Frequently Asked Questions

Contact a SECM in your area, details available on this website, to discuss your choices and gain what information you may need to support your decision about your preferred care and place of birth
OR
Make contact with the Designated Midwifery Officer (DMO) who has governance over your geographical area. They will provide you with the necessary paperwork and supporting information for discussion when meeting with your midwife.

DMOs are the HSE support for the homebirth service. Their role is to guide you through the service, support the SECMs, provide governance of the service for the HSE and be the link between all the stakeholders.

DMO details can be found in the following link – https://www.hse.ie/eng/services/list/3/maternity/homebirth-services.html

SECMs provide care from early pregnancy to two weeks after birth to you and your baby, available on call by phone 24 hours a day, seven days a week. They will inform you in advance of periods of leave etc. Visits may be in your home or a clinic provided by the midwife, this is individual to each SECM. Before, during and after birth, your midwife will liaise with any health professional if review or referral is required. In some instances, it may become necessary for your midwife to transfer your care to your obstetric team if there are concerns around the health of you or your baby. This should be in collaboration with yourself, respecting your input. Your midwife can be available to you to support you through this process if supported to by their DMO.

Your midwife will spend time learning about you, your family, your hopes for the pregnancy and your medical history. Your primary midwife is mainly responsible for providing care for you during and after labour. A second midwife will all be in attendance for the birth, mainly responsible for your baby after the birth but also to support you and your SECM. If your midwife has a student under her supervision, your midwife will ask for your permission to have the student present for your visits and your birth. Your midwife will provide all your necessary care and support in the postnatal period. S/he will also organise the necessary notifications to your G.P., hospital, PHN, birth registrar etc. Your midwife will provide care for you and your baby until two weeks after you give birth where care is handed over to your PHN and G.P.

SECMs advocate that your care continues with us, the SECM, up to 14 days postnatal, regardless of where your birth happens. We believe that women, who may require transfer, or emergency care, in the hospital setting, would especially benefit from the continuity of midwifery care from their known midwife, to support you, and your family, both physically and psychologically to facilitate your transition to motherhood, and reduce potential trauma. 

Outside these appointments your midwife will discuss with you the need to attend for further hospital appointments depending on logistics, your schedule of care, and the availability of your G.P. A significant portion of G.P.’s in Ireland have an insurance policy which prohibits them from providing care to mothers who are choosing to give birth at home. This has no implications for your maternity care until you have been confirmed by the Designated Midwifery Officer (DMO) as being accepted on to the HSE homebirth scheme. Typically this does not happen before 24 to 26 weeks of pregnancy.

For the purpose of vaccinations, prescriptions and completing maternity leave documentation it is ideal to have this completed before confirmation of your homebirth eligibility is received by your G.P. Prior to this documentation you have the same access to your G.P. as any other pregnant person. Some G.P.s value the long relationship they have with you, their role within your family and the fact that they are in no way involved in the birth itself and will continue to offer their support as normal.

Babies will be offered an early newborn check and will be required to be done before 72 hours of age. This is usually completed by your SECM, one of our SECM colleagues or within the hospital where you were originally booked by a suitably qualified doctor, or midwife, with the relevant qualification. Your midwife will arrange this. The G.P. will resume care for the two, and six week appointment, once this check has been completed as stated within their insurance policy.

The midwife will forward your homebirth details to your G.P., obstetric consultant and PHN who will all resume care with you when you are discharged by your SECM at around 10 to 14 days postnatal.

In view of the distance, and environment, there will be a low threshold for transfer. This will mainly occur by ambulance. Your midwife will travel into the hospital with you, and support you as needed, and appropriate, within the hospital setting.

The evidence demonstrated that community midwives are very cognisant of the identification and management of risk and there is no evidence to support a particular distance that would be considered more ‘safe’ than another when planning to birth at home. This is supported both in the context of Irish and international maternity homebirth services.

First sentence ‘ SECMs are covered for clinical indemnity insurance by the States Claims Agency (SCA/CIS) through their contract with the HSE to provide care to women deemed to have an uncomplicated pregnancy, or have an additional factor, which in collaboration with the obstetric team and the DMO, can be managed or mitigated, to facilitate you to have an uncomplicated, supported birth at home.

A list of these potential factors that may require multidisciplinary collaboration and individual assessment by a consultant obstetrician when planning place of birth can be found on Table 8.6
https://www.hse.ie/eng/services/list/3/maternity/hb003-policy-to-support-the-secm-to-assess-the-eligibility-suitability-of-women-for-home-birth.pdf

Link with a local SECM or DMO for more information.

Ongoing risk assessment continues throughout your pregnancy, labour and birth and will determine access for the mother and SECM to this insurance.

Each SECM, also, has public liability insurance through this organisation.

Research has shown that water can provide very effective pain relief to women in labour. We are delighted that the ban on waterbirth at home has finally been lifted by the HSE. If you are interested in having a water birth or using a birth pool during labour, please discuss this with your midwife.

Responsibility for the provision and supply of the necessary pool, liner and equipment for waterbirth will be with the woman

You may have whomever you like with you to support you during your labour and birth. Your primary midwife will be with you once you notify him/her with a second midwife also in attendance closer to the birth. You may not have met the second midwife prior to your birth.

Homebirth remains underdeveloped within the HSE maternity services. Your SECM may ask you to support a midwife or student midwife to be involved in your care. To increase the visibility of the service, and increase exposure to physiological birth, we would be pleased, if where possible, you could support the education and training of future homebirth midwives.

For your part you are welcome to have who you want at your birth including other family members, your children and doulas.

Prior to 37 weeks gestation, directions to your home will be entered onto the national ambulance database for easier access if needed during your labour and birth. Your midwife will also notify ambulance control when she is going to attend you in labour.

Your midwife will closely monitor you throughout your labour and if there are any causes for concern, she may discuss transferring you into hospital for the birth, or in the postnatal period for you or your baby.

All midwives are experts in supporting birth safely from qualification and registration. The continuity of care provided to you will support your SECM to recognise any deviations from the norm.

SECMs are fully trained in dealing with obstetric emergencies that may occur in a home birth situation during labour, birth or the postnatal period and we carry the supplies needed to provide immediate care in an emergency. We do regular professional education and updates in maternal and neonatal resuscitation, emergency skills and drills, supporting normal physiological birth and partake in peer review.

Our outcomes are reviewed annually with ongoing feedback and learning opportunities. Our regional Designated Midwifery Officer (DMO) within the HSE ensures that we are competent, compliant and deemed safe to practice and also ensures that all our equipment is checked on a yearly basis.

normal physiological birth and partake in peer review. Our outcomes and reviewed annually with ongoing feedback and learning opportunities. Our regional Designated Midwifery Officer (DMO) within the HSE ensures that we are competent and safe to practice and who also ensures that all our equipment is checked on a yearly basis.

Once you realise you are pregnant you will need to make contact with your G.P. to arrange referral to the hospital of your choice. This ensures that you have access to obstetric and midwifery support, blood tests and ultrasound if and when you may need it. At the same time you may be looking for a midwife with which to discuss homebirth as an option. This booking appointment with your hospital typically occurs between 11 and 14 weeks. Most hospitals offer a dating scan at this time and a further detailed wellbeing/anomaly ultrasound is offered between 18 to 22 weeks of pregnancy. Bloods are obtained at your first visit to check for your blood group, iron levels and serology. A further blood test is taken to confirm your blood group and check your iron levels at 28 weeks of pregnancy approximately. Outside these appointments your midwife will discuss with you the need to attend for further hospital appointments depending on logistics, your schedule of care and the availability of your G.P. A significant portion of G.P.’s in Ireland have an insurance policy which prohibits them from providing care to mothers who are choosing to birth at home. This has no implications for your maternity care until you have been confirmed by the Designated Midwifery Officer (DMO) as being accepted on to the HSE homebirth scheme. Typically this does not happen before 24 to 26 weeks of pregnancy. For the purpose of vaccinations, prescriptions and completing maternity leave documentation it is ideal to have this completed before confirmation of your homebirth eligibility is received by your G.P. Prior to this documentation you have the same access to your G.P. as any other pregnant person. Some G.P.’s value the long relationship they have with you, their role within your family and the fact that they are in no way involved in the birth itself and will continue to offer their support as normal.For most babies the early newborn check will be required to be done before 72 hours of age within the hospital where you were originally booked by a suitably qualified doctor or midwife with the relevant set of skills. Your midwife will arrange this for you both. The G.P. will resume care for the two and six week appointment once this check has been completed as stated within their insurance policy