University lecturer Aja Teehan, who is 29 weeks’ pregnant, wants to have her second child at home in Thomastown, Co Kilkenny, assisted by a midwife.
However, she claims a “blanket policy” by the HSE of refusing to cover home births for women who have previously had caesarean section births, means she cannot have her baby at home as a midwife will not get indemnity cover to attend on her.
Matthias Kelly, counsel for Ms Teehan, told the High Court yesterday that his client was not trying to turn herself into some sort of martyr, but was trying to minimise the risks.
She was acting as a perfectly responsible mother and had asked the HSE to look at the evidence in her case, but counsel said there was “no engagement” by the HSE, just a repeat of the mantra in declining her application.
Ms Teehan, who already has a six-year-old child and was supported in court by her husband Charles Brand, is seeking an order quashing a decision of the HSE in May and June of this year refusing her application for a home birth.
She is also, in her action against the HSE and the minister for health, seeking a declaration that the HSE’s failure to consider the merits of her application for a home birth is unreasonable and unlawful in so far as it amounts to the application of a blanket policy and fetters the HSE’s discretion. She claims the policy on home birth is unreasonable and breaches her rights under the European Convention on Human Rights.
Mr Kelly told Ms Justice Iseult O’Malley that Ms Teehan is expecting her second child on Oct 13. She decided with her husband she wished to have a natural birth in her own home as opposed to delivery in a hospital.
When she made enquiries about HSE home birth services, she was told expectant mothers with previous caesarean section births are excluded from the scheme and midwives would not be able to engage with her.
She made a formal request for a home birth package on May 23, 2013, saying she was physically fit and practised yoga, running, and gymnastics. This was refused six days later.
She then submitted a medical and expert report to the HSE that indicated she was at the lowest end of estimates of risk for expectant mothers planning a natural birth having had a previous caesarean.
In a letter on Jun 24, 2013, the HSE reiterated its refusal on the basis of the blanket policy. Counsel said there was no consideration of Ms Teehan’s individual circumstances.
The decision to refuse a home birth, her side claims, is not compliant with the European Convention on Human Rights as the application of such a broad policy to Ms Teehan necessarily means her individual circumstances are deemed to be irrelevant.
Paul Anthony McDermott, for the HSE, said the HSE fully recognises the bona fides of Ms Teehan and that she sincerely wishes for a home birth and clearly believes it is safe. However, he said Ms Teehan had not identified to the court what statutory right has been unlawfully fettered. The HSE had not plucked the policy out of thin air but followed the practice in other jurisdictions. He said the policy was a rational one based on medical evidence.
Eoin McCullough, for the health minister, said the policy was that of the HSE and not of the State.
Ms Justice O’Malley said she will give judgment on the matter on Aug 13.