Women wanting to give birth at home have no legal right to funding for the proceudure from their local health board, the Supreme Court has found.
The ruling follows an appeal against a High Court judgment in September 2002 which found the 1970 Health Act did not give women a "legally enforceable" right to have a midwife provided to enable home birth.
Mr Justice Geoghegan, presiding, issued the unanimous ruling in the Supreme Court this morning.
He said the Act required "approporiate medical, surgical and midwifery services" be provided by a health board but that it would be compliant in providing them within the confines of a hospital.
He also found the Act did include the possibility that midwifery services could be provided by health boards in the home. "But this is a far remove from a national statutory obligation on the health boards to provide such services," he said.
Four women took the case claiming the Southwestern Area Health Board (SWAHB) were obliged to pay all or part of the cost of a home midwife under section 62 of the Act.
They were: Ms Sarah Clarke, Ballyvass, Castledermot, Co Kildare; Ms Melissa Lockhart, Craddockstown Road, Naas, Co Kildare; Ms Anne Brannick, Quill Road, Kilmacanogue, Co Wicklow, and Ms Caroline O'Brien, Ballinclea, Glen of Imaal, Co Wicklow.
One of the appellants, Ms Brannick, had also argued that that it was discriminatory for one health board not to provide home midwifery services available in other health board regions.
The Court ruled that health boards are entitled to formulate different policies on how they provide services on condition those poilicies are not "wholly unreasonable".
Speaking after today's judgment, Ms Krysia Lynch of the Home Birth Association of Ireland said: "This ruling has removed choice from lower socio-economic groups. Women who cannot afford private medical care will now be forced to have their babies in hospital."
Ms Helen McMahon, who gave birth to her children at home said she was "completely devastated" by today's ruling. She said: "It's so unfair, there was a grant for home births, now it's gone."