Leading article: The growing demand for home births

WHERE A woman has her baby and, more importantly, who has control of her while she is having it has long been a matter of acute sensitivity in medicine. Home births, which were once the norm, have given way to hospital-based deliveries, and 98 per cent of us now start our lives in these palaces of disease.

It is precisely because they are associated with disease and illness that increasing numbers of women are now choosing the option of a home birth. The medicalisation of birth, while it has achieved dramatic gains in safety, has neglected the human side of one of the most intense emotional experiences that mothers - and fathers - undergo. Although gestures have been made towards improving the experience of childbirth in hospital, with pastel colours, flowered curtains and one-to-one care from midwives, for many women the experience is still sterile, impersonal and unsatisfactory.

Ann Kelly's battle with Dublin's medical authorities, who have accused her of putting at risk a mother in home labour, encapsulates the conflict between safety as judged by the hospital consultants in charge and choice as seen by the midwives and the women they represent.

While the Irish Nurses Board appears to have acted heavy-handedly and with scant regard for the correct procedure, the key issue is whether Ms Kelly, and midwives like her, provide safe care. Safety must be paramount for mother and baby, and that will be decided by the inquiry that has begun and that will continue on 21 June.

But what the case has already demonstrated is that there is a growing demand for a different kind of care - one that is more personal and more intimate than that currently provided in hospital - from women. Those who run the maternity services ignore that at their peril.