caesarean section births are excluded from the home birth scheme and midwives would not be able to engage with her.

She made a formal request for a home birth package on May 23rd, 2013, saying she was physically fit and practised yoga, running and gymnastics but was refused six days later. She then submitted a medical and expert report to the HSE indicating she was at the lowest end of estimates of risk for expectant mothers planning a natural birth having had a previous caesarean section.

In a letter on June 24th, the HSE reiterated its refusal on the basis of the blanket policy and with no consideration of Ms Teehan’s individual circumstances, counsel said.

Ms Teehan claims the application of such “a broad policy” to her necessarily means her individual circumstances are deemed to be irrelevant in breach of her rights under the ECHR.

Opposing the application, Paul Anthony McDermott, for the HSE, said it fully recognises the bona fides of Ms Teehan and that she sincerely wishes for a home birth and clearly believes it is safe.

Ms Teehan had failed to identify what statutory right of hers has been unlawfully fettered, he said. The HSE had “not plucked the policy out of thin air” but had followed the practice in other jurisdictions and the policy was rational and based on medical evidence.

Eoin McCullough SC, for the Minister, argued the policy at issue was that of the HSE and not of the State.

Ms Justice O’Malley will give judgment on August 13th.