Home birth is safe and women at low risk around the State should be offered it as an option, according to a report prepared for the Health Service Executive.
The Domiciliary Births Group report, submitted to the HSE last December, but not yet published, has found that home birth is a safe option for low-risk women "where adequately resourced and supported".
It recommends that the service should be offered throughout the country and integrated hospital and community midwifery services should be developed and extended nationally.
It also recommends that midwifery-led units be established by all maternity hospitals and continuity of care should be a feature of all models of maternity care.
The group found that continuity of care has been associated with a lower rate of interventions and increased satisfaction in childbirth, and that evidence does not support high levels of monitoring and intervention for all pregnant women.
It also found that people want a woman-centred maternity service and that those who used pilot schemes around the country were happy with them.
"Midwives are key providers of care to pregnant women throughout pregnancy, childbirth and the postnatal period," it said. "They should be the lead carers for low-risk pregnancies."
The group was set up following a Supreme Court ruling in 2003 which said health boards were not legally obliged to provide home birth services.
It looked at various models of maternity care around the country, including private home births, community outreach projects and pilot programmes offered in some health board areas such as the Western Health Board Integrated Home Birth Project.
It also looked at available literature and strategy documents on maternity care. It held information sessions with women around the country and reviewed submissions on maternity care from individuals and interest groups.
The report, headed by Cate Hartigan, assistant national director at the HSE, is to be followed up by the establishment of a national implementation committee.
Guidelines are also to be developed for the selection criteria used by women and their health care providers to determine appropriate care.
The group recommended that in the absence of a structured, funded domiciliary service, a standard grant should be paid to women who wish to engage private midwives. It recommended that a second midwife attend home births where feasible.
The report recommended the continuation of the National Maternity Hospital's domino/hospital outreach home birth service, and the continuation and development of the South Eastern area's integrated hospital and community midwifery service and the Southern area Home Birth Service.
