Thursday 25 June 2009
The Australian Government's attempt to ban homebirth - are you serious?
You know how, when you?re doing something very intimate and beautiful, you usually prefer not to do it in a very bright room with a drip in your arm, and a massive belt around your waist attached to a machine that goes BEEP BEEEP, with lots of strangers waltzing in and out of the door, turning up the houselights, using instruments to prod and measure your private parts, and asking you if you would mind if their students came in to watch?
Well, not surprisingly, same rule applies for most women when they?re giving birth.
Fact; some women just do not want to give birth in a hospital. Call me ?craxy!!!?, but fair enough. Birth for them is too special, too intimate, and too precious a thing to occur in a hospital. If your child is sick or your pregnancy is high risk (as in the case of twins), a hospital is the probably right place to be. Normal pregnancy and birth, however, are not illnesses, and Australian women deserve the right to choose for themselves whether they give birth in hospital or at home.
Today, Minister Nicola Roxon proposed a bill that removes this right from Australian women, by excluding homebirth from insurance schemes for midwives. More on this later. The point is, this is beyond belief and deserves a strong rising up from those of us who care about protecting who who are at their most vulnerable.
This is why I urge you to write to Minister Roxon (her details are at the bottom of the email), and ask her to kindly and immediately reconsider her position.
?Who cares where you give birth?? some say. ?It?s just one day in the life of your child. It really doesn?t matter how they?re born!?
Do we say the same for our wedding day? Or the day one of our parents die? It?s just one day? Who cares?
We do ? we were born to care, and in the same way you would want to personally choose and feel a connection with the minister or celebrant who marries you, or who buries one of your parents ? significant life events that happen to many of us ? families deserve the right right to choose who supports them through their pregnancy and birth and beyond, and sometimes, they want to do it in the warmth and safety of their home, with their loved ones around them.
I mean, when you climb Mount Everest for the first time, you want a hell of a good guide there with you.
This is what an independent midwife can be to a women who wants to give birth at home; a highly skilled, exceptionally understanding, professional guide, who knows what to do in an emergency.
How incredible that Australian women have today had the right to safe home-birth taken away from them by Health Minister Nicola Roxon, who really should know better.
This has nothing at all to do with the old wives tale that homebirths are somehow ?less safe? than hospital births; we know now WITHOUT RESERVATION that?s not true (a recent study of almost 530,000 low-risk births over seven years in the Netherlands (where the homebirth rate is still 30%) found no difference in death or serious illness among either mothers or their babies if they gave birth at home rather than in hospital).
The right to homebirths has been lost simply because there are only about 200 independent midwives in Australia, and because there are so few of them, insurance companies won?t insure them (there?s no money to be made on them), and because they won?t insure them, they won?t be able to practice. (To read more about this, please see * at the bottom of the page, from the homebirthaustralia.org website)
There are other minority specialty groups in Australia who also have this same problem ? Obstetricians, for example. And yet for some reason, most likely related to money and powerful medical lobby groups, the Federal Government is willing to put up vast amounts of money to subsidise our Obstetricians insurance. Why is this same courtesy not extended to Australian midwives?
I myself have never had a home birth ? I gave birth naturally to all three of my children in hospital (I took my independent midwife Jenny in with me, because I wanted the continuity of care for my children and myself) and for the record, it was the most brilliant liberating experience of my adult life and extended my vocal range by whole octaves to boot. Natural births in hospital are possible; they usually take a pre-birth education though. Have you heard about what to avoid? Have you every heard about this little thing called ?The Spiral of Intervention**, that seems to occur to so many women who enter hospitals keen to give birth naturally? Worth looking into!
The point here, however, is that women must have the right to access safe home-birth, because they will do it anyway. Says mother of seven and Homebirth Australia?s Justine Cairnes, who is an incredible woman I recently met whilst filming the Insight SBS program on birth in Australia ? ?Women will continue to homebirth, but will now do so without the assistance of a qualified professional. The result will be an increase in deaths for mothers and babies, this is certain. It is absolutely impossible to understand the government?s position on this, other than to say that they have bowed to political pressure from medical lobby groups.? To read this press release in full, please visit
Home Birth Australia |
For the record, I am passionate about women retaining these choices because I have been present and assisted at many births; I know how wonderful and glorious giving birth at home can be. Women who give birth at home consistently express higher levels of satisfaction than those who gave birth in hospital. My mother was one of eleven children, all born at home ? to me it is a normal, natural, way to bring a child into the world. It also costs far less to give birth at home that it does at a hospital, if only our Government would agree to subsidise homebirth as it does hospital birth. Why does it always seem to come down to money?
Also, sadly, I have seen and heard the damage that taking these choices away can do to women, and how devastating it can be for women who feel bullied or under-consulted by impatient Obstetricians (god bless them) who don?t have the time or sensitivity to consider the long-term effects of this kind of attitude in the birthing room. To get an idea of what I mean, read the post-show comments on the Insight Program website. There is a great need for post-birth counselling for many women who have been traumatised by their experience in hospital giving birth. It really does impact on their ability to be present with their baby, and it is tragic and absolutely breaks my heart. I have also personally spoken to hundreds of women over the years about the lasting trauma of having been treated carelessly whilst trying to give birth in hospitals, hospital who try their best but are utterly constrained by budgets and rotating rosters and human error and ridiculous deadlines and so on. When a woman is in labour ? this is the moment in a woman?s life when she is MOST vulnerable, and it is our duty to defend and protect and support and love these women whilst they?re doing the job of bringing through the new generation! Again, hospitals are fantastic when situations are high risk, or when children are sick ? but for normal healthy births, it is imperative we still allow women the chance to give birth at home if they so choose.
The point is, it would be ludicrous to take this choice away from women.
I urge you to support me in petitioning the government, in particular Minister Nicola Roxon, to reconsider their indefensible decision taken in parliament today to exclude homebirth from insurance schemes for midwives. Here is her address ? please write to her today and please send this to all women and men on your mailing lists so we can get her to reconsider.
FEDERAL MEMBER FOR GELLIBRAND
MINISTER FOR HEALTH & AGEING
Electorate Office
1 Thomas Holmes St
Maribyrnong 3032
Ph: 03 9317 7077
Fax: 03 9317 7477
email
nicola@nicolaroxonmp.com
Parliament House, Canberra
Ph: 02 6277 7220
Fax: 02 6273 4146
Here is a list of facts from the homebirthaustralia.org website, any of which you could point to when you write to Minister Roxon
? The Maternity Services Review Report is the 38th review or inquiry into maternity services since 1985 ? An unprecedented number of submissions was received (950) Only 500 were received for the National Health and Hospital?s Reform Commission
? Over half (53% of the consumer submissions to the MSR discussed homebirth and yet the MSR did not recommend publicly funding for homebirth.
? There are plans for a national registration body (July 2010), a necessary registration requirement is indemnity insurance. If private practicing midwives are not assisted with indemnity insurance the option of homebirth will be illegal. This is not acceptable. Women will continue to choose homebirth, many after hospital trauma.
? It is not appropriate to force women to give birth at home without a midwife
? Midwives are currently prevented from working to their level of registration and education
? Child-birth is the largest volume area of health, with now over 280,000 births/yr
? Midwives are the only health professionals without indemnity insurance, despite a $500 M support package for medical practitioners since 2001
? Maternity funding placates the entrenched medical dominance, promoting the professional ?turf-war?
? Maternity care is unique in the fact that it is a finite episode. There are considerable benefits to establish a package payment, a ?baby-bonus? type payment for healthcare
? Since the Medicare Safety-net was introduced in 2004 payments to Obstetricians have increased by around 300%
? Private health insurance is essentially a ?closed-shop? for maternity care. Women are forced to utilise private obstetricians.
? Private maternity care could be more supportive and much cheaper if private midwifery was enabled. Current homebirth midwives are the most experienced in providing 1-2-1 midwifery care. They need to be able to continue to practice to guide the essential reform process.
? Many accepted reforms have come from homebirth midwives and women (partners present at birth, use of warm water for pain relief, removing unnecessary and inappropriate routine interventions enemas, shaving, episiotomy)
*Since 2001 midwives have been unable to purchase an indemnity insurance policy. This was due to global factors with the collapse of the insurance market after September 11 and a landmark obstetric birth injury case proving a payout of $11 million in 2002. Guild insurance was providing indemnity at the time and they made a straightforward economic decision. With just under 200 privately practicing midwives paying approximately $800 per annum, there was simply not a large enough pool to fund a payout of the magnitude mentioned above. Medical Practitioners indemnity premiums were subsidised by the Howard Government and continue with over $900 million of tax-payers money has been spent to date. Homebirth midwives continue to be denied professional parity. Women choosing homebirth are treated as de-facto health consumers and are the only health consumers denied the protection of practitioner insurance. (from homebirthaustralia.org website).
***THE SPIRAL OF INTERVENTION*; is a term given to the series of events that leads to women receiving far more intervention (use of forceps, c-section, etc) whilst labouring in hospital than is recommended by the World Health Organisation. In my understanding, it goes a little something like this ? any variation of the following would fit under this umbrella, but let?s start with this example: ababy is deemed overdue, or labour starts and then stalls, or the birthing mother?s Obstetrician needs to go away for the weekend and wants to bring the patient?s birthing day forward a little (this is a common scenario, believe it or not), so the baby is induced with a hormone called oxytocin, which is inserted intravenously into the birthing mother?s arm, and into her bloodstream, which is connected to her baby?s bloodstream. Because the oxytoin ?comes on strong?, the women is quickly crippled with pain, and her body is unable to catch up and create natural pain-relief hormones it normally would had she gone into labour naturally. In distress, her cervix ?fails? to dilate, the pain she is experiencing is crippling, her Dr tells her she is not doing well enough, and recommends an epidural. The woman then hops up on the bed on her back ? an incredible uncomfortable position for the labouring woman. Lo and behold, her contractions stop. She is given an epidural regardless, strapped to a monitoring machine, removed from the experience of active labour, and cannot feel her contractions. They are monitored and viewed on a TV screen ? when the contractions show on the screen, she is told to push. She pushes very hard but nothing happens. At this stage the woman will again be told that she is ?not doing well enough?, and either a c-section is recommended, or the baby is so far down that this is impossible and a vacuum suction-cup or forceps will be used. This can mean tearing, episiotomy, stitches for the woman and severe bruising and possible brain damage for the child. I do not exaggerate here ? seeing a newborn child with a bruised cone-shaped head that has been brutalised by forceps, screaming in pain and given pain medication an hour after he is born is enough to make anyone cry. C-sections are no walk in the park ? they have serious recovery time, serious implications in the bonding opportunities of mother and baby, and they?re major surgery requiring six weeks of recovery time ? always best to be avoided if possible!!!
Homebirth Issue: Letter from Clare Bowditch
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