Midwives call for water births at home to resume

A ban on home water births at home is “non-evidenced based, unethical and unequitable” and must be reversed, two midwives’ associations have said.

Up until November 2020, the Health Service Executive (HSE) facilitated this form of birth through the national home birth service, in agreement with self-employed community midwives.

However, in a statement at the time, the HSE said it “temporarily paused” the offering “in the interest of health and safety of women and babies”, following a “small number of incidents”. They have not yet resumed facilitating the service.

In a statement on Thursday, the Midwives Association of Ireland and the Community Midwives Association called for the reinstatement of the service in a home-birth setting.

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Pain

Research has previously suggested water birth can result in less pain, less chance of an epidural and shorter first stage of labour.

“We query how much progress there is in Ireland if midwives can’t practice basic midwifery skills and in this case are disallowed from providing the pain relief and support which water birth gives to women in a home-birth setting,” the statement said.

"Now 18 months on, we reiterate that this ban is non-evidenced based, unethical and unequitable and should not still be in place. Given the evidence of the safety of water birth internationally, we ask the Minister for Health Stephen Donnelly instruct the HSE to lift this ban on water birth with immediate effect."

The HSE was contacted for comment on whether it intends to resume the facilitation of water births at home.

The two midwifery associations were speaking on International Day of the Midwife, and highlighted the changes the profession has experienced over the decades.

Home

“Prior to the 1930s many infants were born at home under the care of midwives, often in impoverished circumstances,” the statement said.

“Throughout the decades, while new technologies have improved safety, modernising many areas of reproductive care, midwives now work within a system that promotes medicalised care over midwifery-led care. This is not to refute the absolute need for interventions in the case of safety for women and her babies.”

The statement said the country’s 19 maternity units and hospitals are consultant-led obstetric units, adding there are only two pilot midwifery-led units.

The associations described the national maternity strategy has having “stalled”, adding that less than 1 per cent of the population give birth at home.

“Midwifery skills are in some areas downgraded to very basic care. Midwives unable to practice midwifery as thought through international-based education programme, sadly choose to leave the profession,” they added.