Dáil Éireann - Volume 441 - 14 April, 1994

Written Answers - Home Births.

29. Mr. Shatter asked the Minister for Health the arrangements, if any, made within each health board area for the provision of a midwife to facilitate mothers who wish to give birth at home; the fee paid by each health board to a midwife who attends a mother at her home for the birth of her child; and his views on whether the current arrangements are adequate.

Minister for Health (Mr. Howlin): It is the Department of Health's policy that, on medical grounds, the delivery of babies should take place in consultant staffed maternity units. This policy is in line with the recommendations of the Comhairle na nOspidéal report — Development of Hospital Maternity Services — which examined in detail the objectives of health care in relation to maternity services. It is generally accepted that this policy has contributed to the marked decrease in the level of maternal, perinatal and infant mortality. I am pleased to say that the annual State of the World's Children report from UNICEF seems to indicate that Ireland is now the safest country in the world for women giving birth, with a mortality rate of two per 100,000 births — the lowest of the 145 countries reported upon.

I am aware that at present, health boards are experiencing difficulties in [687] providing services for home confinements. This situation has arisen because of the practice of hospital confinement over the past 20-25 years and the consequent unavailability in some areas of experienced practitioners in home delivery. Where private midwives are engaged, the fee payable by health boards is £58.40.

I am aware that, regardless of departmental policy and professional advice, some women will choose a domiciliary birth. I am anxious that appropriate provision be made to cater for their needs. Health boards are being asked to reexamine their arrangements for domiciliary births.

A review of the maternity and infant care scheme is nearing completion. I intend to review current policy in relation to all aspects of the scheme, including domiciliary births, when I receive the report of the review group.