Maternity services consumer group welcomes Rotunda’s decision to withdraw from homebirth MOU – HSE Home Birth Service should be fit for purpose

The Association for Improvements in Maternity Services (AIMS), Ireland today welcomed the decision by the Consultant Body in Rotunda Maternity Hospital to refuse to engage in the sign off process of the HSE Home Birth Service.

Under new legislation, homebirth eligibility is determined by criteria created by the HSE and State Claims Agency and falls into 3 categories (i) eligible (ii) un-eligible (iii) eligibility is uncertain and must be determined by a consultant obstetrician The Master of the Rotunda Hospital, Dr Sam Coulter-Smith, informed the HSE last week that they were no longer prepared to approve women for maternity care under the HSE Home Birth Service, following unease within the consultant body to engage in this process.

Welcoming the move, Krysia Lynch, co-chair of AIMS Ireland said: “We are pleased to learn of the Rotunda’s decision to step away from the HSE Home Birth Service. It demonstrates that hospital consultants are in agreement with AIMS Ireland and the women who use our services that the current HSE Home Birth Service and MOU is a flawed model that is in need of a full review”

“The HSE indemnifies and pays self-employed community midwives (SECMs) in Ireland to facilitate home births around the country. These midwives are fully trained, highly skilled experts in their field and are more than qualified to make clinical decisions around the suitability of women for a home birth. Obstetricians have a hugely important role to play in Irish maternity services particularly in the care of women at high risk of complications, however home births are outside the scope of their practice, they have no working knowledge or expertise in the area and therefore should not be expected to be brought into the process in an ad hoc manner. It is both unreasonable and unsafe to expect obstetricians to dip in and out of a women’s care and take responsibility over a woman’s care path when they have no clinical relationship with her nor will be involved in any of the clinical decision making or care”, Lynch continued.

“We are calling on the HSE to revisit the homebirth memorandum of understanding so that the scheme is a seamless process for women, ensuring their security and peace of mind while also allowing our midwifery professionals to decide the criteria under which women should be referred for obstetric care. The current MOU has failed. A new, workable solution is urgently required” Lynch concluded.


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