Patients of midwife Philomena Canning, many of them in advanced stages of pregnancy, say they have been told by the Health Service Executive to give birth in a hospital or find their own midwife.
Up to 50 women and children protested outside the Four Courts yesterday in support of Ms Canning, who has been threatened by the executive with the withdrawal of her indemnity cover. They were critical of the amount of notice given by the HSE about the matter and the lack of alternative options for them to complete their pregnancy at home.
"This has put me in a risky situation because of where I live, over an hour away from hospital at some times of the day," says Lesley Ann Wiley of Kilpedder, Co Wicklow, who is expecting her fifth child and her third home delivery.
She was told last week that Ms Canning’s indemnity cover was being removed and other midwives in her area were not in a position to take her on. “The first two births I had in hospital were traumatic. I really don’t want to go back to that.”
Aid worker Lucy Hayes, from Wicklow, came back from Sierra Leone to give birth to her second child at home. Now, two weeks from her due date, she says she is getting "really anxious" over the uncertainty about midwife cover. "I had a stressful time dealing with Ebola before this but came home to de-stress before the baby arrives, and now this."
Ms Hayes says she was told by the HSE to find a new midwife for herself, a suggestion she describes as "appalling and totally disrespectful to pregnant women". "The women had no idea this was coming down the road, that care would be removed by the HSE and no substitute provided," according to Krysia Lynch of the Home Birth Association of Ireland. "This is a national home birth service run by the HSE, so women need to know service is consistent and won't disappear in a puff of smoke."
Fewer than 1 per cent of babies born in Ireland are delivered at home, but demand is high. Since 2008, the HSE has operated the National Home Birth Service free of charge to women. It uses 19 self-employed community midwives as contractors and pays their indemnity cover.
Women with serious risk factors such as heart disease or diabetes are not allowed to participate in the scheme, while women with less serious risk factors must be seen by an obstetrician before they can join.
Women are free to engage a midwife outside the scheme. The HSE says it is up to women who make private arrangements to ensure that their midwife has alternative insurance cover in place.