References

Brown LA Birth visionaries: an examination of unassisted childbirth.Boston, MA: Boston College; 2009

Cameron HJ Expert on her own body: contested framings of risk and expertise in discourses on unassisted childbirth.Ontario: Lakehead University; 2012

Chervenak FA, McCullough LB, Brent RL, Levene MI, Arabin B Planned home birth: the professional responsibility response. Am J Obstet Gynecol. 2013; 208:(1)31-8 https://doi.org/10.1016/j.ajog.2012.10.002

Cheyney MJ Homebirth as systems-challenging praxis: knowledge, power, and intimacy in the birthplace. Qual Health Res. 2008; 18:(2)254-67 https://doi.org/10.1177/1049732307312393

Cheyney MBelmont, CA: Wadsworth Publishing; 2011

Dublin: Comhairle na n Ospidéal; 1976

Community Midwives Association. Welcome to the Community Midwives Association. 2015. http://communitymidwives.ie (accessed 18 January 2016)

Dahlen HG, Jackson M, Stevens J Homebirth, freebirth and doulas: casualty and consequences of a broken maternity system. Women Birth. 2011; 24:(1)47-50 https://doi.org/10.1016/j.wombi.2010.11.002

London: The Stationery Office; 1993

Department of Health. Independent review of the requirement to have insurance or indemnity as a condition of registration as a healthcare professional. 2010. http://tinyurl.com/gthcb6q (accessed 12 January 2016)

London: The Stationery Office; 1970

Dublin: ESRI; 2012

Edwards NPLondon: Routledge; 2005

Feeley C, Burns E, Adams E, Thomson G Why do some women choose to freebirth? A meta-thematic synthesis, part one. Evidence Based Midwifery. 2015; 13:(1)4-9

Freeze RAS Born free: unassisted childbirth In North America.Iowa City, IA: University of Iowa; 2008

Dublin: HSE; 2004

Dublin: HSE; 2008

HSE, Dublin: Quality and Patient Safety Audit. Final Audit Report; 2012

Health Service Executive. National Home Birth Services. 2013. http://www.hse.ie/eng/services/list/3/maternity/homebirth.html

Home Birth Association of Ireland. HBA statement re: Dr. James Reilly statement 2012/06/05. 2012. http://tinyurl.com/jnwgwut (accessed 18 January 2016)

Jackson M, Dahlen H, Schmied V Birthing outside the system: perceptions of risk amongst Australian women who have freebirths and high risk homebirths. Midwifery. 2012; 28:(5)561-7 https://doi.org/10.1016/j.midw.2011.11.002

Janssen PA, Henderson AD, Vedam S The experience of planned home birth: views of the first 500 women. Birth. 2009a; 36:(4)297-304 https://doi.org/10.1111/j.1523-536X.2009.00357.x

Janssen PA, Saxell L, Page LA Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ. 2009b; 181:(6–7)377-83 https://doi.org/10.1503/cmaj.081869

Kenny E, OBoyle C An exploration of the unmet demand for home birth in Ireland. Int J Childbirth. 2015; 5:(1)20-32

2001. http://tinyurl.com/hfvkqnh (accessed 12 January 2016)

KPMG. Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area. Final Report. 2008. http://tinyurl.com/zeyumnp (accessed 12 January 2016)

Lundgren I Women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care. Sex Reprod Healthc. 2010; 1:(2)61-6 https://doi.org/10.1016/j.srhc.2010.02.001

Macfarlane AJ, Blondel B, Mohangoo AD Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study. BJOG. 2015; https://doi.org/10.1111/1471-0528.13284

Meaney S, Sweeney S, Delaney JCork: Health Service Executive; 2013

Miller AC “Midwife to Myself”: Birth Narratives among Women Choosing Unassisted Homebirth. Sociological Inquiry. 2009; 79:(1)51-74 https://doi.org/10.1111/j.1475-682X.2008.00272.x

Miller AC On the margins of the periphery: unassisted childbirth and the management of layered stigma. Sociological Spectrum. 2012; 32:(5)406-23 https://doi.org/10.1080/02732173.2012.694795

Murphy-Lawless JCork: Cork University Press; 1998

National Institute for Health and Care Excellence. Intrapartum care for healthy women and babies. 2014. http://www.nice.org.uk/guidance/cg190 (accessed 12 January 2016)

Dublin: National Maternity Hospital; 2015

National Perinatal Epidemiology Unit. Birthplace in England Research Programme. 2015. http://www.npeu.ox.ac.uk/birthplace (accessed 12 January 2016)

Dublin: NMBI; 2015

Nursing and Midwifery Council. Free birthing. 2012. http://tinyurl.com/j8w98fa (accessed 12 January 2016)

OBoyle C ‘Just waiting to be hauled over the coals’: home birth midwifery in Ireland. Midwifery. 2013; 29:(8)988-95 https://doi.org/10.1016/j.midw.2012.12.010

OBoyle C The context and consequences of professional indemnification of home birth midwifery in Ireland. Int J Childbirth. 2014; 4:(1)39-54 https://doi.org/10.1891/2156-5287.4.1.39

: Supreme Court (Irl.); 2003

Percival R The management of normal labour. Practitioner. 1970; 204:(221)357-65

Rothman BKNew York: WW Norton and Co; 1991

Royal College of Midwives, Nursing and Midwifery Council. 2011. http://tinyurl.com/gr3jj2f (accessed 12 January 2016)

Shanley LK, 2nd edn. Santa Barbara, CA: ABC-CLIO; 2012

Stake REThousand Oaks, CA: SAGE Publications; 1995

: IEHC 383; 2013

Wickham S Unassisted birth: listening and learning from the minority. Pract Midwife. 2008; 11:(6)4-5

Worman-Ross K, Mix TL “I wanted empowerment, healing, and respect”: Homebirth as challenge to medical hegemony. Sociological Spectrum. 2013; 33:(5)453-81 https://doi.org/10.1080/02732173.2013.818509

Yin RK, 5th edn. Thousand Oaks, CA: SAGE Publications; 2013

Deliberately unassisted birth in Ireland: Understanding choice in Irish maternity services

02 March 2016
13 min read
Volume 24 · Issue 3

Abstract

Four individual cases of professionally unattended birth are used to explore the larger ‘case’ of homebirth service provision in Ireland. The women in these cases were unable to access midwife-attended homebirth. They depended on emergency services for hospital transfer. They hid their intention to birth unattended in order to avoid criticism of themselves or their lay attendants. Current Irish Health Service Executive (HSE) homebirth provision does not adequately address demand for homebirth in Ireland. Some women, including those considered too high-risk for homebirth, will choose to birth alone if midwifery attendance is unavailable.

In Ireland, some women who are unable to access a midwife-attended homebirth are choosing to give birth at home without assistance. This paper describes the experience of four such women, whose stories reveal the context and larger case of the Irish homebirth service. Background literature on unassisted or ‘freebirth’ is followed by an outline of current Irish homebirth services, illustrating the context of the women's decisions.

Deliberately unassisted birth, where the option of birth attended by a trained professional is freely available, has been called ‘freebirth’ (Shanley, 2012). Freebirth must be acknowledged as a ‘choice’ only in resource-rich contexts where access to hospitals and trained birth attendants is largely unproblematic (Lundgren, 2010).

In countries such as Ireland, the UK, New Zealand and the Netherlands, midwife-attended birth is the norm and, to varying degrees, homebirth is accommodated. Freebirth, however, is seen as an active rejection of cultural birth norms and is described as an explicit critique of the dominant maternity services (Miller, 2012; Worman-Ross and Mix, 2013).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • Unlimited access to the latest news, blogs and video content

  • Monthly email newsletter