Home-birth system is a ‘risk to patient safety’, audit finds

The current home-birth system in Ireland creates a “risk to patient safety”, an internal health audit has found.

The Health Service Executive (HSE) audit reached this finding as there is no agreed maximum safe travel time to the nearest maternity unit or self-employed community midwife (SECM).

In February 2022, the home-birth service was moved from community operations to acute operations and is now integrated into the 19 maternity services nationwide.

In light of this, the HSE conducted an audit to establish the “adequacy and effectiveness of governance and risk management” of the home-birth service.

The auditors examined three sites – Cork University Maternity Hospital, Rotunda Maternity Hospital and the Coombe Maternity Hospital – and reviewed 30 midwifery notes relating to home births that occurred from March 1st, 2023, until February 29th, 2024.

It found weaknesses in the system of governance across all three sites that the audit said created a “significant risk that the system will fail to meet its objectives”.

According to the audit report, there is “no national governance structure in place” for home births as acute operations no longer has oversight due to the reorganisation of the HSE into the six health regions.

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Source: Irish Times, 23 September 2025