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birth place
Rural home births may be restricted as HSE stands by 30-minute distance limit
Noteworthy reveals this restriction was raised as ‘non-negotiable’ at a HSE meeting in March despite protestors feeling the issue was resolved last year.
WOMEN IN RURAL Ireland who want to have a home birth may face restrictions as the HSE still wants them to live no further than a 30-minute ‘blue light’ ambulance distance from a maternity unit.
The HSE has confirmed to Noteworthy that the controversial guidance “remains in place” despite protests against it last year – and an inconsistent take-up of the advice by some hospital groups.
Last summer, key leaders within the HSE recommended that “all women accessing the National HSE Home Birth Service would reside 30 minutes or less blue light distance from their nearest maternity service” – that is the distance ambulances can travel with their siren or ‘blue light’ on.
However, when pushed on lack of implementation of this guidance, a HSE spokesperson said that it is “it is guidance, not a rule” so it remains unclear whether the 30-minute ‘blue light’ guidance is being followed by any maternity unit or if policies will be changed.
Noteworthy asked each hospital group for restrictions in place, including in relation to distance, but most redirected our query to the HSE.
The Community Midwives Association and a number of campaign groups that we spoke to raised the lack of evidence used to come up with the 30-minute distance.
“There’s no evidence nationally or internationally that recommends a certain distance from the woman to the hospital,” according to Aisling Dixon, chairperson of the Community Midwives Association.
Noteworthy, the crowdfunded community-led investigative platform from The Journal, supports independent and impactful public interest journalism. Support our work here>>
Though obstetrics professor Richard Greene isn’t involved in home birth policy, as director of the National Perinatal Epidemiology Centre (NPEC) he has overseen a number of audits of the home birth service.
The results show “home births are quite safe in Ireland so there’s no reason” for the service to be discontinued. He added that the NPEC hasn’t “identified any issues with regard to distance”.
A geospatial analysis, obtained by Noteworthy through Freedom of Information (FOI) – which we are making available online here – was conducted to assess the areas covered by ambulance ‘blue light’ travel speeds.
Large parts of rural Ireland (outside the red zones below), in particular along western counties as well as Wicklow in the East were to be excluded from access to home births if this recommendation was implemented.
Indicative ambulance travel time zone for 30 minutes Health Atlas Ireland Geospatial Analysis (via HSE FOI)
Health Atlas Ireland Geospatial Analysis (via HSE FOI)
The South/Southwest Hospital Group (SSWHG) – covering Waterford, Cork, Kerry and Waterford – had requested such guidance be drafted by the HSE.
Following protests by advocates including Births Rights Alliance Ireland last year, the hospital group then said there was no change “in terms and time and distance”, with home births in the area proceeding as normal.
This was noted in SSWHG minutes in December where it also stated that a “due diligence process” was to be completed.
As far as midwives and campaigners across Ireland are concerned, no change has been implemented. But minutes of the HSE Homebirths Committee reveal that official policy states otherwise.
In March 2023, months after these protests had resolved, John Smith, the HSE’s Assistant National Director Acute Operations, stated that “this is clinical advice and [in] his understanding it is non-negotiable”.
Noteworthy obtained these minutes through FOI as part of our BIRTH PLACE investigation examining lack of choice for expectant mothers – being published across this week.All of the meeting minutes we obtained are online here>>
When asked for an update given this “non-negotiable” stance, a spokesperson for the HSE stated that the “30-minute ‘blue-light’ guidance remains in place and will be kept under review”.
It is important to note that the 30-minutes is a guide for maternity networks when assessing requests for a homebirth.
They added that “it is provided to support decision making, in conjunction with clinical judgement”, as well as the eligibility criteria for HSE home births.
Midwives unaware guidance in place
From a HSE perspective it is “in place” but, as yet, there is a very different story happening on the ground.
The service is delivered by self-employed community midwives (SECMs). Dixon from the Community Midwives Association is a practising SECM in the Ballinasloe area.
She was unaware of any HSE meetings this year in relation to the 30-minute guidance. SECMs had not been involved in any discussions about this guidance since the controversy was supposedly resolved last year, according to Dixon.
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“We’re not aware of a woman being denied access to a home birth because her home address is more than 30 minutes from her nearest hospital.”
No SECMs were at the HSE Homebirths Committee Meeting in March, with attendees made up entirely of staff from both the National Women and Infants Health Programme (NWIHP) and Acute Operations.
Dixon also said that they have not been told by the HSE that this guidance is currently in place.
We would be disappointed to hear it’s on the table. It’s not evidence-based practice.
It is evident from minutes of the various meetings last year that strong objections were made by midwives, including SECMs, Designated Midwifery Officers and Irish Nurses and Midwives Organisation (INMO) representatives.
Added stress during pregnancy
Hayley Purtill-Quin (pictured on right) holds her son after giving birth Hayley Purtill-Quin
Hayley Purtill-Quin
We spoke to a number of women who live outside the 30-minute blue light distance and had or were planning a home birth during the period of uncertainty last year. They all commented on the extra stress it added, especially towards the end of their pregnancies.
Hayley Purtill-Quin said that this restriction was recommended when she was around 38 weeks pregnant. She lives in Co Wicklow and her location falls well outside the 30-minute distance.
She looked into other options, including relocating for the birth, but the restriction was not implemented in the end so this was not needed.
The birth of her son, her second child, turned out to be extremely quick: “I think I gave birth within 30 or 40 minutes of realising I was in labour”.
Had she not planned a home birth, she said that “it would have been really stressful and traumatic” as it would likely have been at the side of the road on the way to the hospital.
Instead, two home birth midwives arrived a few minutes after her son was born. “They were monitoring me and looking after me. Everything was nice and calm.
I have no trauma from that birth. I only have positive memories of it.
Sasha Kinch is now also based in Co Wicklow and was supposed to move there before she gave birth towards the end of last year, but stalled her move so that she stayed in her home birth catchment area.
She would now fall outside a 30-minute distance if implemented nationwide and said this would be a factor in her decision to have another child. “That would be very hard for me,” she said.
Sasha Kinch at home during labour last year and with her daughter and son this month. Sasha Kinch
Sasha Kinch
‘Basic standard’ not met by analysis
Concerns over lack of evidence for this guidance was noted in minutes of hospital group and HSE meetings last year, with two Designated Midwifery Officers saying in November that the geospatial analysis “does not contain a literature review to inform decision-making” – which they state is “a basic standard requirement”.
The geospatial analysis quotes the HSE’s Midwifery Practice Guidelines which says: “Ideally, the woman should be transferred to an obstetric unit within 30-40 minutes from the phone call to the ambulance service requesting the transfer. However, it is recognised and acknowledged that for many women it commonly takes 60 minutes.”
It states that “this quoted time relates to studies of services” in the UK.
However, when Noteworthy examined the referenced research, there was no reference to any ideal distance or time, only the 60-minutes time taken.
When this was put to the HSE, the spokesperson said that the NWIHP – who developed the guidance – took into account a range of factors “including historic transfer rates into [a] maternity unit of mothers who commenced labouring at home”.
They also used the geospatial analysis to balance the assessment “versus access of women to the service”. This found that over 80% of the projected populations of women aged 15-49 were within the 30-minute zones.
Dixon said that that was a “city-centric approach” and for some midwives in their association, “85% of their practice would automatically be removed”.
The Designated Midwifery Officer for the Cork and Kerry home birth service – where 36% of Ireland’s home births take place – raised this at a hospital group meeting last year. She said that two-thirds of women due to give birth between November 2022 and February 2023 were “outside the 30-minute boundary”.
Areas covered by the 30-minute distance in Cork (left) and Kerry (right) Health Atlas Ireland Geospatial Analysis (via HSE FOI)
Health Atlas Ireland Geospatial Analysis (via HSE FOI)
The HSE also told Noteworthy that the transfer recommendation was heavily guided by the NICE Caesarean Birth Guideline in relation to a category one caesarean birth – when there is immediate threat to the life of the woman or fetus. In these cases, it is recommended they are carried out “before or within 30 minutes”.
Dixon said that over the past five years “no woman had attended a maternity hospital and required a birth immediately”, which reflects the “good decisions” being made by midwives about when women require hospital transfers.
Home birth information “needs to be followed on an ongoing basis”, Greene said, as is always the case.
“If there’s evidence to support that stance, then fine, then we’d support it. And if there’s not evidence to support it, then we probably need to consider, do we relax it?”
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Hospital groups ‘expressed concerns’
It is clear midwives are not happy. It turns out neither are a number of hospitals.
A survey of the six hospital groups was also discussed at the March meeting of the HSE Homebirths Committee. In it, they were asked whether the 30-minute guidance “has been accepted” or “it hasn’t” by their hospital group.
Dr Cliona Murphy, Clinical Director the HSE National Women and Infants Health Programme (NWIHP) was one of the two key leaders, alongside Angela Dunne – NWIHP’s Lead Midwife – who issued the guidance back in July 2022. Both were at the meeting in March.
In relation to the survey, Murphy said at the meeting that “some answers were surprising, some feedback in writing differs to what was said verbally”.
She had thought only SSWHG and University of Limerick Hospitals Group (ULHG) had “issues with the guidance” but “others expressed concerns in the questionnaire”, and specifically mentioned Ireland East Hospital Group (IEHG).
Nine of the 19 maternity units are covered by these three hospital groups, including the National Maternity Hospital, which falls under Ireland East.
More details of the results of this survey and the concerns of these hospital groups were requested from the HSE, but it did not respond to these queries.
An interview with both NWIHP’s Dunne and Murphy was also requested but this was not accommodated by the HSE.
Choices around maternity care proposed
Though midwives are highly critical of this guidance, they did suggest a number of ways to increase maternity choices and address concerns during a number of documented meetings last year.
One Designated Midwifery Officer suggested last November that it was important to involve both service users and Birth Rights Alliance Ireland in discussions around “the proposed restriction”.
This did not happen, according to Jeannine Webster, midwife and co-founder of Birth Rights Alliance Ireland. The group alongside AIMS Ireland, took part in protests and a march last year when the restricted was put forward.
She told Noteworthy it was the first she had heard of this suggestion and felt the idea of them being involved was a good one. However, she said that the group was “never asked” for their opinion.
Plans for increased community services were also discussed as well as the rollout of improved hospital facilities.
At a meeting in October, in reaction to objections from midwives, the NWIHP “suggested home-away-from-home rooms as a solution”.
Though a nicer environment than a labour ward, these still provide quite a different experience to women than home. They are based in a hospital setting and, depending on the maternity unit, can be obstetric rather than midwife-led. They are also not available in every unit as yet.
When asked about this proposal, a HSE spokesperson said that “all maternity hospitals/units, bar four, have home-away-from-home rooms in place”. They are missing from Portiuncula in Galway, Letterkenny in Donegal, Clonmel in Tipperary and Kilkenny.
Noteworthy is the crowdfunded investigative journalism platform from The Journal. This investigation was proposed and funded by our readers alongside direct support from our investigative fund.
What’s next? We also want to uncover how a broken system is detrimentally impacting women’s health. Help fund this work >>
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@Mirabelle Stonegate:
I suggest you check the prices as they are actually the cheapest way to get around at the moment. Fares reduced by 20% for most people, 50% for students.
Bus to Dublin was €20 for me, €11 on the train. using viamichelin(dot)com estimated car costs to be €16
@Tim Pot: If I want to go to Cork City, I have to pay about €20 for a taxi, or more one way if I want to drive into town for a bus, and pay for parking, then €14 return for a ticket. Then, if I want to go to Dublin, it’s a further €21.49 each way.
Based on the Iaranrod Eireann website, it’s €31.31 each way by car.
So, by car, it’s €62.62 to Dublin. Or to go by train, it’s €97, once a taxi and a bus are added into the mix. €63,50 return, to go by bus, without having to account for the train.
To get a train to Dublin, I have to literally get a bus in the opposite direction first.
@Paddy Bo Diddly: Unfortunately you have to pay the tax and insurance, and NCT, whether you bring the car or leave it at home. The only way to avoid it is to get rid of it altogether which isn’t really an option for most as some of the Donegalese commenters have poonted out.
And if you did that you’d have to get the bus/train/taxis everywhere so you’d likely end up spending more than the tax/insurance would have cost you. Bringing a family anywhere would cost a fortune!
@Paddy Bo Diddly: But most people that use public transport will also have a car, therefore tax and insurance should not be considered, so dave is correct, public transport is still too expensive to encourage people to use it instead of a car. It needs to be less expensive. Trains are now overcrowded in Germany with tickets at €9 per month, thats how we need to be going here in Ireland. We still need to charge to use public transport, but not at the current prices
@Dave Connolly: yeah no idea how this isn’t a commuter train and fare yet. Day out in Dublin on the train for a family of 4 is 75 quid. Makes zero sense to me why it’s so expensive yet naas 15 minutes up the road is only 9€ return
@Paul Owens: you have them costs anyways. Very few people outside the major cities don’t have a car. It’s nearly impossible to not have a car in any county outside Dublin. If you have kids trying to get them to matches is impossible without a car. Ireland isn’t designed to survive without a car unfortunately. But the places that have good train infrastructure trains should be a viable cost option. And at 25 quid return it isn’t. Driving is cheaper even for one person
@Gary: agree with you on a few points there but most people I know who use public transport don’t own a car. Thats why they use public transport. And they choose not to drive because they can use public transport. So it doesn’t need to be factored in for many
@Dave Connolly: factor in the time taken to find a parking space and the stress of driving in Dublin traffic. Average cost of suburban parking is €1.80 per hour and city centre parking €3.50 per hour. Doing business on the train journey can be helpful pre meeting and the benefit of knowing that a couple of pints won’t affect your journey on the way home. If you’re within walking distance of your nearest train station, then it’s a lot less stressful to use the train and the online fares are much cheaper than the €25 you quote. A lot of return fares from most places are good value and allow you to include the city centre return fare on your ticket… There also provincial bus services that are very competitive too.
@Dave Connolly: in Porto at the moment – 3 day travel pass €15, metro, bus and trams. Probably cheaper if you get weekly or monthly pass. Always on time.
@Dave Connolly:
€5 in the difference and you haven’t even paid for parking yet. You can work on the train, read a book etc. When was the last time the train was delayed due to the evening rush hour?
I think it’s you who need to do the Math to be honest.
@Paddy Bo Diddly: I’m sure the insurance, tax and maintenance need to be paid regardless of an occasional train journey! Plus for every additional passenger in the car it soon works out multiple times cheaper.
@Paddy Bo Diddly: Let’s also add in the chaotic seat booking where you may not even get your reserved seat/s. The complete lack of refreshments available on board and having to put up with the antisocial behaviour that occurs quite regularly on board, If the price difference is negligible no one in their right mind would choose it over the comfort and convenience of their car. Sorry but that’s the truth.
@Jim Buckley Barrett: That’s easy if tedious. Try getting from 50 kilometres out of Cork (say to the West) to a village 30 kilometers out of Galway using only public transport – on a Sunday.
I use the train every day for work. I wish I didn’t have to. I wish we had a system like any other European country.
Capacity issues, frequency issues, signalling issues, dirty carriages, etc etc. As someone who uses the train to get to work every day, it is more rare that the train is on time. And connections? You can forget about it. Public transport in Ireland is not punctual and then you end up waiting an hour to make the connection waiting for the next bus/train.
Disgusting system altogether, and anyone who defends it is part of the problem. We are one of the wealthiest countries in the world, why do we have the worst infrastructure in Europe. See: any other country in Europe.
@Tomo: I don’t see either why people without a Leap Card can’t buy a train and DART ticket in one machine. Visitors don’t have a Leap Card handy, they don’t have coins to hand coming from an airport, but they have to queue for vending machines at each leg of a connecting journey.
@Tomo: If you want to get even angrier about our own train service, have a look at this YouTube video by a Canadian living in The Netherlands – he reckons that Swiss trains are even better than his own Dutch ones – it’ll make you sick if you use Irish trains – https://www.youtube.com/watch?v=muPcHs-E4qc
@Fiona Fitzgerald: there is a visitor leap card which is available at the airport. There is a 1, 3 or 7 day card which can be used in all public transport..
Our rail days went with the British, there’ll never be new track of significance as contemporary politicians are just jobbers, with no vision or long-term plan to improve life on the island, even if there was we won’t pay for it, zero aspiration.
Vision impaired people cannot drive have free travel in Ireland… How do I get from Wexford to Kilkenny? Oh I can’t. I would rather pay a little bit and actually have a service… has The train still left Rosslare port before the boat actually gets in? How do we reduce using the car if there is actually no alternative? It’s easier for me to get to London than to get to the beach ten miles away
@Anne Marie Kearney: and arrived in the Port after the boat has gone. IR only want the few busy lines, the test can close as far as they are concerned.
Prices are reasonable at the moment with the reduction. The problem is frequency & journey time. Rail still can’t compete with the car at the moment on those fronts.
@Mirabelle Stonegate: they have some very good Park and Ride systems in place outside towns and cities in the UK, why can’t we have them? And the parking in these should be included in the price of the bus/train ticket. Public transport needs to be an attractive option, not money making, but in Ireland it will always be too expensive to ditch the car
Got the train from Dublin to Kerry 14 years ago, cost €80.Got a flight from Dublin to Amsterdam 6 years ago cost €80 plus I got to Amsterdam in less time.
@Brian Tracy: Considering a plane moves at about 500 mph +, of course you got there in less time lol. Looked to get a train for my parents from Cork to Waterford a few months ago online. It would have taken them over 4 hours (other times were over 5 hours) absolute joke.
For a major European city like Dublin, it’s embarassing that we don’t have a train service to and from the airport. You arrive at Dublin Airpport at 5am, there are no buses running & you have to get a taxi. Such a disgrace!
A number of years ago I used the train to and from Dublin at off peak times. On each trip there were undesirables in the carriage, loud aggressive & somewhat drunk. One clown had a radio on full blast. I noticed that some of the the ticket checkers avoided them. I won’t be going using that method of transport again as, for me, it feels too unsafe & menacing. I wish it were otherwise but it ain’t.
@Richard Ahern: That’s why I switched to coaches at peak times or Bank Holiday weekends. When a train’s full, you can’t easily change carriage to get away from drunks. Our trains are fine at off-peak times – but there aren’t enough routes.
The last time I used a train was Dublin to Cork in December a number of years ago. There was no heat, we had to sit in coats and gloves. The light was broken in the overflowing toilet so it was a case of holding it or risk catching a disease. Never again….
I travel 5 days a week with a bicycle ( booked on website free of charge ) out of normally 4/5 carriages 1 carriage for bicycles that fits max 3 at a squeeze, note most of the time full with suitcases.
If you book your seat 80 percent of the time there is a technical issues with the seat reservation system.
What’s the point booking when it becomes a free for all
prices for one-way tickets in Germany start from €19 for short distances (up to 250 km). For longer distances prices start at €29 (Second Class) and €49 (First Class) Travel on the ICE is possible. Prices for two people traveling together start at €49 in Second Class.
@Liam Meade: 9 € per month for tickets for all regional trains in Germany (can also be used on trams & buses). ICE tickets can be bought cheap well in advance, 115 € return to Paris first class from here in Germany.
It’s a twenty minute drive to the nearest station and an hour to the one with the better routes, car parking isn’t cheap . Then there is the other end, taxis are expensive buses might be available and there might be routes to where I need to go … but only in large cities.
Even if the train was free it would be marginal on cost and a dead loss on hassle except perhaps for trips to Dublin. .
An electric car wins hands down – self driving would be gravy.
Cmon lads , Ireland had 3500km of railways in 1930s. Today, maybe 2000. Instead of building new towns in Dublin , money should be spent on adding more train tracks all over Ireland. That would make amazing impact. Then families would consider moving into deserted homes in many beautiful counties of Ireland.
@Robert Lumezi: The market is not there for more routes in rural parts of the country. . Limerick to Galway is a loss leader. Not enough passengers use the daily service.
It’s more expensive than bus and not so frequent. For me Train tickets, monthly, is slightly less than half the cost of fuel. Whereas bus would be 1/3 of my fuel costs. But I get bus sick and the walk from the bus stop to my work place would be 20mins .
It’s a very limited service. Some lines only have trains travelling toward Dublin in the.mornings so it you wanted to commute in the other direction youd have to get a bus or drive. Also no or limited late night service. It is the most pleasant way to travel. Please keep the trains alcohol free. It’s far nicer when there’s no vomit.
Cost of return ticket Dublin to Killarney €60; cost of similar car journey €120. But the onboard experience is poor…..no hot drinks available, inadequate messages, welcome non-existent!
The Drogheda Commuter train is cheap from Balbriggan, then 3km up in Gormanstown, then Laytown and Drogheda, the exact same train becomes mad expensive as it is just outside the Dublin short hop zone. People drive to Balbriggan to be able to use leap card, park and ride instead of paying massive fares for the same train. Irish rail and NTA are driving people onto the roads every day with their extortion. They’ve a lot to answer for.
@Paul O’ Riada: Exactly – the really crazy part is that the more congested the town or city becomes, the more it costs to use public transport instead. It should be the default and faster option.
Not since I was a child, and the same can be said for the bus.
After all, by the time I’d have used the car, to get to the bus station, to catch a bus in the opposite direction to my ultimate destination to catch a train to beyond my ultimate destination, through a change at Limerick Junction in Tipperary (which means again I was probably travelling in the wrong direction for a bit on the train too) and then catch another bus to somewhere near my destination and have a friend or cab meet me and go the last bit, which would probably be next door to that village’s closed railway station, which I had passed through on the train on the way there, I’d have been there cheaper and faster driving there and would have saved myself the car parking fees too!
Way better system when I was a child when there was a bus stop within reach, and the trains actually stopped in every parish and the network worked!
BTW, I’m not actually that old so a lot of others should remember how it was too.
What really annoys me is that the value faes are usually gone but there are loads of flexi fares available. Why cant all seats be value and you can upgrade to a flexi if needs be (flexi fares aren’t even that flexible anway). And it’s cheaper to fly from Kerry to Dublin these days
Still waiting for the western rail corridor to be finished. But Leo had other ideas when he disregarded the whole western region from Belfast to Cork by excluding us from EU fund Ten T when he was minister for transport. He said Ireland had not got the funds but amazing we had for East of that. Disgraceful Leo, wasn’t it Cromwell that had that attitude about the west and see how popular he was.
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Information about your activity on this service (for instance, forms you submit, non-advertising content you look at) can be stored and combined with other information about you (such as your previous activity on this service or other websites or apps) or similar users. This is then used to build or improve a profile about you (which might for example include possible interests and personal aspects). Your profile can be used (also later) to present content that appears more relevant based on your possible interests, such as by adapting the order in which content is shown to you, so that it is even easier for you to find content that matches your interests.
Use profiles to select personalised content 33 partners can use this purpose
Content presented to you on this service can be based on your content personalisation profiles, which can reflect your activity on this or other services (for instance, the forms you submit, content you look at), possible interests and personal aspects. This can for example be used to adapt the order in which content is shown to you, so that it is even easier for you to find (non-advertising) content that matches your interests.
Measure advertising performance 127 partners can use this purpose
Information regarding which advertising is presented to you and how you interact with it can be used to determine how well an advert has worked for you or other users and whether the goals of the advertising were reached. For instance, whether you saw an ad, whether you clicked on it, whether it led you to buy a product or visit a website, etc. This is very helpful to understand the relevance of advertising campaigns.
Measure content performance 60 partners can use this purpose
Information regarding which content is presented to you and how you interact with it can be used to determine whether the (non-advertising) content e.g. reached its intended audience and matched your interests. For instance, whether you read an article, watch a video, listen to a podcast or look at a product description, how long you spent on this service and the web pages you visit etc. This is very helpful to understand the relevance of (non-advertising) content that is shown to you.
Understand audiences through statistics or combinations of data from different sources 75 partners can use this purpose
Reports can be generated based on the combination of data sets (like user profiles, statistics, market research, analytics data) regarding your interactions and those of other users with advertising or (non-advertising) content to identify common characteristics (for instance, to determine which target audiences are more receptive to an ad campaign or to certain contents).
Develop and improve services 82 partners can use this purpose
Information about your activity on this service, such as your interaction with ads or content, can be very helpful to improve products and services and to build new products and services based on user interactions, the type of audience, etc. This specific purpose does not include the development or improvement of user profiles and identifiers.
Use limited data to select content 38 partners can use this purpose
Content presented to you on this service can be based on limited data, such as the website or app you are using, your non-precise location, your device type, or which content you are (or have been) interacting with (for example, to limit the number of times a video or an article is presented to you).
Use precise geolocation data 43 partners can use this special feature
With your acceptance, your precise location (within a radius of less than 500 metres) may be used in support of the purposes explained in this notice.
Actively scan device characteristics for identification 25 partners can use this special feature
With your acceptance, certain characteristics specific to your device might be requested and used to distinguish it from other devices (such as the installed fonts or plugins, the resolution of your screen) in support of the purposes explained in this notice.
Ensure security, prevent and detect fraud, and fix errors 86 partners can use this special purpose
Always Active
Your data can be used to monitor for and prevent unusual and possibly fraudulent activity (for example, regarding advertising, ad clicks by bots), and ensure systems and processes work properly and securely. It can also be used to correct any problems you, the publisher or the advertiser may encounter in the delivery of content and ads and in your interaction with them.
Deliver and present advertising and content 96 partners can use this special purpose
Always Active
Certain information (like an IP address or device capabilities) is used to ensure the technical compatibility of the content or advertising, and to facilitate the transmission of the content or ad to your device.
Match and combine data from other data sources 68 partners can use this feature
Always Active
Information about your activity on this service may be matched and combined with other information relating to you and originating from various sources (for instance your activity on a separate online service, your use of a loyalty card in-store, or your answers to a survey), in support of the purposes explained in this notice.
Link different devices 50 partners can use this feature
Always Active
In support of the purposes explained in this notice, your device might be considered as likely linked to other devices that belong to you or your household (for instance because you are logged in to the same service on both your phone and your computer, or because you may use the same Internet connection on both devices).
Identify devices based on information transmitted automatically 84 partners can use this feature
Always Active
Your device might be distinguished from other devices based on information it automatically sends when accessing the Internet (for instance, the IP address of your Internet connection or the type of browser you are using) in support of the purposes exposed in this notice.
Save and communicate privacy choices 64 partners can use this special purpose
Always Active
The choices you make regarding the purposes and entities listed in this notice are saved and made available to those entities in the form of digital signals (such as a string of characters). This is necessary in order to enable both this service and those entities to respect such choices.
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