Birth stories · Episode 4

Giving birth in the Azores: a hospital fire, a midwife on a plane and a home birth

When the maternity ward burned weeks before her due date, Irene Jaspers had 24 hours to choose a new plan. Her story of trusting her body in the Azores.

Born to be Wild · 2026-09-28

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Irene Jaspers, co-host of the Born to be Wild podcast, lives on Santa Maria, the southernmost island of the Azores: about 6,000 inhabitants and no maternity care. On episode 4, she sat on the other side of the microphone to tell Aviva Markowicz the story of her second birth, the one that made her become a doula.

Pregnant on an island without a maternity ward

On the smaller islands of the Azores, pregnancy comes with logistics:

Scans and exams often mean a flight to a bigger island. Inter-island planes work "more like a bus".
Around 36 weeks, pregnant women are sent to another island, usually São Miguel, to wait for the birth near a hospital.
Without family nearby, Irene and her husband rented a house near Ponta Delgada, found a babysitter for their son Sam, and even shipped their car.

Irene had a wonderful pregnancy: training four or five times a week, hiking, walking 15,000 steps a day until the end. Her follow-up mixed care in the Netherlands, visits to the local health centre and a doula on São Miguel, since there were none on Santa Maria.

Weeks before the due date, the hospital caught fire

Days before she was due to fly to São Miguel, the public hospital where she planned to give birth caught fire, and the maternity ward was destroyed. Care moved to the private hospital, and her monitoring appointments were cancelled.

At 37 weeks, her doula described the reality: partners not allowed in the delivery room, women giving birth in shared rooms, epidurals and synthetic oxytocin used to keep things moving in a crowded, improvised space. Irene nearly cried.

"When you give birth as a woman, you want to feel safe. This felt like the least safe scenario I could have imagined."

Plan B: a midwife flying in from Lisbon

In the same conversation, the doula offered another option: an independent midwife from the mainland would fly in when labour started and support a home birth in their rented house.

Her husband was hesitant at first, as partners often are. After a day of talking it through, they agreed, on one condition: it had to be medically safe. All the equipment would be ready, and if the midwife couldn't arrive in time, Irene would go to the hospital.

The midwife was Raquel Cajão. She reviewed Irene's files and asked a question Irene loved: what does your intuition say about when your baby will come? Irene answered: two or three days after the due date. She was right.

Saying no in the emergency room

At 40 weeks and one day, with early contractions, Irene went to the private hospital's emergency service just to get a document stamped. After half an hour on the CTG, the team wanted to admit her and do a vaginal exam. She declined, then declined an internal ultrasound, and accepted only an external one.

Four nurses kept pressuring her, telling her "every woman in Portugal gives birth like this", and even that her baby would die if she went home. Only the gynaecologist was supportive. Her husband wasn't allowed in the room.

"That was one of the worst experiences of my life. I started crying."

She respects how hard the staff were working in an improvised setting, in a hospital used mostly for C-sections. But it was not respectful communication. In the end, she went home.

Remember: you can say no to any medical exam or procedure. Portuguese law guarantees the right to informed consent and to informed refusal, including in the emergency room (Lei n.º 15/2014).

Labour at home: techno, a birth pool and a loud "bang"

The next day was calm: a long drive with her husband, Sam at the babysitter, spicy Indian food in the evening. When she lay down to cuddle her son to sleep, "the oxytocin hit me".

She sent her husband to bed so he could rest, and laboured alone in the bath with her headphones on, listening to techno and rock "like a little party". Around 1 a.m. the contractions got strong. The midwife and doula arrived ten minutes later and set up the birth pool.

Warm water poured over her back eased her back labour.
Sitting on the toilet helped a lot: for Irene, it's a place where the body lets go.
Raquel never did vaginal exams. Instead, she encouraged Irene to feel her own dilation, and the baby's head.

At 5 a.m., sitting on the toilet, her waters broke with such a bang that everyone ran in, thinking the baby had fallen. Irene burst out laughing.

Transition, a 20-minute nap, and a gentle birth

Transition brought every emotion. Irene begged her husband for this to be her last birth. Once fully dilated, her contractions paused and she fell asleep for about 20 minutes with her face in her doula's hands, while the midwife lit the fireplace.

Then came the urge to push. Exhausted, Irene wanted to push actively, but Raquel suggested waiting until the urge to push came on its own, rather than pushing on command. Many midwives prefer to let the body lead. Research comparing spontaneous and directed pushing hasn't found a clear difference in tearing, and directed pushing hasn't shown clear benefits either (Cochrane, 2017). About 15 minutes later, her daughter was born in the water. She was calm and took her time, then found the breast on her own.

Her son slept through the whole birth and woke up an hour later, amazed to find a baby and a bathtub in the living room.

What made the difference

Knowing herself. Irene had read books and listened to many birth stories. Her mantras were "when you think you can't go on, you're only at 40%" and "this too shall pass, we're not in a rush".
Trusting her body rather than relying entirely on professionals, as she had the first time.
A network of women: a doula, and a midwife who got on a plane.

"Your birth doesn't have to look like anyone else's. It just has to feel like yours, and it has to feel safe."

Read the next chapter of this story: Raquel Cajão, the midwife who flew in, on home birth in Portugal.

Frequently asked questions

How does giving birth work on the smaller Azores islands? In Irene's experience, islands without a maternity unit send pregnant women to a bigger island around 36 weeks, to wait for the birth near a hospital. Check with your health centre, and plan the logistics early: housing, childcare, and support.

Can I refuse a vaginal exam in a Portuguese hospital? Yes. The law guarantees your right to information, informed consent and informed refusal (Lei n.º 15/2014). You can ask what an exam is for, request an alternative, or decline.

Can a midwife from the mainland support a home birth in the Azores? In Irene's case, an independent midwife from Lisbon flew in once labour started. It requires planning, a healthy pregnancy and a clear hospital plan B. Find a midwife in our directory.

Sources

What our guests share comes from their own experience and practice. The medical and legal information in this article is based on the sources below. It doesn't replace advice from your care team.

Listen to the full episode

This article is based on episode 4 of Born to be Wild, the podcast: A hospital fire. A midwife who got on a plane. And a home birth., with Irene Jaspers. Listen on Spotify.