Hospital alarmed by home birth deaths

Obstetric and paediatric staff at the Rotunda Hospital in Dublin wrote to the Department of Health three times in the last two years over concern at deaths of babies following home deliveries.

The staff at the hospital also called for regulation of the home birth system.

Three of the babies would almost certainly have survived had they been delivered in hospital, says the Rotunda.

The Rotunda followed its initial letter of September 2000 with others in April and August 2002.

The letters, which have been seen by The Irish Times, have resulted in no response from the Department.

The letter of 2000 describes "several avoidable deaths attributable to home confinement".

This first letter gives details of three pregnancies "that delivered or were planned to be delivered at home".

"In the three cases described, the outcome for the third baby would not have been changed irrespective of where the labour was conducted.

"The risk in the third case lay with the mother, not with the baby.

"In the first two cases however we feel that the outcome i.e. normally formed babies who died from intrapartum hypoxia [lack of oxygen], could have been averted."

In April 2002 the hospital wrote again to the Department after the admittance of a mother and dead baby following home delivery.

The mother had had a previous Caesarian section, "a fact that probably should have made her unsuitable for home delivery in any event".

The hospital continued, "we would like to know what steps you have taken to regulate this area since we last corresponded with you."

The letter was acknowledged though no response was made regarding steps to regulate the area.

The hospital also referred in its correspondence to similar situations encountered by the National Maternity Hospital at Holles Street.

News of the correspondence follows Wednesday's Supreme Court decision that has reignited the controversy over home birth services.

The court found that health boards had no statutory obligation to provide home birth services.

The former Master of the Rotunda, Dr Peter McKenna, yesterday again expressed concern at the fact that independent domiciliary midwives were subject to no supervision and could, currently, agree to deliver the baby of a woman at home who has been advised against a home birth by an obstetrician.

"I have nothing against home births per se and I have no argument with women and midwives who opt for them. My argument is with the Department, which has done nothing to take this issue on."

A spokesman said the Department was "still examining the issue".