My submission to the Senate Committee

[Julie Doula]

Dear Senator Moore,

Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills

I am opposed to the amendments that have been introduced to the above bills that would require midwives to enter into formal collaborative arrangements with medical practitioners.

I deplore the actions over many years by the AMA to establish a medical monopoly over maternity services. They are copying the example of the AMA in the US, and ignoring the examples set by the UK, NZ and other developed countries. They are reducing the role of midwives to that of obstetric nurses. They are pushing a hierarchical system that will make midwives subordinate to obstetricians instead of being autonomous professionals. This promotes the medical model of childbirth and marginalizes the midwifery model of childbirth. This makes it much harder for consumers to access true midwifery model care and natural birth alternatives, including homebirth. Homebirth is a bastion of natural birth skills and knowledge, it is being targeted by the medical lobby not because it is ‘unsafe’ but because as long as homebirth exists, its excellent results show up how sub-standard medicalised, institionalised birth services are. Consumers in a democracy deserve a choice. Do not allow our choices to be eliminated or reduced. The midwifery model of care must remain as an option for Australians, including homebirth and continuity of care with a care provider of our choice.

http://www.health.gov.au/internet/main/publishing.nsf/Content/maternityservicesreview-741/$FILE/741_Toohill%20&%20Soong_scanned.pdf

This document is entitled Improving Maternity Services in Australia - A Discussion Paper from the Australian Government. It is dated 31 October 2008.

The paper poses this question:

"What are the key workforce barriers to integrated models of care?"
And states,

"All facilities should offer women choice of carer and place of birth, more education and should promote midwife-led care across the continuum. An enormous obstacle is private obstetric charges, as obstetricians may be hesitant to forgo lucrative incomes of up to $9,000 per pregnancy, with some Sydney doctors reported to be charging up to $12,000 and earning collectively up to $1.4 billion per year."

It also recommends the following:

"The state and national governments must shift the emphasis from a medical model of care to a social model of care in childbirth that encompasses women's needs holistically rather than focussing on the clinical aspects of pregnancy and labour."

and

"Women and families should be actively encouraged to take control of their pregnancies and be supported in their decision making."

It is of extreme concern that the points high-lighted in this paper seem to have been ignored and dismissed by government in recent legislation. The well-being of babies and mothers and the right of women to choose the midwifery model of care as an alternative to the obstetric, institutionalised model, is being dis-regarded in favour of enabling a medically dominant system similar to what we see happening in the USA.

The attitude of Australian obstetricians as seen in the following statement, makes it clear that this government is being cultivated to prefer the interests of obstetricians over the interests of mothers and midwives:

"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) does not endorse Home Birth. Home Birth is not endorsed as it is associated with an unacceptably high rate of adverse outcomes."

This is a flat lie.

In 2006, 282,169 babies were born in Australia. There were 2091 foetal deaths. 30.8% of the 277,436 women who gave birth had caesareans. Only 58% had spontaneous vaginal births. 708 women had homebirths. No foetal deaths occurred during these 708 homebirths. The infant mortality rate for homebirth in 2006 was ZERO. The main reason for the caesareans was previous caesarean. 83% of women in Australia who have a primary caesarean will have a repeat caesarean. (AIHW National Perinatal Statistics Unit 2006)

So why is the AMA demonising and marginalising homebirth?

And why is the government playing into their hands?

Perhaps it is less to do with this:

"Home Birth is not endorsed as it is associated with an unacceptably high rate of adverse outcomes."

and more to do with this:

"An enormous obstacle is private obstetric charges, as obstetricians may be hesitant to forgo lucrative incomes of up to $9,000 per pregnancy, with some Sydney doctors reported to be charging up to $12,000 and earning collectively up to $1.4 billion per year."

This government must stop ignoring the voices and interests of women, mothers, families and midwives, and stop enabling the greed and monopoly of insurance companies and doctors.

80% or more of women in the UK and NZ access the midwifery model of care as an alternative to the obstetric model. The AMA website states that obstetricians are the most appropriate careproviders for women. Not 'high risk women'. Just - 'women'. This is indicative of their agenda to secure a monopoly over the billion-dollar industry of birth services, to eliminate the competition, and to use the birthing population of Australia as fodder for a massive obstetric/caesarean industry, pushing up rates of induction, and therefore primary caesareans - which generates guaranteed repeat business, as less than 20% of women who receive a primary caesarean are able to achieve VBAC in our hospitals.

Meanwhile, 96% of primips who plan homebirths achieve a spontaneous vaginal birth. (25% of the 708 women who gave birth at home in 2006 were primips.)

95% or more of women who engage the care of a homebirth midwife for a VBAC birth achieve a successful VBAC.

The AMA would have you believe that homebirth, with its 4% caesarean rate, is "unsafe", and that midwives operating outside of an obstetric hierarchy must be excluded and criminalised. They would also have you believe that even if there is a publically funded homebirth system, VBAC women must be excluded from this as being too 'high risk".

Do you not see any selfish, profit-driven agenda here?

The caesarean rate has increased by more 10% in 10 years, from just over 20.3% per cent in 1997 to 30.8% in 2006.

The following 2005 article indicates that clinical safety is NOT the driving factor behind the rising rates of induction, intervention and surgery for birthing women:

"The AMA said there was no need to be concerned by the record high and women should always choose what is right for them.

Dr Pesce said litigation was a major factor in the jump in caesarean rates.

"No obstetrician has ever been sued for performing a caesarean section, when they get sued it's because they didn't perform one," he said."

The fact that Pesce also patronisingly states that we should NOT BE CONCERNED about the rising c/s rate hints that Pesce et al (whose patients have an 80% caesarean rate) have a vested interest in eliminating natural birth alternatives and any competition to what is a lucrative trade for them.

An unprecedented number of submissions were received on this issue. It is clear and plain that Australian women demand and deserve a choice between the obstetric management of birth and autonomous midwifery model care that supports natural birth.

This is clear in the 2008 Homebirth Review for the Department of Health, WA:

“It is encouraging that the latest state government policy document is supportive of a direction that is woman centred and in line with national and international evidence and trends. It is our impression however that some women are choosing homebirth in WA as there are limited options in relation to access to midwifery continuity of care, waterbirth, support for vaginal birth after caesarean section or access to birth centre environments. It seems apparent that the maternity systems are, for some women, too medicalised and restrictive, and do not meet their needs. It is our impression that some women, who in other models and systems would not be ‘eligible’ or recommended for homebirth, seem to be choosing this option as a surrogate means to access midwifery continuity of care and waterbirth. This issue was apparent in both metropolitan and rural areas. The reviewers believe that the choice to give birth at home or in water will continue, as will the choice to have a vaginal birth after a caesarean section. Therefore, developing systems to support safe and satisfying systems of care that provide childbearing women with a diversity of options is essential.”

This government has a responsibility to ensure that a diversity of birthing options, including waterbirth, midwifery continuity of care, midwife-led care, homebirth including home VBAC, are available and accessible, funded and supported, for all consumers of maternity services.

It is not the role of this government to be lackeys for the AMA, promoting the interests of the 27,000 members of the AMA, over the well-being and preferences of Australian women and babies. Reducing midwifery and natural options so that fewer and fewer women even realize they are are options is manufactured consent – even coerced consent in some cases - not informed consent, and I deplore these unethical tactics to herd an unsuspecting population of birthers into the medicalised system by reducing their awareness of, and their access to, their rights and choices.

A “collaborative team approach” does not mean: "obstetricians in charge, who set obstetric policy driven by insurance stipulations, who have the authority to force midwives under their hierarchy to conform to obstetrically-set policy, thereby making it impossible for midwives to deliver the midwifery model of care, so that consumers have no alternative to the obstetric model, it is the only reality they know, so obstetricians get most of the money and hold most of the power, and the only way women can access the midwifery model is to go underground." That is not team work. That is distortion of a healthy and just balance of power. That is corruption.

Collaboration means midwives are autonomous professionals delivering the midwifery model of care to the low-risk women who choose them, who consult with and refer clients to obstetricians if/when necessary. It means obstetricians being required to up-skill on normal birth practices, such as attending homebirths with private midwives as a pre-requisite to joining a collaborative team with midwives. Collaboration means it is not obstetricians who assess who is low risk and who is high risk. It means obstetricians are specialists in high-risk obstetrics who respect midwives as equal professional who are specialists in normal birth. What's good for the geese is good for the gander; the power hierarchy must end and obstetricians cannot be allowed to continue to call the shots on what is good for women in Australia.

The RANZCOG statement on homebirth states,

"Home Birth should not be offered as a model of care as there is a reasonable public expectation that any model of care that is offered has a margin of safety that would be acceptable to most women. This is not present in the setting of Home Birth ... women who choose to prioritise this aspect of their birth experience above that of risk minimisation."

This implies that women planning homebirths selfishly place their desire for a gentle and humane birth experience above the safety of themselves and their babies, perhaps because they are ill-informed of the risks, as this sentence implies:

"Women contemplating Home Birth must be provided with accurate information about the risks involved."

(This inference that homebirth women are ill-informed, risk-taking mavericks contrasts with the fact that most women planning homebirths are older, educated, highly-informed, affluent city-dwellers.)

The AMA cannot have any concept of what is ‘acceptable to most women’, as within the dynamic of ‘manufactured consent’ that is the norm within the medical system, and the dearth of any system of collecting and analyzing feedback from women as consumers of maternity services, as per the mandatory Birth Review in New Zealand, the preferences and needs of ‘most’ women are being ignored.

Yet correspondence from the Victorian Department of Health on 15 October 2009 gives us the following information:

Of 1000 women, 170 matched the criteria for a 'standard' primip woman.

170 first-time mothers (primips) planned to have their first babies at home during the period 2003-2007.

Of these 170 women, none were induced. (Compared to a 25% induction rate in Australian hospitals.)

Of these 170, 11 women were transferred and had caesareans in hospital - a 6.5% caesarean rate. (Compared to a 15% primip c/section rate in public hospitals; and a 27% primip c/section rate in private hospitals.)

Of these 170, 1 woman sustained a 3rd or 4th degree perineal laceration (0.6%) - after transfer to hospital.

138 of these 170 actually gave birth at home.

None of these 138 were induced.

None of these 138 sustained a 3rd or 4th degree perineal laceration.

30 women planned VBACs at home between 2003 and 2007.

Of these 30, 100% achieved vaginal birth after previous ceasarean (VBAC). (Compared to a 30% VBAC rate in public hospitals, and a less than 20% VBAC rate in private hospitals.)

These are key performance indicators according to the Victorian Government.

These results were delivered by midwives who provide care according to the midwifery model of care. These births were not 'supervised' by medical doctors, as stated by the AMA in this September 2008 article: “Medical Supervision Key to Safe Maternity Services”

Medical Supervision Key To Safe Maternity Services, Australian Medical Association

Medical practitioners did not attend these births as recommended in the RANZCOG statement on homebirth:

"Women choosing Home Birth should be cared for by both an experienced medical practitioner and a registered midwife..."

Homebirth midwives consult with, and refer clients to, specialist care when necessary, however, these births occured outside of the control of and supervision of the medical hierarchy, and these results were achieved without the supervision the AMA deems necessary ostensibly for .... safety reasons? Is it really “safety” that is the driving motive behind their policy of 100% medical involvement in, supervision of and management of ALL births, even low-risk ones that are managed by midwives in all developed countries except the USA?

I would like to contrast these statistics from the Department of Health with the following comments from Daniel Andrews, Victorian Minister for Health:

(To homebirth midwives who met with him in his office):

"You're cowboys. There is no place for independent midwives in Victoria. You'll get an exemption from the legislation over my dead body. Homebirthing women are not representative of women in Victoria. I don't care about the 700 or more women in Victoria who had homebirths last year."

This sentence (below) in the RANZCOG homebirth statement indicates that the plan to use compulsory indemnity insurance to eliminate homebirth midwives and homebirth as a natural birth option for women, was an intentional strategy. It is well known to RANZCOG that midwives have been uninsured since 2004, when Lloyds of London ceased to cover midwives worldwide because it was not financially viable as the pool was too small. It is well known that no insurance is available for homebirth midwives.

"Health professionals supervising Home Birth should have appropriate indemnity insurance. Indemnity insurance premiums must reflect the associated increased risks."

By falsely claiming that:

- homebirth is risky

- homebirth must be supervised by doctors

- homebirth midwives must have insurance

and by pressing these arguments on the government, the AMA have created a situation by which all competition to their monopoly may be eliminated, and women will have no means by which to compare the highly promoted medical model, touted as being the 'safest in the world' by the AMA, with safer, gentler and less traumatising care delivered by autonomous midwives.

These same tactics were used by the AMA in the USA: Obstetricians Use Dubious Methods to Discredit Homebirth

This is a wrong that must be righted. This government should not collaborate with a plan to eliminate autonomous midwifery and thus restrict safe normal birth options for Australian consumers. Any service providing a 6% caesarean rate for first time mothers, a 100% successful VBAC rate, and a less than 1% perineal laceration rate, deserves the attention and support of our government. It does not deserve to be maligned, stitched up, marginalised, muzzled, and driven undergound.

Roxon's amendment states,

"For midwives to be eligible to participate in the new arrangement they will need to meet advanced practice requirements and have collaborative arrangements with doctors."

What guarantee does this government offer that obstetricians will collaborate with independent midwives who provide homebirth services, when RANZCOG has blatantly stated that they refuse to support homebirth? What pressure will this government bring to bear on obstetricians who have already stated that they do not support homebirth, to ensure that they willingly collaborate with homebirth midwives?

How is this viable? How will this government guarantee that Obstetricians will support and collaborate with midwives providing services for women wanting home VBACs?

What advanced practice requirements will obstetricians need to undergo in order to be adequately skilled-up in natural birth practices? Most have never seen a normal birth in a homebirth setting, and don't believe it is possible for women to give birth safely without intervention. Obstetricians will need to be required to attend homebirths apprenticed to midwives in order for them to be safe enough to collaborate with midwives providing homebirth services. Collaboration is a two-way street – not a tool of dominance and hierarchy.

How will the government ensure that obstetricians WILL collaborate with midwives - without coercing these midwives to conform to obstetrically-set policy, so that the midwifery model of care is not compromised - and that obstetricians will be sufficiently trained and experienced in the midwifery model that they do not jeopardise it?

It seems to me that if it is a condition that midwives have collaborative arrangements with obstetricians, and obstetricians refuse wholesale to support homebirth midwives, then you have the homebirth midwives nicely stitched up, you've played into their hands, and homebirth families and midwives are wrecked.

I urge you to take a stand against the selling out of the womanhood of Australia and take all measures necessary to ensure that midwives are treated with the same equity as obstetricians in all regards, and that we as consumers can access natural birth options (including homebirth) and the midwifery model of care as easily as we can access obstetric models of care.

The fact that Pesce is blatantly bragging about his ability to manipulate Nicola Roxon and his success in forcing an untenable and unviable amendment demanding unilateral collaboration and unilateral right of veto for doctors as his greatest success in this article:

Meet Mr 3am: the nation's dynamic top doctor

should be adequate evidence that the holisitic welfare of birthing women and our right to democracy is not his prime consideration. Members of the public raised their objections in these letters to the Editor (one of which was sent in by my husband): An Attack on Women's Rights

How dare this government enable Pesce and his ilk to place them in a position of power over midwives and women, with punitive powers to force our compliance to a system that rising rates of PTSD reveal are damaging to women, and empower them to demonise a gentle, safe alternative like homebirth? This government is duty bound to observe the example of the UK and other nations in guaranteeing midwifery-led care, including homebirth is available to all consumers, including Indigenous women and those in remote areas.

This is the 2007 RCOG/RCM joint statement on homebirth:

The Royal College of Midwives (RCM) and the Royal College of Obstetricians and
Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There
is no reason why home birth should not be offered to women at low risk of complications and it
may confer considerable benefits for them and their families. There is ample evidence showing that
labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe, with
implications for her health and that of her baby.

http://www.rcmnormalbirth.net/webfil...0Statement.pdf

There is no reason that Australian women should be deprived of the rights afforded our peers in the UK.

Yours faithfully,

(signed)

[BellyBelly]

Bloody brilliant woman.... you rock you birthing goddess you *mwa*

[Bella29]

Julie that is fantastic!!!! What a way to put it!! Great job! If they can read that and still not be moved, it is obvious that they have alternative priorities than the well being of Australian women and are perhaps being paid off. Maybe an inquiry into corruption and misconduct needs to be instigated.

Bella

[sneakysparkle]

you are SO AWESOME!!! I need a bowing emoticon!

[e_p]

Julie that is the best thing I've read in yonks!!

[Traveller]

What an awesome statement
That they listen

[Julie Doula]

By contrast, here is a media release from NASOG:

http://www.nasog.org.au/documents/me...ase_090818.pdf

Tuesday August 18 2009
Please Put the Safety of Babies and their Mothers Ahead of Home Birth Ideology: Specialist Doctors
Australia’s peak group of obstetricians and gynaecologists today repeated its warning that home births – with or without a midwife – carry too much risk to babies and their mothers and the Government should resist calls to indemnify midwives outside of hospitals.
The President of the National Association of Specialist Obstetricians and Gynaecologists (NASOG),
Dr Hilary Joyce, congratulated the Government-majority Senate Committee investigating proposed
legislation relating to the role of midwives, for putting the safety of babies ahead of protestations by a small but vocal minority of people.
“I would urge all politicians to look to the evidence and to speak to the doctors and the midwives who
have to deal with some of the tragic consequences of home births,” Dr Joyce said today.
“Australia has one of the safest and highest quality maternity services in the world where specialist
doctors work side by side with qualified midwives to ensure babies and their mothers have a safe and successful birth experience.”
Dr Joyce said she was determined to help drive change in the way public and private hospitals present their maternity services to encourage all expectant mothers to opt for a safe and positive outcome under the care of specialist doctors and midwives working together.
“There is irrefutable evidence that women and babies are significantly safer in hospitals because of
the immediate access to specialist care. Thankfully, only 0.25% of Australian women risk their lives
and that of their babies by choosing a home birth.”
Dr Joyce said the Minister for Health and Ageing was acting in the best interests of babies and their
mothers by refusing to financially endorse the unsafe practice of delivering babies at home.
“There are things that can go wrong suddenly in a birth which, if not under specialist care or near
medical assistance, can result in an avoidable death or permanent injury,” Dr Joyce explained.
Dr Joyce said rather than call for the Government to fund insurance for an unsafe practice, politicians and health professionals should ask for funding to be directed to educating women and their families about the risks of home births.”
Dr Joyce said her organisation would continue to work closely with the Federal Government to
deliver the optimal collaborative model of obstetric care to all Australian women.

... "educating" women about the risks of homebirth? More like brain-washing according to their self-serving bias and using scare tactics to force compliance.

[Julie Doula]

*ahem* brace yourselves dears because this submission comes from someone who calls a spade a spade!!!

Dear Fascist Bully Boys,
I don't know why I am bothering to write this, because it made no f***ing difference the first 8 times I wrote it. I want the right to make my own decisions about where and with whom I use my vagina. I don't want your input on whom I sleep with nor with whom I choose to birth with.
Do you really honestly think for one minute that you care more about the outcome of my birth than I do? How much have you invested into my birth? Who much has Pesche? THIS IS MY CHILD AND MY BODY... I HAVE INVESTED EVERYTHING IN IT!
I don't want your medicare. I don't want your insurance. I don’t want your idea of collaboration. I just want to be treated like the highly intelligent person that I am and given the basic human right to choose homebirth with a midwife for myself and my family.
Please keep your laws off my body.
Signed,
Angry tax-payer

I love it!

[paradise lost]

This is very interesting - on what grounds do they repeatedly say homebirth isn't safe? That wouldn't fly in the UK, because there are no medical studies to support the assertion. People might say/think it, but the government couldn't say it or act on it...

Bx

[Traveller]

I love the 2nd submission too

[thebas2560]

Does anyone mind if I post mine here? I'm a facebook friend of Julie.

Dear Senator Moore,

Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills

This is a letter from the heart. I am sure you have already received countless letters, all with supporting evidence, telling you all the reasons why it is a disastrous idea to introduce this bill so I won't repeat them. I thought it would be better to tell you our story.
I am a busy Dad of three beautiful children and husband to a wonderful wife and mother who has been through a lot over the last few years in regards to her birth experiences. My wife has come to experience all the typical symptoms of post-traumatic stress and has battled depression, as well as ongoing physical repercussions since our first birth. We went into our first birth unaware of any of the controversy and debate in the world of maternity services. No-one had told us, but we experienced it for ourselves, in our most vulnerable moments.

We experienced all the cliched abuses (and I don't use that word lightly) at the hands of interfering, impersonal and I would even say bullying obstretricians as we were poked and prodded into the 'cascade of interventions' which ended up in, we truly believe, an unneccesary c-section. We watched as our lovely midwife (who we hadn't met before) backed off and threw her hands up in the air as if to say 'sorry' when the obgyns put their foot down (with no good reason but midnight was coming up and they wanted to go home thrown in with an alarmist 'do you want your baby to die?'. I assure you, my wife was barely out of pre-labour and there were no signs of distress). We have come to hate this powerful word weapon used on so many of our friends.

My wife desperately wanted a safe, natural birth. It was buried powerfully and deeply within her, feeling almost like a rite of passage as a woman. We understood that if things were to not progress as they should, that a c-section would be necessary. Disappointing, but necessary. We found ourselves, however, in a really horrible environment where we really felt we were thrown in to a power struggle we did not ask for. To cut a very long story short, we felt violated, dehumanized and out of control.

The following births now had us fighting for a natural birth. It didn't take much research to realize that VBACs (Vaginal Birth After Casareans) were very safe. But we were mocked and resisted at every turn by older, harsh schoolmaster-like obstetricians who basically treated us like stupid kids. All the research supported us. They didn't care to debate the issue, they wanted to pull rank. They let us have a 'trial of labour'. It did not progress after the water broke and my wife was still in prelabour. So a 2nd c-section was done. We had to fight like hell to get a few concessions to make the experience better (unlike the traumatic 1st experience in which our child was whisked away and handled by a heavily smoking, rough, insensitive midwife as my wife lay on her back in surgery crying, given little sympathy. And then she was left by herself, paralyzed in her room as the midwife took her baby away and forced me to go home.)

This time we had a doula to help us (why did we need re-inforcements??). The obgyns reluctantly allowed us to have skin-to-skin contact, he was weighed and measured in the room and got to stay with his mum. This greatly helped bonding and made breast feeding much easier. There was no reason any of this shouldn't happen but we had to fight to get it at every turn. It was a much more positive experience. But still very disappointing.

Our 3rd birth was an attempted homebirth. Both of us are intelligent, tertiary-educated people. We researched vigourously. It was here where I was saturated in the midwifery debate- where I discovered the countless stories like ours, where we were continuously gobsmacked as a whole world opened up to us. The more we read, the more we were shocked- the history, the money, the mortality rates, the explosion in c-sections etc etc. I tried to read both sides but I couldn't see a clear debate. All the evidence was on the side of the midwives. Journal after journal, study after study worldwide saying the same things. The medical model of childbirth was a runaway freight train and a disaster in the history of childbirth. What was meant to be a positive development for dealing with birth complications was becoming the default. Kicking down doors was replacing using doorknobs.

But this wasn't just a bland ivory tower debate. This was effecting the very fabric of our lives and the heart of our most important life choices- when, where and how we would have our children, and how it would effect future pregnancies. This debate had forced us into fights and positions that we never wanted to fight. We learnt that homebirth (with a midwife) was safe, even safer than hospital births in some ways, that it was emotionally healthy for mother and child. We also learnt that VBACS, even multiple, were safe too. That the risks were very low and could be compared to the alternate risks of multiple c-sections (but this is another debate).

We did not have much money, but we hired an amazing, experienced, trustworthy independent midwife anyway who was with us all the way. We were going to bypass the system altogether, with all its lies and bullying (that sounds over the top but it is our experience and perspective) and do it the way many developed countries are doing with great success.

The labour did not progress. We got to 9cm dilated and it went backwards. We did just like we told everybody we would do, the way it should be done, we transferred to hospital. Here, we were treated like scum. The obgyn, a young lady, who took us on proceeded to lecture us, giving us hopelessly bad figures that have famously been disproven. We asked for our concessions. She basically said, I paraphrase “Too bad. Sucked in. You should have played our game to begin with. You lose. Your c-section will be as cold and clinical as we can make it.” My paraphrase is more accurate than you can possibly imagine. Our baby and my wife were examined and the results they came back with were exactly what the midwife was telling them already from her previous examinations. The baby was fine, heart-rate was fine, she was 6cm dilated, but meconium present for a designated time meant that the baby needed to come out soon. My wife held out from signing consent forms and we considered going to another hospital. The obgyn huffed and puffed (remember the baby had been proven fine and we still had plenty of time).

A senior obgyn entered the room. He heard our story from the younger obgyn and said “Sure, we can do those things. That would be great!”. He then proceeded to tell us the actual risks, quoting stats that we recognized and blatantly contradicting what the previous obgyn had said. The younger shocked obgyn then huffed some more and stormed out of the room. The new OBGYN then really looked after us. He said we could continue trying to labour as baby was fine and see what happened. We thought it wasn't looking good so we booked the c-section. He wanted to do it, but couldn't, but made sure it was how we asked. Even our beloved midwife was allowed in with us to support us through our mix of joy and sadness as we went to theatre again. We were lucky. The OBGYN that happened to walk in that day was Dr Thou, the person who ran the St George home birth centre.

Unfortunately, we have found that Dr Thou is a rarity. And he fights a tide that pressures him to comply. I fear that he could be deregistered and/or refused insurance if he colludes with the homebirthing 'enemy'.




Our next birth, which we believe we have an inalienable right to do, presents a nightmare situation for us. What do we do? We have developed a justified mistrust and fear of OBGYNS in our birthing process. We are intellectually convinced that homebirth with an independent midwife, within access to a hospital (it's 2 minutes down the road), is our safest and least traumatic option.

It is looking like we are having this choice stolen from us. And in a free, democratic country, we are being forced into the hands of an industry we believe is not in the best interests of ours or our babies physical and mental well being and is frankly corrupt. Even if this is not true, we believe it passionately and it terrifies us. Our perspective is important and a freedom we deserve. There is surely enough academically researched evidence to anyone who pays ANY attention to the debate that shows our choices are not putting our precious babies at any more risk than in a c-section. So do we homebirth without a midwife? We don't want to do that. Are we forced into another unnecessary c-section under the knife of people we felt have been the cause of so much pain in our lives (along with the all-too-often unpublicized risks of that)? We don't want to do that either. So are we forced into the choice of having no more children? Think about that. Such a clear and precious right. How could this right possibly be taken away from us when it is unnecessary?

I assure you, everything I have written is the tip of the iceberg. This is our life. Our choices for the safety of ourselves and our children. What it means to be human in a free society. How would you feel if, assuming you have children, you were forced to feed your children a new food that you truly believed was dangerous because the government made it legally binding to do so? Would you feel angry? Betrayed? I find it disconcerting that for the first time in my life I actually feel hatred towards some of my authorities. We feel violated. I just keep saying to myself “How COULD they? How DARE they?” And we're not the only ones who feel exactly the same way. There is a reason there was such a big turnout in the cold wind and rain at Canberra for the homebirth rally. I don't want to feel this way about a government that is meant to exist to represent me, to protect me, to fight for my rights. This a world first for Australia.

Obstetrics will not collaborate with midwifery. They will redefine it. All that will be left is obstetric nurses afraid for their jobs. I hope you listen. Please don't do this. Don't take away the people we trust and love to help us walk through the most difficult and powerful moments in our lives. At least let it be how it was. We will pay out of pocket, no medicare, just don't take our independent homebirthing midwives away. I hope I've communicated just how important this is to us and many others.

Benjamin Skinner

[Julie Doula]

What was meant to be a positive development for dealing with birth complications was becoming the default.

This gave me chills .... so true.

Unfortunately, we have found that Dr Thou is a rarity. And he fights a tide that pressures him to comply. I fear that he could be deregistered and/or refused insurance if he colludes with the homebirthing 'enemy'.

As has happened to other highly skilled obstetricians who supported natural birth and homebirth. Refusing insurance to doctors who follow compassion and common sense instead of strict obstetric parameters some of which are not even evidence-based, is a tactic used to force compliance among doctors. Some OBs in the USA have resorted to hanging up a signs saying, 'We do not have insurance' just so that they can practice according to conscience.

Obstetrics will not collaborate with midwifery. They will redefine it. All that will be left is obstetric nurses afraid for their jobs

Chills again ...

Ben, if you and your beautiful wife should decide to have more children, with or without the legal safety and assurance of government and legislative support, you will have a circle of people around you abo****ely committed to seeing that you receive the best care possible, even if they have to break the 'law' to do it. You both deserve it. Every birthing couple does.

[Tanya]

You women put me to shame... You are AWESOME!!

I just want to say that whoever is thinking of writing a submission then please do! I think they close today. They don't have to be as long or in depth as some you see here, Julie gave a great example of a short submission, I also wrote a very short letter. Any submission will do

xx