Pregnant women go to court to obtain a free midwife service

A number of pregnant women who want to have their babies at home have taken High Court proceedings seeking to compel the Northern Area Health Board to provide them with free domiciliary midwife services. Or, if these are not available, that the board should pay for their hire. Mr Justice Kelly yesterday said he would list the cases for mention on Monday with a view to a full hearing before the end of the law term.

One of the women, Ms Eliza Kane (31), of Convent Road, Wicklow, whose third child is due on July 15th, said she wanted to have it at home with a midwife in attendance.

She said she had her first child in hospital, after a 12-hour labour, and the second at home, after a three-hour labour. She believed she was capable of delivering her baby without artificial means. She did not want the birth "actively managed by artificially speeding up the process". Ms Kane said that when she told her public health nurse she wanted a home birth and sought information, none was forthcoming. She was later told there was no midwife service in the town.

She approached the Home Birth Association of Ireland, which told her of a local independent domiciliary midwife. She was willing to take her on as a client for £1,200, to cover antenatal care, attendance at confinement and post-natal follow up.

Ms Kane and her husband could not afford to pay the midwife. She believed that, under the Health Act 1970, health boards had a statutory duty to provide expectant women with medical and midwifery services. If the NAHB had no domiciliary midwives in its employment, it should at least provide the cost of obtaining such services.

Her solicitors had asked the NAHB to provide her with a home birth service and made clear a "subvention" towards the cost of private midwifery care was not acceptable.

But, on April 10th, the board informed her it was refusing to provide domiciliary midwife care in the district and offered £650 towards the cost of hiring a private midwife.

Ms Kane said the board, in refusing to pay the full cost, had cited a policy of "best practice" but did not explain how that policy excused it from compliance with its statutory obligations.