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.

@lamppostliving I've never understood refusing the vit k injection. My ex went on to have a baby with an older woman and she did free birth, I couldn't believe it. I wonder if she was going to one of the Mother Earth types for classes. They wanted my just turned 7 year old ds there too! Ex was always very anti hospitals - he hated waiting, nothing to do with anything else. Anyway luckily it all worked out well for them but they refused the vit k and home visit from the midwife and HV visits, they were turning up unannounced in the end, and rejected at the door. I'm not sure what happened with it. My ex seemed to think the nhs team were the problem.

After this saga my son needed a cystoscopy and ex was refusing permission for months. He did eventually agree to it. I do wonder how far my ex could have taken it, I found out unless it's life saving emergency treatment he can refuse consent for my ds and the nhs can't go against him so I'd have needed money for court or something? The next thing was him wanting ds to be in a forest school and ds stopped wanting to wear shoes for a bit too. Luckily I'm the opposite of them so ds will hopefully stay balanced

She wasn’t denied midwife care, she decided to decline the options she was given. It was her choice, and the “doula” who went along with this should be arrested for manslaughter!

As someone who had a sudden and unexpected PPH, I strongly disagree. Bleeding to death isn’t something I’d wish on anyone.

I am on a group this lady was in. It is absolutely tragic and could have been avoided. It really looks like she didn't think it was that big of a risk. Saying things like there was a 0.5% risk of rupture so a 99.5% chance of success. That it is far more likely to be successful with at home with no intervention and if you waited for spontaneous labour. - That was advice she gave to another lady on trying for a VBA2C.

She was given the option of having a supervised VBA2C in hospital and I am guessing decided to go against it so that they couldn't intervene. I have friends who successfully had a VBAC in hospital, I don't know personally of any VBA2Cs. I did join the other groups that were recommended when I was considering a VBAC but left very quickly because I found a lot were very against medical advice.

I do often feel like I am part of a herd when I am at clinics etc and it is very impersonal but I also think the care I have received has been very good if yes very clinical. So I think some women pull away from that. But I wouldn't decided to not call 999 and have a heart attack at home.

But most of her posts she was just a regular mam, doing regular mam things and looking for advice on boring regular things. She leaves 4 children and a husband and I cannot imagine what they are feeling right now

I’d say the opposite. Maternity services are stretched and those who want homebirth are often refused/not fully supported. I had to fight 30 years ago to get a homebirth with my first. I’d be even more reluctant to go into hospital given the current crisis in maternity care. I would never choose a free birth but I can see why it happens.

@Notellinganyone but she was unsupported for a good medical reason. I would have loved a home birth on my first but for medical reasons I was initially advised against it and then it turned out I had pre eclampsia and ended up in high dependency so I needed lots of medical intervention and was very glad of it. I've come off groups over the years as I've seen more and more craziness creep in (no other words to describe it). I got so mad one day when another pregnant woman had extremely high bp readings and the hospital were advising possible admission for observation and meds and was being online told that rest and relaxation was all she needed. And it's only online where I find this. In any other setting whether it's chatting with friends or family or the parents at toddler groups etc people are always happy with the care they receive. Yes the clinics are busy no the hospitals are not luxurious and absolutely they could be better but that wouldn't put me off using one. Actually one mum recently at the school was singing the praises of the mental health team she saw while pregnant due to severe pnd after her first baby.

@SparkyBlue totally agree. She was refused as she was high risk and went against medical advice.

I wouldn’t call it disgusting. Midwives can’t be expected to oversee a very high risk birth at home with no support if anything goes wrong.

This is the thing I don’t understand. I had a ventouse delivery as they had to get my baby out really quickly as baby had passed meconium and the heart rate was low. My body didn’t “know what to do”. It was traumatic but I shudder to think what it would have been like at home with no medical professionals. I felt so much safer in hospital and there were loads of midwives and doctors around. I feel as though there is an underlying message that it is “bad” now if you require medical interventions during birth. Years ago before these medical interventions were available childbirth was far more dangerous for women.

@Thetroutofnocraic1 it is a bit mad isn't it. We don't consider medical 'intervention' bad for pretty much anything else (maybe some theories on cancer but I won't divert!)

I'm due baby no 2 in a few weeks. I had an EMCS 1st time and while I'm not really what society would consider high risk I have a few bits which together are putting me at high risk. The doctors and MW have been leaning towards elective for months, but were willing to attempt a VBAC, if I really wanted. I was getting some confusing messages online. Like that if I didn't 'at least try' I'd be less for it - not said in those words but that's what it made me feel.

I had a very frank discussion with the consultant 2 weeks ago, booked the section and left all those groups! Of course like with all surgery I know there are risks but they seem far smaller than any other option.

@pontipinemum this is exactly what I mean it’s so ridiculous. Nobody should feel less for having a c section. I don’t know why this sort of thinking is out there but it definitely is. I think some of these type of online groups may be dangerous for pregnant women.

@pontipinemum that's it. It's all the little things coming together that can cause an issue. I cant just can't get my head around completely ignoring all advice. We are having units built in units in our sitting room at the moment and the carpenter straight away said he'd done a neighbours house and there is something off with the measurements and it's because there is a weird slope(same when we got tiles) in our houses so things are a little off. So a bit of extra work involved but no big deal. I'm probably really bad at explaining this but my point being people know how to do their jobs. No one wants extra work so doctors aren't advising things for fun or extra work. If every woman was able to have a straightforward vaginal delivery with no interventions then it would be amazing for the health service and save millions. Obviously absolutely no one is saying doctors are gods who should never be questioned but it's the questioning and disagreeing just for the sake of it I can't understand.

@SparkyBlue this is so true. At the end of the day doctors have had years of studying and training especially consultants. Doctors are not always correct, they are humans like everyone else. It is clear in this case the medical team were very much correct in their advice for this woman not to have a home birth. I really feel for this poor woman and her family and wonder what lead her to make the decision. I would be very frightened at home

We don't know the details of what happened but it is possible that having a midwife present at a homebirth rather than a doula could save the life of someone having a postpartum haemorrhage as they have acess to drugs such as syntometrine and oxygen, can perform emergency manouvres such as bimanual compression, cannulate, recognise shock faster and even just saying the right things to get an ambulance asap. The cost of litigation in obstetrics is so high and increasing which I feel does influence not being 'allowed' a homebirth. I feel that if someone makes an informed choice to have a homebirth when deemed 'high risk' it should be granted but Midwives must be supported. I think Doulas can be a huge assest to women in labour when working with a Midwife or Obstetrician but attending freebirths disturbs me because I wonder if it gives freebirthing women a false sense of security that they are with an birthing expert however many times the doula explains they aren't clinical. I have known Doulas who do have an agenda and make terribly unsafe recommendations when they shouldn't be giving advice. If they are there for advocacy and emotional and practical support then they can be great. A good midwife in a supportive workplace can be both doula and clincian at the same time, I really wish all women could access quality care.

I think there's some of it coming from the amount of women needing intervention in childbirth who maybe question later if it was really needed. And obviously women wanting to have a more positive experience of birth and doing what they can to set themselves up for that.

I was very nervous about birth and did lots of hypnobirthing and read lots about how to encourage a positive birth experience but so much of it hinged on an unmedicated natural birth, just trusting your body etc and was quite negative about the effects of say, induction for example, that when I was told I had medical need to be induced early and couldn't have the lovely waterbirth I'd been visualising thanks to those books, I was utterly petrified and ended up having an elected section. Now I feel that was the right decision for me due to concerns I had. But, it does seem very unfair to women who aren't able to have certain types of births and I think it does mean some women might go against medical advice to try to achieve a positive birth..

@lamppostliving The Midwife at the homebirth you mentioned did save her life as much as the medical team who physically did by recognising the problem, following the protocol and arranging the transfer to hospital before the massive haemorrhage. This is what midwives do- recognise and make the recommendation to transfer to Obstetrician care if needed as it occurs as well as having intensive training for emergencies whilst waiting for Obstetric care. Of course she would say to the Mum it's 'just a precaution'. There are a lot of things a Midwife can do at home that are life saving or at buying time whilst waiting for the ambulance.

This is what is so worrying to me about doulas attending freebirths as 'birthing professionals'. A good Doula is a 'professional birth partner' in my opinion which is a very valid but totally different thing. The yoga teacher described above makes me so angry. It is true there is so much uneeded intervention because of the fear of litigation and staffing issues amongst others and women are often ignored and coerced and statistics are misused but then the yoga teacher types can take things too far the other way. They just don't have the training and experience of a Midwife who has been on the job full time for say 10 years and seen so much they often intuitively knows what's happening before it does and who has all the training and education that go with it. A good midwife will always support the woman to make an informed choice and them support them in whatever that is, reconfirming as things progress. It's so sad so many women don't have that.

I think the complicated thing is that c-section rates are very high in Ireland and the hospitals are under resourced and basically need people to move through the system quickly which leads to more interventions. They have midwife led births , home births (with midwives) and are talking about birthing centers for low risk births to address these very real concerns. If more woman had less interventions it would save millions but it’s not how the system works at the moment.

But also, in this case, this woman just simply wasn’t low risk enough to have this type of birth. This advice would have been given even if the system was different. But the situation in the maternity system obviously led to a lack of trust in the services generally.

I'm not sure if anyone is still reading this thread. I am in a mothers group with everyone due in the next 8 weeks.

1 woman keeps telling others that the doctors have said she is higher risk but she won't be listing to any of their nonsense about induction and certainly not section. That her body will know when and what to do. How do you address someone like that?

Firstly it is hugely insulting to those of us who do listen to the 'nonsense' I am probably very risk adverse when it comes to this, 4 mc's might be a factor there. I have to say the hospital have been good with me and given me my options. I know it's easy for me since my only goal is a healthy baby I have zero birth plan/ desire. Some of them have said things like they want to heal the trauma of their first birth with a good experience on the 2nd. I had a long drawn out failed induction and EMCS so wasn't a dream but honestly it's not something I think of

Hey OP.
I live in NI, and I know a lot of women have concerns about their maternity care here too.
I ended up having my last baby at home 12 weekd ago. Very unintentionally and just my partner present. My totaly labour from first pain to baby out was just over 1 hour.
I am a nurse, and I can tell you I was shit scared. The baby was coming regardless and I knew it was safer to try and stay put rather than head out in the car in the dark as the journey to hospital would have taken a good 25 mins.
All I could think of was what if the baby got stuck, what if the cord was around its neck? When the baby came out, I couldn't bear it until I knew she was breathing, and my placenta didn't come away until I got an injection in hospital........the ambulance took 50 minutes to come. If there had been a complication, we could both have been dead.
I honestly do not know why a woman would willingly put herself in the position of having no medical help or support when giving birth. It took me a few weeks to get my head around the situation, and even now I prefer not to think about it.

@nats2010 oh wow! What an experience I would be bricking it too. I live about 45 mins to the hospital. So glad you are both fine. Hope you are settled into each other now

Hope you’re looking after yourself nats2010, that sounds scary AF. When I read about this case a few weeks ago I had similar thoughts. I had an ectopic in 2021 when DD was just shy of 2yo and all I could think of when they were wheeling me down for surgery was, “what if something happens and DD is left without a Mummy”. I’m not a parent who has put my life on hold for my kids, but in that situation being there for her was my priority and that filtered through into the subsequent choices I made for my birth with DS. I get wanting to have a positive birth experience and that that looks different to different women, but I’ll never understand choosing this course of action knowing the risks when you already have three very young kids at home.

Thankyou we are all very well and it hasn't taken a fidge out of us lol
Just have to get on with it.....have a couple of teenagers and an 18mth aswell to run after.

@pontipinemum to be honest, don't feel it's your responsibility to say anything. At most, you could nicely paraphrase what you wrote here and reference the recent free birth tragedy. People will make their own choices.

Some of these online communities are responsible for scaring vulnerable women into mistrusting the medical community, and it is outrageous and frankly dangerous the gibberish they spout. (Also, they are also responsible for making women feel they have "failed" at childbirth if they need medical assistance, which makes me so angry on behalf of all women who take on that guilt!)

My perspective - as a large and small animal vet of many years I have delivered thousands of animals ranging from calves, foals, lambs, cats, dogs and a few pigs... No, not any humans - thankfully. But I have seen the sheer brutality of nature at play when things are going wrong, and things go wrong often.

Some of the things I have had to deal with at work are just horrific. The thing is, decades of succesful medical intervention have removed most of society from reality - we have actually forgotten how dangerous childbirth can be. Darwin once wrote that nature is "clumsy, cruel and horribly wasteful". I can tell you how true that is, and we should not forget how lucky we are to have access to modern medicine.

This was a very tragic case. I feel so sorry for the mum who lost her life, for her family, and for the medical professionals who tried to save her. They must be all so traumatised.