Choosing your birth care provider
Lads, I know, it’s a bit of a minefield! I know on my first pregnancy I just did what my friend did. I did zero research into what kind of pregnancy and birth care I was buying into, something I deeply regret. I regularly get asked what options are available, so I thought it might be helpful to list some of them out here for reference. I have included the options I am aware of. I know more about homebirth and midwife led options as you will see!
Homebirth
So many women aren’t even aware this is an option for them and a safe one too. Of course there are some circumstances that may prevent a woman from accessing this service but so many of us can safely deliver at home, in our own environment, under the watchful eye of our highly trained midwife and snuggle up in our own bed after with our baby. Personally, I can’t recommend this option enough if it’s something you feel drawn to. It’s so important you feel safe wherever you birth and that’s why it is such a personal choice. But the evidence shows it is safe.
Home birth is as safe as hospital birth. In fact some studies have shown home birth to actually be safer than hospital birth. Aims, Ireland
HSE
The National Home Birth Scheme is run on behalf of the HSE by Self Employed Community Midwives (SECMS). You can find more information out here.
Hospital based
The DOMINO scheme, which operates out of the National Maternity Hospital in Dublin provides women within a certain catchment area the option to birth at home. This is what I personally did for my second birth and first homebirth. You can find out more on the service here.
Other hospitals that offer a homebirth service are:
Waterford Domino/Home Birth Service Phone Janet Murphy 087 9243538
Wexford Maternity Unit Phone Sue Ryan 053 9153000
Private care
The third option and my personal favorite is Private Midwives Ireland. I had Liz as my midwife and the level of care as well as the continuation of care was literally outstanding. Needless to say I’m going with Liz again this time. The other notable thing about this service is as they are under UK law, they are not bound to the same restrictions as the two options mentioned above. Some moms, who for example have had a previous section, conceived through IVF or complication may still be eligible for this service and it is decided based on individual circumstances rather than a one rule for all. The whole service is highly personal. If you have health insurance it is covered depending on your package. There is a huge choice in care packages starting as late as 36weeks. You can out more here.
For women who commence labour in our care, 89% go on to have a normal, healthy birth without medical intervention. This includes some women who have not had straight forward pregnancies in the past.
Private Midwives Ireland
You can find out more general information about homebirth services available within Ireland here.
Midwife led care/ Domino Services
So, there are different options depending on your hospital of choice. Some hospitals offer a domino service and it is different in it’s nature to midwife led care. Domino schemes are smaller in nature and so you may meet the same midwives at many of your visits. One of the domino midwives will also usually look after you in labour, which is lovely as you may have met them before. It is for women who hope to have an unmedicated birth and it is a public option, meaning it is free of charge. These services sometimes are combined with your GP and operate out of satellite clinics that may be closer to your home as well as an early transfer home scheme, where your midwife will visit you at home in the days post birth. The NMH describe the service as:
This is midwifery led care from the beginning of your pregnancy, during labour and until your baby is 5-10 days old. Antenatal care is provided by a team of midwives in one of our community based clinics. Our ethos while caring for you and your baby is to encourage and support normal childbirth with minimum intervention, with the aim of early discharge from 6 hours post delivery. The team will continue to provide postnatal care, support and advice in the comfort of your own home, for 5-10 days following discharge from the hospital.
NMH, Domino Scheme
Hospitals that offer this service are:
Waterford regional Phone Janet Murphy 087 9243538
Midwife Led Care
A lot of hospitals offer midwife led care for low risk women. It is a public option and you may meet different midwives at every visit. Midwife led care in general has less birth intervention rates than consultant led care. Check out your local hospital to see if they offer this option! Our countries cesarean rates are way over the World Health Organisation recommendations at present. The rates are up 50% since 2000. You can find out more about intervention rates in Ireland here.
The Coombe, Drogheda and Cavan offer water birth options.
A good reference for all care options in Ireland is available here.
Consultant led care
This is the area I know the least about. It’s available nationwide and can be broken into three subsequent categories public, semi private and private. Consultant led care is designed to cater for women who may be deemed high risk and need closer monitoring throughout pregnancy. That said, lots of people opt for this option for a wide variety of reasons. If you are public you will be seen by one of your consultants team at your visits and visits can be notoriously long, so bring a book! Semi-private and private options are usually quicker, with private being the most efficient. The other difference is the room you are in post birth. That said, you are not guaranteed a private room if you go private, but you will receive one if it’s free.
You may or may not have your consultant for your delivery and a lot of labour ward care and delivery is carried out by midwives. If you are having a planned cesarean you generally will have your consultant. I went semi-private on my first baby as I didn’t know midwife led care was even an option at the time. I was seen by my consultant at visits and during labour midwives looked after me for the most part. A consultant who was on the ward came in for the birth as I ended up having quite a lot of intervention.
Of course it is possible to go with a consultant and have an intervention free birth, it’s just that it can be more difficult to achieve. Frustratingly IVF is still considered a high risk pregnancy and lots of women who would love to have midwife led care cannot access it in Ireland. One exception is homebirthing with Private Midwives Ireland.
If you are hoping for a Vaginal Birth After Cesarean (VBAC), it’s worth choosing your consultant and checking out their cesarean and success rates of VBAC. Check out your local hospital and look into the consultants.
As with all birth avenues I always recommend using Gentlebirth as it changed my birthing game, you can find out more here. I hope this has helped explain some of the options that may be available to you! Wishing you a very healthy and happy pregnancy!
Aisling xx