Irish Examiner view: Home birth tragedy unlikely to offset growing demand

University Hospital Limerick has commissioned an external review after Lisa Liston died after giving birth to her first child. Picture: Dan Linehan

Home birthing is still a rare experience in Ireland and relatively few parents elect to take advantage of the offer where it is available. The HSE says that it is an acceptable and safe alternative for low-risk healthy women and cites a number of reasons why some people may prefer it.

Home birth may be chosen because the woman wants to feel in control; or feels safer; or wants to avoid intervention; or dislikes hospitals or doesn’t want to be separated from older children. All very cogent and understandable reasons.

Another reason which has stimulated interest is the restrictions which were in place during the Covid pandemic. These were well-intended, but they carried inherent potential for a negative maternity experience where partners and families were excluded and the levels of emotional support and bonding were diminished. 

Research papers show that women, when asked to describe their experience of early labour in hospitals, used words and phrases redolent of isolation: “lonely”; “just me”; “at the end of the day, it’s just you.” 

Their husbands and partners were confined to the car park. One expectant mother decided “enough was enough” after an early encounter with the rules and switched to a home birth.

Demand increased by a third during the pandemic and it is likely to grow again. But the constraining factor is the number of midwives who are available to implement a significant change in approach. 

Put at its most simple, if there were more midwives, there would be more home births.

Almost 650 women gave birth at home last year across public and private services, with the national service treating 53% more women than in 2019 despite some counties lacking community midwives. The National Maternity Strategy of 2016 recommended that the option of homebirth should be fully integrated into the network.

Laura Liston.

 The subject has come into sharp focus in the past week when the UL Hospital Group suspended services in the midwest following the tragedy of Laura Listonwho died after giving birth to her first child, a son named Shay, in Croom, Co Limerick on June 5.

UL has commissioned an external review including midwifery and obstetrics experts to look at “patient safety, clinical governance and any other issues arising”.

The suspension means that women registered to have a home birth in the region will have to attend the University Maternity Hospital Limerick until further notice.

While it is appropriate that the sad circumstances surrounding this death be fully investigated, we should not imagine that there will be an overall diminishing of interest in the prospect of delivering your child at home. There is a momentum for this which is unlikely to recede.