References
Deliberately unassisted birth in Ireland: Understanding choice in Irish maternity services
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).
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