The Registered Home Births in Ireland Annual Report published by the HSE in collaboration with the NPEC, presents an overview of the home births service provided by Self Employed Community Midwives (SECMs) and Integrated Hospital Community Midwives (ICHMs) in the Republic of Ireland for the year.
The primary aim of this audit is to provide national statistics and an overview of findings from the HSE home birth service in the Republic of Ireland (ROI).
This audit aims to collect data on the clinical care and outcomes for all women who registered for a home birth, examining both the maternal and infant outcomes of planned HSE home births, including outcomes whereby the care of the woman is transferred for hospital care in the antepartum, intrapartum
or postpartum period. Thus, facilitating maternity services to undertake reviews of its own practices, through monitoring these outcomes with regular audit. This information is essential to ensure that standards of home births in ROI are met.
The report draws on information collected from the planned home birth in Ireland audit, offering an informative resource for those clinicians providing guidance to women and for the women themselves to be self-informed in a clear and transparent manner in relation to home birth as an option in Ireland. The content of each
report reflects the commitment and hard work of many people involved in the maternity services, to which we are very grateful.
For further information on the Registered Home Births Audit, please contact Indra San Lazaro Campillo (indra.campillo@ucc.ie) or Jessica Keane (jkeane@ucc.ie)
Latest Recommendations from the 2021 Annual Report
It is recommended that the home birth service identifies a communication pathway to continue to capture
data points when a woman’s care is transferred to the maternity unit.
A high percentage of cases submitted to the NPEC have a level of missing information, exacerbated following a transfer of care. To more accurately capture the outcomes of both mother and baby in these circumstances, it is recommended that communication pathways are further supported between the services. Gaining access to electronic records, where relevant, for the home birth services may facilitate this further.
Newborn Infant Physical Examination (NIPE) availability in the community setting.
Further work to be done to improve access to midwives trained in NIPE exam for home birth population in order to facilitate newborn examination being completed in the community. Of the infant’s born at home, 75.0% (n=183) had their newborn examination completed in the hospital in 2021.
Continue to encourage presence of a second midwife at the home birth.
The presence of two midwives at the home birth has been a mandatory part of the service since 2014 (Annex 1). This should continue to be encouraged as an important safety measure when providing community care.
Further detail regarding the factors influencing length of transfer should be examined.
As transfer times are a crucial component of safe and efficient care, further detail around the factors that may influence the length of a transfer should be further examined as part of this clinical audit. Including, defining the start and end times as a standard point of reference and to capture further detail on the communication with the other support services.
