A letter to Nicola Roxon, Health Minister...

[BellyBelly]

Just in case some of you have no idea where to start, or are interested... oh and you can write to Nicola at: Nicola.Roxon.MP@aph.gov.au

Letter to Nicola Roxon

The Hon Nicola Roxon MP
Minister for Health and Ageing
Australian Government

Dear Nicola,

It is with the greatest disappointment that I write to you today. This week, you have proposed legislation that fundamentally makes my position as a private practicing midwife redundant. This was clearly stated in your speech that there will be no Medicare benefits for homebirth services and no professional indemnity insurance for midwives, under the commonwealth contribution scheme Bill, 2009. As you know private practice midwives cannot access PII. Therefore, this will exclude midwives from providing high standard intrapartum homebirth care to women and will prevent me from gaining employment in this field, under this bill.

Nicola, you have made homebirth illegal under the wise and skilled counsel of midwives. This therefore reduces women?s choice of care provider and place of birth. This is not a celebratory day; you have made this into political propaganda and lies. You have also restricted a midwives right to practice to the full scope of practice in any setting to which her educational qualifications allow, as clearly stated by the World Health Organization and the International College of Midwives. Can the Australian maternity community accept government interference in defining the setting of practice of a midwife? Would the medical community accept such wanton interference in its professional boundaries? I think not, and nor will midwives.

For me, working with homebirthing women is my income and my career. I have worked all my professional life to be where I am today, to provide the highest possible care to childbearing women. No other health profession has been outlawed by the government preventing them professional earning in the private sector. Why is private midwifery practice being outlawed when high quality research very clearly states that homebirth with a midwife is just as safe? Why are we being forced into ?midwifery practitioners? status? I am already a midwifery practitioner, who has the highest levels of qualifications and maintains best practice standards clinically and educationally. This is very discriminatory as no other health professional is being singled out in this review. If this is being made legislation to midwives, why then aren?t obstetric surgeons being made to upgrade their qualifications into practitioner status? MIDWIVES ARE ALREADY THE SPECIALISTS IN MATERNITY CARE, we do not need further qualifications to practice safely. And Nicola, tell me, why are doctors able to attend birth at home with full Medicare rebates?

Why are you driving childbirth into a medically dominated model and high cost model of care? Hospitals do not make birth safer and private midwifery practitioners like me, DO NOT WANT TO BIRTH WITH WOMEN IN HOSPITALS, unless there is a very good clinical indication that would enhance the safety of the birthing outcome. Confining all women to this obstetric model of care is discriminatory and disrespects their customs, religious views, and common belief that birth is a normal, natural and a safe part of life.

A few years back Nicola, Medicare 16400 was introduced. This allowed UNSKILLED NON midwives to provide antenatal care and NON-obstetricians and NON GP/OB?s to oversee the care of these NON-skilled nurses. Queensland Health now endorses a two-day course for nurses to practice UNSKILLED midwifery. This is NOT good or best practice. You are sending us back to the dark ages and fast! It is the right of women to have high standard of maternity care and this is not the way to go about it. The maternity services review was overwhelmed by the responses by women wanting homebirthing services, in fact these responses accounted for most of the applications, AND YOU ARE IGNORING THEM!

The Australian government has come to the aid of obstetric surgeons to assist with PII. Where are you now to assist midwives, whom are the specialist in maternity care?? You cannot provide PII for antenatal and postnatal care and expect that women will want to birth in a hospital. Homebirthing women are birthing at home not only because of the broken maternity system, but because we choose too. Women will continue to birth at home with or without a midwife. Are you prepared to face the consequences of that?

Nicola, as a woman and as a mother I cannot understand that you are being so neglectful of a woman?s right to choose with whom and where she gives birth. Although this legislation lacks common sense and reasonable thought, I would have thought you would have more compassion towards your fellow sisters in birthing.

I am coming to Canberra on the 7th of September 2009 and will bring with me every woman and family that can make it to protest against both you and your legislation. Since this bill directly affects me, I demand that you give me the courtesy of your time to meet with my colleagues and I on that day. I would also expect that our Prime Minister to be present at that meeting.

I ask for your response in writing within 7 working days please.

We will not take this like an obstetric patient, flat on our backs!

Legalize homebirth midwifery!

Sincerely,


Rachael Austin
Midwife in Private Practice
Registered Nurse, Registered Midwife, Immunisation Practice Nurse, Advanced Childbirth Educator, Student Child and Family Nurse, International Board Certified Lactation Consultant Nominee (July, 2009)

[The[cookie]Doctor]

Wow what a great example. Thanks for sharing Kel!

[Helly]

Awesome, thank you so much for posting this, it gave me something to start off! I've emailed the PM, my local member, Nicola Roxon - any more ideas?

[Jennifer13]

I'm going to email the Health Minister too. I got a great reply the last time I sent one about the bfing toll free helpline, so I hope they have the time to respond to the masses of emails that should come in about this.

[Lulu]

Dear Nicola,

I don?t understand why you are doing this to us. Why are you forcing my sisters and I to birth in a hospital? Why do I have to leave my peaceful home, surrounded by familiar faces and MIDWIFE support, where I can labour and give birth where I want to?
Why do you propose I leave my home, clamber into the car (had contractions in a car before? ? it SUCKS), wake my children or call for a babysitter in the middle of the night when I could happily stay home and birth the way I have a RIGHT TO.
I don?t need a doctor but I do need midwife support. I don?t need a hospital, I NEED MY MIDWIFE.

Please don?t do this ? it?s a backwards step.



That was my teeny, not as eloquent go at it.....

[fionas]

OK - this is my attempt - if someone can post me a quick link to some homebirth safety stats that would be t'riffic and I'll copy and paste to the relevant para.

-----------------

Dear Nicola

I did not have a homebirth with my daughter and fully intend my next birth to be in a private hospital with my lovely private obstetrician.

That is my choice.

However, I fully support the rights of women in Australia to give birth at home with a private midwife. Thanks to your legislation, this will soon become impossible.

When our feminist predecessors have fought so hard for women to be able to have choices in most areas of their lives now, why take away such a basic choice? Why ensure that women have no practical alternative to birthing their baby in a hospital? Why interfere with a basic woman's right to give birth where she chooses?

Of course, there probably won't be too much of a public reaction and I imagine you won't lose too many votes because the general public will fall for the usual lies when it comes to homebirth about it not being safe.

You and I both know that even a cursory glance at the statistics shows this is not the case. Homebirth IS safe.

Australia always seems to lag behind. It's taken years for us to get maternity pay and now, while countries such as New Zealand, the UK and Holland are encouraging women to give birth at home, we are effectively banning it.

Sorry, but that makes absolutely no sense to me.

[Jennifer13]

I stole a bit from Rachael Austin .

Dear Nicola,

I am very disappointed to read about the proposed legislation that will essentially make it impossible to use the services of a private practicing midwife for a homebirth. With no Medicare benefits for homebirth services and no professional indemnity insurance for midwives, this will exclude me from accessing my preferred option for my next birth.

Effectively making homebirth illegal under the wise and skilled counsel of midwives reduces women?s choice of care provider and place of birth. Why outlaw private midwifery practice when research very clearly states that homebirth with a midwife is just as safe as a hospital birth? Why are you driving childbirth into a medically dominated model and high cost model of care? Hospitals do not make birth safer. Confining all women to this obstetric model of care is discriminatory and disrespects common belief that birth is a normal, natural and a safe part of life.

For my first child, I had to give birth via a scheduled caesarean section due to a medical complication ? placenta praevia. At the moment, we are considering trying to conceive a sibling for our daughter next year. After having done much research and spoken with my partner, a certified private midwife and a doula, we concluded that my next birth should be trialled at home. We would like our daughter to be present for the birth of her sibling and would like to welcome our second child into the warm and loving environment of our own home. Unless another medical complication arises during my pregnancy, I do not see why we should not be permitted to explore this option. We live in a Sydney suburb where there are skilled midwives who regularly attend homebirths in our area, plus we have the safety net of several good hospitals close by in the unlikely event that further assistance is needed. If I lived in the UK there would be no issue with my family choosing to welcome our child into the world in this way, so why is Australia treating its mothers in such a discriminatory manner?

The Australian government has come to the aid of obstetric surgeons to assist with indemnity insurance. Why won?t you do the same for midwives? I cannot understand being so neglectful of a woman?s right to choose with whom and where she gives birth, when there is clearly progress in other maternity policy in our country.

Legalise homebirth midwifery!

Sincerely,
Jennifer13 (not really - I put in my real name!)
Mother and homebirth hopeful

[Helly]

man..... you guys are awesome! I'm nowhere near as eloquent, but here's my effort:

Dear (whomever)

I am writing with regards to the recent proposed legislations by the Health Minister Nicola Roxon. While I am happy about the promised Government reforms for midwives, which includes Medicare, access to the Pharmaceutical Benefits Scheme and indemnity insurance, it also greatly saddens and angers me that there will be no Medicare benefits for homebirth services and no professional indemnity insurance offered for midwives practicing at home, under the Commonwealth Contribution Scheme Bill, 2009. As private practice midwives are unable to access professional indeminity insurance, so this action will essentially make it illegal for a homebirthing midwife to practice if this bill is allowed to pass in July 2010. Not only that, but a birthing mother, if she allows a midwife to assist her, will also be considered to be breaking the law.

Please allow me to tell my story. As a qualified naturopath, I have always been aware of alternatives to common medical practices, and homebirthing was, as far as I could glean from my research, considered a viable, safe, and even desired alternative to a hospital birth, when attended by a qualified midwife, and provided the mother was a low risk candidate. When I fell pregnant myself, I immediately set out to determine whether I was a low risk candidate, as I also wanted a homebirth. Long term studies and statistics have shown, as I stated above, that it is just as safe if not safer than hospital births. Also the rates of interventions (medications, assisted deliveries, need for pain relief etc) are considerably lower. (I would turn your attention to this article Homebirth: What Are the Issues? - by Sara Wickham, RM, BA (Hons) which contains excellent information as well as references to individual studies at the end)

Having contacted a local private midwife, who after the assessment of a doctor, agreed that I was an excellent candidate as I was in good health, I then hired her on for the majority of my pre and post-natal care. The care I received from her was professional, friendly, and at all times I felt I was in excellent hands. When I finally went into labour, my midwife was with me the entire time, constantly monitoring the baby?s heartbeat, checking my progress, and so on. I felt totally relaxed at home, comfortable in my environment, and was allowed the time to labour as I could. After over 24 hours, it became apparent that my baby was not turned around fully and was not progressing as fast as she liked down the birth canal. Immediately she contacted the hospital, even though it wasn?t strictly an emergency, and advised that I transfer. She was not willing to take any risks that involved a mother and child, a commendable attitude for any professional. She remained with me throughout the next day until I gave birth to my son.

While in the hospital, my husband and I felt as though matters were constantly being taken out of our hands, we felt helpless, and hopeless. It was only the presence of my midwife that kept me going and didn?t allow me to give into the doctor?s callous assessment that I ?Might as well have an epidural now for your C-section later, as there?s almost no way you will birth this child on your own.? I might add that a C-section is major surgery, which takes a very long time to recover from, invites infections such as golden staph, and interferes with mother and child bonding as well as breastfeeding. Australia?s current rate for C-sections is around 30%-40% - phenomenally higher than the WHO?s current recommendation of no more than 3%-5%. Thankfully, with her and my family?s support, I was able to birth naturally, with no complications.

Once we went home, my midwife continued to visit me daily, giving me support in establishing breastfeeding, aftercare, and generally being supportive and helpful. I wouldn?t have gotten through those firth weeks without the excellent support I received.

I cannot speak for every Australian woman. I can only speak for myself when I state that at no time under my midwife?s care did I feel that I was in any danger, or that any decisions she made were for anything other than my absolute care and health. I have absolutely no hesitations in homebirthing again, even though it ended at the hospital. I am saddened, frustrated, and even horrified that our government would consider making such changes as would prevent me from birthing my children that way, and the place, I choose. Even if I was told today that I can never have another homebirth due to medical reasons, I would not stop fighting for that right for other women, and my daughters. Surely, as an advanced and modern country we would never consider passing such a legislation.

What of those women whose religion does not allow them to give birth in a hospital? Are they now to be considered criminals, and denied the excellent care they deserve? What of women such as my own mother, who, when in labour with me, entered the hospital where she had been so badly treated during her previous birth, and the stress of the situation caused labour to stop for over three weeks? Why aren?t we supporting, and even funding, private midwifery which provides superior care to women, and saves the government and hospitals money?

It would be impossible for me to completely divorce myself from the emotion of this issue, as it is very close to my heart, and affects me personally, as I want to have more children. But I would ask that you would look into the facts, which, devoid of emotion, tell the tale as it should. Ignorance and scaremongering are no excuse to allow legislation such as this to pass!!

Thank you for your time,
Sincerely
Helen