Free births in Ireland

[Thetroutofnocraic1]

I was particularly saddened and shocked to hear of the recent death of a young woman who had a free birth at home in Louth. It makes me wonder how common free births are in Ireland and what leads women to make the decision to have a free birth instead of going into hospital. I wonder if people have lost faith in maternity services in Ireland to go to such extremes. Also makes me wonder about doulas and how this practice is regulated. Just curious if anyone else has any thoughts on this issue.

Looks like OLOL Hospital was her closest. Perhaps they offer home birth support too, but she was deemed high risk so wasn't suitable. She had previous C-sections, so would have had consultant led care.

This is an American trend stemming from how ignored birthing mothers wishes and how overmedicalised the American health care system is.

As with many things social media is a contributor creating echo chambers and also forums where women can egg each other on and encourage women to ignore medical professionals because “your body knows what to do” 🙄

I read an incredibly sad and moving post by an American woman who had “free birthed” in America. her husband ended up driving her to a hospital while she was on all fours in the back of a station wagon with her dead baby still lodged inside her.

www.nbcnews.com/news/us-news/she-wanted-freebirth-no-doctors-online-groups-convinced-her-it-n1140096

Is there usually a huge risk if you've had 2 sections for a vbac or was she just unlucky?

Here is the HSE guidance. The more sections you have the higher the risk.

Birth options after a caesarean - HSE.ie

Thanks for the information Caitlyn. It seems there are more options for women to home birth in the UK.

ROI is a very litigious country so I don't think our Health Service Executive is open to allowing as much freedom of choice when it comes to healthcare.

@bananaphon .. based on my rudimentary google... there is between a 1 in 100 and 5 in 100 chance of having a PPH when you have a baby - not all women will die from this, but treatment to stop the bleeding is recommended. Having 2 previous cesarean operations increases this risk by a factor of 4. (these are US stats where the rate of Maternal Mortality is 4 times as high Ireland... so in Ireland the risks could be 4 times lower than this.

As Sara Wickam says - it is important to understand the circumstances around any statistics. We do not have large scale studies of births without any medical attendance and without recourse to medical support. Skilled medical professionals are likely to be able to detect increased risk factors which may have been able to prevent this or limit the impact - signs of pre eclampsia including high blood pressure or foetal distress for example.

Was she unlucky - yes. Would this have happened to every woman with history of 2 cesarean births - based on the figures above - she might have been looking at a 1 in 5 chance - which is incredibly high. She may have been considering different risk factors, or different studies - and maybe she thought that an 80% change of not having a PPH was OK. She may have been trusting that she would be in the 'majority of people' cohort... and that if she had her baby in hospital, she risked being the 'minority' cohort for whom hospital births result in significant harm.

What is clear that without the presence of a medical professional, the risks to her life, once the PPH started, were significantly higher than if there had been a medical professional present.

So many statistics are 'thrown' around ... both by medical professionals and by social media influencers - It is important to look at large scale data that is relevant to your setting and your situation. Not all obstetric decisions are based on good information - not even all of those made by professionals.

I read her previous pregnancy was twins which are almost a year old so her body had already been through a lot in a short space of time..

That’s not accurate. HBACs are not supported in Ireland by hospital employed midwives. They used to be by independent midwives. I don’t know if that is still the case. I know of 3 but they’d have been 15+ years ago. Other countries do allow them. Some HBACs may not be deemed advisable but a lot will depend on specifics including why the c-Section took place. Having had 2 sections she would have been higher risk.

I’m not defending her decision. I think it was absolutely insane. And tragic.

As far as I'm aware the HSE won't insure any midwife to attend a HBAC, although there's a private midwifery company that will facilitate it. I'm not sure if that company would support a HBA2C. It's was very difficult to secure a midwife to provide care for a homebirth in Ireland back when I was having my dc, perhaps it's easier now.

I agree that it's an absolute tragedy.

This is so sad. The doula sounds dangerous. I'm not a medical professional but an unassisted VBAC after a csection sounds insane.

I have had lovely, peaceful unmedicated births at NMH in Dublin with midwives, its so sad that this woman felt she had to take this route.

The doula who assisted Naomi says on her social media that she is a birthing professional, not a medical professional.
The doula also says that women who have had caesareans previously must be informed that they have “options”, including a freebirth, for future pregnancies.
Naomi attended a retreat in April that was run by this doula, alongside other pregnant women.
Naomi had engaged with home birth services while pregnant, and been advised that the risk of a home birth was too high for her due to her previous caesareans.

Growing number of unassisted births happening in Ireland, say birth experts

It’s understood that she was offered a safe trial of labour, which is when a woman who has previously had a caesarean and who wants to have a vaginal birth is allowed to go through labour in a controlled and monitored hospital environment.

It's very sad but she should have been in hospital, as was advised. You do what medical professionals tell you to do or the gamble is on your own head. I was hoping for a vbac for my last pregnancy but the Drs in Drogheda told me I needed a c section. So I did what I was told because they know how to keep me and my daughter as safe as possible.

I have been involved in (thankfully a very small number) cases where babies have been severely injured or have died after their mother made decisions about her birth that went against medical advice.

Unfortunately in my experience women in these cases will turn on and blame staff who were involved, no matter how clear those staff were beforehand about the risks. Firstly this is because they fundamentally don't believe / trust health professionals that a particular way of giving birth isn't safe, and they continue not to believe it and look for other reasons even after the risks they were warned about have literally played out. Secondly, it's a coping strategy - how do you even begin to face up to being responsible in some way for your baby being hurt, at the same time as you are grieving your baby and/or their future?

I can't blame any midwife who will not support/attend a dangerous birth plan. Careers can be ended by cases like this, not just as a result of any possible professional sanctions but also as a result of trauma. It is not a small thing to witness a baby or mother die and to "fail" to save them. There is even a risk that staff could be criminally prosecuted and lose their liberty. Women don't have the right to put professionals in that position.

It's terribly sad that this poor woman has died. I feel the unregulated people that encourage and facilitate this type of thing should face some kind of consequences but of course the whole point of them is that they are not regulated, they have no professional accreditation to be taken away.

Booksunderthebed - as you say that Doula does sound dangerous. I would guess she is a hippyish, free spirited nutjob who is completely deluded. Medical professionals are there for a reason, they aren't trying to annoy you or make your life more difficult. They deal with life & death every day. For that doula to try and convince that lady otherwise for her own gain is insane. I hope she cops the blame for this and her career is finished. This can't happen again.

This is so sad.

I’m not in Ireland nor am I Irish but I hope you don’t mind me responding with regards to the question of why women choose to do this. I have a friend who had four unassisted homebirths. She has a history of medical trauma and does not trust the medical establishment so she was not willing to go to hospital to give birth, nor was she willing to have midwives in her home to assist.

It worked out very well for her and I don’t believe she regrets her choices. It’s not something I would ever do or suggest a friend should do. (My friend’s husband also didn’t agree with her choice but he had no option but to go along with it).

Since she had her babies, my friend has needed medical treatment for other conditions and she has gone along with that so I don’t know whether her views on medicine have now changed or whether her willingness to accept medical treatment depends on the condition!

Consider the case where a midwife was hounded out of her job and then blacklisted by multiple NHS trusts because she administered a lifesaving blood transfusion without a prescription to a woman experiencing postpartum haemorrhage in an ambulance. Her employers tried to end her career. I believe she had to fundraise for legal representation. Her name is Leona Harris. It took four years for her to be cleared of any wrongdoing. Four years of absolute hell. As far as I'm aware, the events leading to the PPH were unforeseeable, just a low risk planned home birth. That's the kind of climate of blame midwives may find themselves practicing in.

The obstetric system harms mothers and babies, without good evidence, every day. Two other women died shortly after childbirth the same week as this lady.

Cesarean birth is not safer for mothers and babies than physiological birth, cesarean rates above 10% are not associated with reduction in maternal and neonatal mortality rates. In Ireland that rate is somewhere around 36%.

I am not defending the position of the mother or the doula, in any way. It is a very sad situation.

I wonder what her previous birth experiences in hospital were like for her to have made the decision to free birth. It's so sad and now her babies are left without a mother

Thankfully in Ireland we have one of the lowest maternal deaths in Europe. But the reality is risk can't be eliminated. I know in many years we have 0 deaths, I remember reviewing stats before choosing a hospital.

This was a woman who was refusing to follow medical advice, given for her and her child's safety. Midwives advise when the birthing at home mother needs to be transferred to hospital for her own safety. Advice this woman likely would have refused.

if a midwife was present they would in all likelihood have had to watch this woman bleed to death. Health boards are quite right to refuse to put their staff in this situation. Midwives are right to refuse to put themselves that situation.

There is nothing a midwife could have done at home to save this woman's life.

This is not the first time a mother or her baby has died because the mother refused to follow medical advice after listening to natural birth advocates. Some of these advocates give really dangerous advice, and tell mothers not to trust medical staff. They have deaths on their hands.

I had a friend who had a homebirth and her placenta was delayed coming out. The policy was that she should be transferred to hospital, so she was, with the midwife saying this was just a precaution (my pregnancy yoga teacher would have said this was nonsense and she should just have stayed at home and a delayed placenta was entirely safe and normal...). Just as well as she started to haemorrhage just after they arrived at the hospital and she lost so much blood so rapidly that the medical team were preparing to go in though her neck to get blood into her. She genuinely thought she was going to die.

There is nothing a midwife could have done at home to save her when it was so touch and go even with an entire consultant led hospital team around her.

It's a really sad case but I'm not sure what you can do when someone refuses to listen to medical advice. The lady was aware that she was making a risky decision and unfortunately lost her life doing so.

I know 2 women who have had homebirths here in Ireland, one went off without a hitch and mum and baby were fine. The other lady unfortunately lost her baby, something went wrong, I'm not sure what exactly and she lost the baby before they could get her to a hospital. Apparently if she was in hospital she would have been sent for an emergency c section and things could have looked very different. The poor woman felt a lot of guilt about her decision to have a homebirth but she was supported by midwives in doing so.

I think modern medicine has made people unaware of just how many mums and babies lost their lives when interventions weren't available and lulls some women into a false sense of security. I've seen a fair bit of this 'freebirth' lark on tiktok and it's all appears to be a very romanticised view of childbirth. Lots of I want to give birth under the cherry blossom tree in my garden communing with nature stuff going on.

I would imagine she had lost her trust in the hospital services. Maybe she had a poor experience in her previous c-sections. I feel sympathetic as I had a lovely first time birth and walked in very trusting to my second which soon turned into a horrific experience. I was very wary walking in on my third.

My friend is pregnant now and she tells me her hospital (the Coombe) are offering some kind of review service to go through your notes and speak about what happened during your last birth and why. I think this a very useful way to reengage people who have lost faith in the system. But, in my limited experience, the maternity system is simply overcrowded and under resourced and it’s not put women’s and babies overall well-being first environment by any means. It’s a get them in and out, as quickly as possible without dying experience .

I hope completely unassisted births aren’t common. Very tragic.

Lampostliving, my yoga teacher spoke the same sort of tripe insisting that an induction was not necessary, your body knows when it's ready etc etc. Well I've heard of babies dying because of the placenta failing and the placenta has a high risk of failing after 42 weeks. Baby can be starved of oxygen. This is all proven yet they think they know better than medical professionals. Thankfully most of us know to trust the professionals but some people may be more easily led. That poor lady was obviously more trusting of the doula than medical staff, to her own detriment. Heartbreaking.

Yup. I had two mothers to be at my pregnancy yoga class work themselves up into an entire state after several months of listening to the dirge the yoga teacher fed them. They were on the verge of hysteria, saying how they now knew more than the doctors and midwives did and how they were terrified the doctors and midwives were going to force them to have interventions they did not need.

A third, having been fed the line that its perfectly natural to go beyond 42 weeks and its nothing to worry about, got to almost 44 weeks and still had not gone into labour. Turned out the umbilical cord was wrapped around her baby's neck. She needed a c-section.

This teacher also told us that we could refuse the vitamin K injection. That's to stop haemorrhaging. Its insane to encourage women to refuse such a simple thing that can save their life, just because its an ' intervention.'

The report into the high deaths and poor maternal care at Telford and Shrewsbury maternity blamed, in part, the emphasis the staff had on natural births which meant they were not intervening enough and babies were dying as a result.

Birth has been really, really dangerous for women and babies for most of human history. Its riskier for us than for other animal species. Its great that we have medical care that keeps nearly all mothers and babies alive. It didn't use to be like this.

What is it about pregnancy yoga teachers? Mine said that people use ultrasounds to demolish buildings so think what an ultrasound scan does to a foetus. I also found it a bit embarrassing doing primal screams.