Sir, - As independent midwives, we wish to express our outrage that a member of the National Expert Group on Home Birth should be recommending a change in the law entitling women to a home birth service from the state ("Fundamental rights the issue at stake", Features, April 11). In view of Dr Michael Mylotte's intention to restrict women's rights in this area, as well as his alarmist views on home birth ("Women's Right to Home Birth on Trial", Features, March 27th), his membership of the National Expert Group is surely bo longer tenable.
Michelle McDonagh's interview with Dr Mylotte was riddled with contradictions, and Marie O'Connor is to be congratulated for making sense of it. Low-risk pregnant women, Ms McDonagh said, were now being given the choice of home birth "under the supervision of a trained midwife". This choice has always been there. Independent midwives - the specialists in home birth - have been providing this service for years, safely.
Doctors cannot guarantee total safety in hospital, according to Dr Mylotte: "If we cannot achieve 100 per cent success in hospitals, how can we achieve it at home?" This is a good question, and the answer to it is to be found in the many studies on domiciliary midwifery care. Dr Mylotte is wrong about the risks of planned home birth. Midwifery care in the home, as Marie O'Connor said, is as safe, if not safer, than hospital delivery under medical supervision. A national survey on planned home birth in Ireland has shown that domiciliary midwives are providing a service which compares well with the best in the Netherlands, a country with a 35 per cent home birth rate, where midwives are recognised as independent professional practitioners.
To assume that all home births in Ireland are planned, as Michelle McDonagh did, is nonsense. For every planned home birth in Ireland, there is an unplanned out-of-hospital delivery. These babies are known as BBAs, or Born Before Arrivals, to use the trade description. This gets over the inconvenient fact that centralising birth in large hospitals does not cater for the needs of childbearing women in rural areas. Independent midwives are the only care providers at present filling this gap. The alternative to planned induction - if you live in West Cork and you have a history of short labour - is planned home birth.
For the record, the major providers involved in the delivery of maternity care services, namely midwives, are not represented on the National Expert Group on Home Births. The other majority stakeholders in maternity care not at the table are women. Perhaps the group would now consider inviting representatives both of home birth providers (independent midwives) and home birth consumers (mothers) to become part of a more transparent and accountable process. The alternative is to continue to put the fox in charge of the chickens. - Yours, etc.,
Bridget Sheeran, Barr na Farraige, Baltimore, Co Cork.
Philomena Canning, Loreto Avenue, Dublin 14.
Ann Kelly, Temple Crescent, Monkstown, Co Dublin.