Jersey's home birth suspension remains in place

More than a year on, islanders have been told that home births will remain paused.

No date has been given for the service's return, but the Health Department has announced in the States Assembly that the Maternity Unit will need to do a safety review before it returns.

Politicians have asked for a timeline of the review and have questioned why women are not being given options.

Assistant Health Minister Andy Howell says we need to have a safe service.

"Any service that is provided has to be safe, and that is the only consideration I am able to give.

"It will be a clinically led decision.

"I agree that perhaps at the moment women are not given every choice, but my priority is safety for our mothers and our babies.

"The Coroner has decreed that this has to be a nationwide look at home births and safety, so until all of the review is carried out by Jersey in relation to this, we cannot restart the service."

Assistant Health Minister Andy Howell

The Coroner's report into the death of a woman and her baby in Manchester highlighted a lack of national guidance in respect of home births, and that there has been an increase in women with 'high-risk pregnancies' requesting one, despite being in a setting where interventions cannot take place or are 'significantly' delayed.

The report says that Jennifer Cahill was pregnant with her second child, Agnes, in 2023, and despite her pregnancy being considered 'low-risk', she was referred to a consultant due to complications in her first labour, with haemorrhaging.

Coroner, Ms Joanne Kearsley, notes that it was assumed that Jennifer would be delivering her second child in the hospital, although there was no conversation about her intentions. However, in June 2024, she went into labour and proceeded with a home birth.

Ms Kearsley says that Jennifer received 'ineffective pain relief' due to issues with the Entonox (gas and air), she had a raised blood pressure, and her baby had decelerations in fetal heart rate, up to an hour before delivery.

Agnes was born, but resuscitation was 'not conducted' effectively. The Coroner believes it was 'hampered by a split in the bag valve mask' and went unnoticed on arrival when the equipment was checked.

Paramedics took the newborn baby to the hospital after effective resuscitation, but Jennifer suffered a fourth-degree tear during labour, which resulted in a post-partum haemorrhage shortly after birth.

After delivering the placenta, she suffered a second post-partum haemorrhage and went into cardiac arrest around 40 minutes after giving birth to her daughter.

She passed away in North Manchester General Hospital two days later.

Agnes was initially taken to North Manchester General Hospital but transferred to the neonatal intensive care unit at Royal Oldham Hospital, where she died on 7 June 2024, three days after her mother. 

The report says that of 29 out-of-guidance home births, 15 (50%) required transfer to the hospital for varying degrees of obstetric emergency.