Come on women and men of Australia - we REALLY need you right now...

[BellyBelly]

Hey all,

It's so so so important that as many of you as possible write submissions to the government for the Maternity Review. We need to let them know what we want, that we want choice, no matter if it's a minority choice... at the end of the day choice is choice.

The full details of the review are here. The official review website is here.

Please use this thread to share your submissions and get help/advice/suggestions in writing your own. It doesnt need to be formal and professional - we just need the numbers sharing their experiences.

Come on ladies, lets do this - you can email in your submissions, its so easy!!!

LETS STAND TOGETHER AND DEMAND CHANGE... TOGETHER WE WILL MAKE A DIFFERENCE!!!!!



Get those keyboards burning hot - invest even 15 minutes into writing something to change the culture of birth in Australia which is spiralling out of control.

[Lulu]

Yep, will do tonight, just marking the page so I remember!

[kirsty_lee]

ditto as lulu... Not going to be able to concentrate atm with ava-jayde playing her favourite game of 'lets throw our toys on the floor and make mummy pick them up cause its funny"

[Tobily]

Working on mine at the moment, will post it here when I'm done.

C'mon ladies we spend so much time and energy here posting about the problems, all it takes is the same amount of time and energy directed to making a submission so that we can tell the people who have the will and the power to make some changes.

We haven't had a chance like this for a long time - the health minister is actually listening.

[Beach Mama]

Marking too and will be back later tonight. Mine might be a tad long! Tobily would love to see what others come up with!

[Trillian]

Here is mine. I did it last night.

Submission for the Maternal Health Services Review.

I write this to you as a mother of 4 children who had to travel 80 kilometres just to give birth to them.

This review is long overdue and my hope is that it makes serious inroads into the state of maternal health care in this country.

When my husband and I found out that we were expecting our first child, due to be born in early 2001, we were hoping that we would be able to birth him in our brand new local hospital, which was completed in the previous year. It was a state-of-the-art facility, complete with Maternity ward and we were excited to think that our child could be born there. Although we knew that in the ?old? hospital that the Maternity unit had been downgraded to only accept those women considered ?low risk? ? women who had no previous complications during birth and those who were multiparas (women on subsequent pregnancies), we hoped that with this new hospital it would bring a new opportunity for those women previously excluded to be able to birth there.

But we were to find out that the status quo would continue at the new hospital. This meant that I was excluded from our local hospital and that I would now have to travel a 160 kilometre round trip to the next town to see a Doctor I had never met before, in a town I didn?t frequent and give birth in a hospital far away from family. There was the vague hope that after I gave birth I would be able to travel back to my local hospital for my post-partum hospital stay, but within 6 months of my falling pregnant, even this option was taken away from me.

And even then there was no guarantee that I would give birth in this hospital. It was only a small District Hospital and could only take women after 38 weeks of gestation, women with singleton pregnancies, women with no health complications for themselves or their babies. If you were in any way considered to be ?high risk? then you were forced to travel to the NEXT hospital, which was a further 80 kilometres away.

Overall I cannot complain about my births, I had the best Doctor?s and the best Midwives, I had vaginal births and I had perfect and healthy babies and although I had some complications after one of my births, I was attended to in an extremely professional manner and quickly received the treatment I needed. But not all women are as fortunate as I and suffer terrible birth traumas that can take many years for them to fully digest and recover from.

The situation has only become more dire as the years have gone on. Not one single pregnant woman I talk to doesn?t have concerns that she will not make it to the hospital in time and fears either giving birth at home unattended or by the roadside. This raises another, separate issue, in that the husbands and partners of these labouring women are under even more pressure to get them to the hospital ?on time?.

It makes me wonder if women and their babies will have to start dying before anything is ever done about this situation. I accept that sometimes it is a staffing issue ? there just isn?t enough Doctors or Midwives in an area to run rosters. But most disgraceful of all is that often it is just Bureaucratic red tape or bungling that sees fully functioning Maternity wards either downgraded or closed.

Rural women have a right to the same quality of Maternal health care as our city sisters. We want more choices, we want access to Independent Midwives for homebirths, we want fully functioning hospital Maternity wards, and we want Birth Centres. Our choices are severely limited before we even start.

Not only do we have severely limited choices for our preferred mode of care, which currently stands at Public or Private Hospital only, we are also at the mercy of the care we have. Women who have had surgical births have no option to have a future vaginal birth (or VBAC ? Vaginal Birth After Caesarean) because none of the current care providers are willing to take it on or encourage it because it?s just too hard for them. Obstetrician?s would rather talk a woman into having another surgical birth than let her have a vaginal birth ? a birth which would see her leave hospital for home sooner, as opposed to a surgical birth which would see her in hospital for a longer stay, which then takes beds away from other women, not to mention taking up valuable theatre time which could be better used towards shortening the surgical waiting lists.

We need to move away from the Medicalised birth industry and start treating birth as the natural and normal process that it is. Australia has a disgustingly high surgical birth rate and steps need to be made to lower it. For too long Obstetricians have ruled the roost when it comes to birth and this needs to change. Of course they have their place in birth when it is complicated and needs to be medicalised, but when birth is taking place in a normal, healthy woman with a healthy baby, then there is no need for them.

Sadly though the AMA, and namely Obstetricians specifically, are at loggerheads with the natural birth movement and shun the idea that Midwives are fully capable of taking over control of birthing women and this needs to change. The choice should be given to the birthing women, not to have it dictated to them by the medical fraternity.

Medicalised birth costs this country millions of dollars each year, money which could be redirected into other health areas.

Another problem that goes hand in hand with Maternity services is the post-natal care that women in rural areas receive and basically there is none. There are Maternal Child Health Nurses for the weekly check-ups of our babies, but where is the access to qualified Lactation Consultants? The Parliamentary Inquiry into Breastfeeding last year found that there were severe issues in this area that needed addressing, but it hasn?t solved the problem. The attrition rate for Breastfeeding is very high in rural areas simply because there isn?t the backup and support needed once a Mother is home with her baby. Often the advice one receives in hospital is conflicting and can leave a new Mother, who is struggling trying to establish a breastfeeding relationship with her baby with no other option but to turn to artificial feeding of her baby ? something which can have a possible long term impact of the health of the child. Very concerning is that not all midwives are certified Lactation Consultants, so that at the most crucial time for establishing breastfeeding a women can?t even access the best person to help her.

Unlike our city counterparts, we don?t have access to Lactation Consultants that can come into our home once we leave hospital and give us the direction we need if we are struggling. All we have is access to a phone help line, which is staffed by time-starved mothers themselves and speaking to someone on the phone who could be hundreds of kilometres away isn?t conducive to helping us the way that we need it the most.

We often don?t even have access to proper care and treatment for Post Natal Depression. All we get is the Edinburgh test and there isn?t enough follow up treatment or access to qualified counsellors if we need them.

Another issue is that the sheer distances required to travel to seek care for some women mean that they put off appointments for check ups, or they simply don?t go because either the cost of travel or the distance (and often both) is too prohibitive. This means that lives are possible at stake if complications arise and remain untreated.

In the weeks before the birth some remote families have no option but to relocate to be closer to where they will give birth. This means that they then have to travel the long distance back home in the post-partum period, so it is no wonder that women are being failed by the system when they bid their farewell to the hospital and face the daunting challenge of becoming a parent with no support network once they get home.

I am part of an online Conception, Pregnancy and Parenting community forum and every single day I read of the hardships that women face when having to decide on care providers and which mode of care they want for their pregnancy and birth. It breaks my heart to read of women who cannot get into the precious few Birth Centres that there are in this country due to lack of places, of women who want a homebirth but can?t because they cannot afford it, of women who blindly trust their Obstetricians are led into the most Medialised of births ? something which can ruin all future births for them, of women who aren?t educated enough about the choices they do have, and about women heartbroken because they couldn?t establish breastfeeding.


What I would like to see changed in our Maternal health care system is;

• Fully funded Independent Midwives to allow women to choose homebirth ? something which should be encouraged as a valid option as it lessens the burden on Hospitals ? both in regards to bed shortages which is pandemic in almost all hospitals and also freeing up time-starved medical staff.
• Women given a choice of care models, whether it be Independent Midwife led care, Midwife led care in a hospital or birth centre setting or the medicalised mode of care led by Obstetricians.
• More places for direct entry Midwifery at Universities. This will put more Midwives into the workforce quicker than it previously does with the current limited placements for direct entry B.Mid, meaning that those who miss out have to take the ?long road? and do their Bachelor of Nursing first.
• Re-open closed Maternity wards as Midwife led care Birth Centres for the smaller townships. This way low risk mothers will get to give birth locally.
• Include Lactation Consultancy as part of the B.Mid. Currently as it stands this is an ?optional extra? and what is included as part of the degree isn?t comprehensive enough. Only those that wish to pursue it further do so. It should be mandatory for Midwives to also be qualified Lactation Consultants so that new mothers get the help they deserve at the time they need it the most.
• Access to Post Natal Depression counselling and help for those that need more intensive treatment.

We?re not asking for much and it may be too late for me, as my childbearing days are finished, but I want this for those that are to come after me, and for my Daughters. I shudder at the thought of what the Maternal health system could be like when they are giving birth to my Grandchildren.

I thank you for allowing me the opportunity to have my say on a subject that is very close to my heart.

[Trillian]

And this is the related article I posted about the Review earlier today https://www.bellybelly.com.au/forums...-our-help.html

[~clover~]

OMG! I have a local hospital, but had to travel 2 hours to have DS - passing 2 other hospitals on the way that you can't birth in! I mean NOONE! No matter how many babies you've had, well unless you are going to give birth in 5 minutes. As well as travelling the 2 hours just for ante natal care every week towards the end.
I'll bbl to have a better read!

[Schmickers]

Here's mine.

I make my submission as a consumer of maternity services in NSW, as a health care professional, as a husband, and as a father.
I have two beautiful daughters, both of whom have been born at home. On both of these occasions, we took responsibility for the arrangement of a privately employed midwife, and paid for her services.
It continues to astound me, as both a health professional and as a parent, that such services are not provided as part of the public health system. Research from around the world into the use of independently practicing midwives to manage pregnancy care, birth, and postnatal care in the home setting has consistently confirmed two outcomes – that home birth is as safe as hospital birth or safer for women who are appropriately screened, and that the rate of intervention is much lower. Other similar research has indicated that for women who have pregnancy care and give birth in the home setting, rates of satisfaction are higher than for similar women who have their pregnancy care and give birth in a hospital setting.
While I understand that the provision of maternity services is a politically fraught area, and I have read the Australia and New Zealand College of Obstetricians and Gynaecologists statement concerning their refusal to endorse home birth as a "safe" option, even this organisation cannot deny the wide-ranging body of research that demonstrates the benefits of this model. Indeed, such a model of midwifery-led maternity services has been successfully implemented in New Zealand, where caesarean section rates are now much lower than our own country.
Consider also the cost of providing midwife-led and homebirth services, as opposed to allowing obstetric- and hospital-based management of maternity care for all women, irrespective of their risk factors. Independently practicing midwives currently charge between $3,000 and $4,000 for their services; this fee includes all prenatal, birth, and postnatal care and the provision of all necessary equipment. While I do not currently have access to accurate financial statistics pertaining to the cost of maternity services in the hospital setting, consider that a hospital stay, including interventions such as forceps extraction, continuous fetal monitoring, or a caesarean section, costs considerably more than the cost of a homebirth. Also consider that the number of women who require a caesarean section in the hospital system is around 30%; the number of women who require a caesarean section during an attempt to birth at home is around 2%. While some of this disparity can be explained by the more stringent screening procedures that apply to women who home birth, it is clear that even if the government were to fund or partially fund independently practicing midwives under Medicare, or alternatively introduce such services as part of the public maternity system, the result would be significant cost savings.
Home birth and midwife-led care for appropriately screened clients is safer, more satisfying for clients, and less expensive than obstetric- and hospital-managed birth. It is a disgraceful mark on our health care system that this form of care remains so inaccessible to the majority of women, in particular low-risk women living in rural areas who under the current system are often required to leave their homes and travel hundreds of kilometres only to be placed under obstetric (high risk) management. This situation needs to be addressed.

[~clover~]

As a mother of three I am concerned about our health system & maternity care.

When I had my first daughter I lived 10 minutes away from a hospital with a maternity ward, but as I was only 18 and it was my first child I could not have my baby there and had to make the forty minute drive to a bigger hospital.
I also did the same with my second daughter.

When I had my son we lived in a different area. I was living 5 minutes from the closest hospital, 40 minutes from the next one, then had a third one hour away. Not one of these three hospitals had a functioning maternity ward. Instead I had to travel two hours to my nearest maternity ward.

I also had to travel those two hours to visit my ante natal clinic as it was the closest to me. This meant that by the end of my pregnancy I had to keep my oldest child out of school for one day a fortnight, then one day a week.

Then when I was close to having my son I went to stay with my mother and father in law so I could get to the hospital in time. This meant another two weeks my daughter couldn't attend school and two weeks I had to be away from my husband as he had to stay for work.

Then when I went into labour my husband had to travel the two hours to get to me before his son was born. We are lucky that my labour was 5 hours. He made it with just over an hour to go before I had our baby.
But this meant I was alone til he got there.

I think the situation should be reevaluated. Maternity services are dropping off where they are needed. The town I live in has a high rate of teen pregnancy, yet these teens are supposed to be able to find their way to the bigger hospital to have their needs met when there is a very slim chance that they or their partners have a license or car.

When I was pregnant with my second daughter I chose to only see my general practitioner and went into labour without having seen an obstetrician once. My labour was attended by a midwife only and it was the most relaxed and natural labour I have had.

I think it is about time everyone realises that we are women. We have been giving birth for thousands of years. Why can't those of lower risk give birth in their home towns where they are close to family and friends when they will need them the most?

I would rather have just me, my husband and a midwife at a small hospital, than just my husband and I on the side of the road trying to make the two hour drive.

Can you guys read over this for me & let me know what you think first? My baby brain isn't quite sure how it sounds!

[Trillian]

I think that's fine Skye, well done.

[Neenee Jellybeanie]

I don't know what to say in mine.

[Tobily]

Trillian, Michael and Skye....

Neenee - what they're looking to hear about from mums are your personal experiences of birthing in the current system. Whether you found the system met your needs in terms of choices for care, and whether your expectations were met with care you did receive. If not, what would you have liked to see improved?

For example for mine, I will talk about how the only options given to me when I was pregnant with my first child were public or private hospital care. I had no idea about independent midwives or the safety of homebirth...in fact I didn't even know Australian women could have homebirths. I experienced a highly intervened labour involving a number of practices which are not supported by evidence, for example breaking my waters, intravenous antibiotics without presence of an infection or reason to think I would develop one, syntocinon under circumstances where it wasn't yet necessary. I'll probably mention the early breastfeeding difficulties we experienced and the (total) lack of assistance despite the fact that I live in the middle of a major capital city. I'll also talk a little about some of the "stand out" experiences I've had in hospitals supporting other mothers.

Finally, you can make some suggestions for improvements.
The big things are:

1. Provider numbers for Independent midwives. This will enable mothers to claim for their services through medicare.
2. Addressing the lack of indemnity insurance for IM's. This lack of professional insurance is a guarantee that a good proportion of qualified middies are "scared off" independent practice because it is too risky for them personally to not be insured.
3. Rural access to maternity services - the closure of maternity wards in rural areas seeing low risk, healthy women travel ridiculous distances to birth.
4. Addressing the issues in the way our system is structured that sees a high proportion of low risk women under the care of obstetricians - who are proven to intervene in their pregnancies and labours more often than midwives, with no improvement in outcomes. Intervention can be life saving when it's needed, when done "just in case" it increases risks for mother and baby.
5. Support for breastfeeding - wider access to subsidised lactation consultants and implementation of the other recommendations that came out of the previous governments breastfeeding inquiry.

OK off you go

[~Aveta~]

done, sent, and the links forwarded to my local doula and other mums


Dear Ms Bryant,

As a woman in her forties trying to have another child in a small town, I have been distressed and disappointed with the lack of services available to pregnant women in the Coffs Harbour area. In February of this year, a routine ultrasound at 9.5 weeks gestation revealed that my baby’s heartbeat and growth had stopped at around the 7.5 week mark. I was advised by my GP to go to Emergency at Coffs Harbour Health Campus for a D&C. My fianc? and I waited fourteen hours, grieving and in pain, to be examined by a doctor. When I was finally taken up for the surgery there was a mistake in the admissions process, I was never given pre-op meds, and the surgeon I had spoken to beforehand wasn’t the one who actually did the D&C.

I was sent home with no post-op instructions, no painkillers, and no antibiotics, with no appointment for a follow-op checkup either. Later that week I was back in emergency with retained products of conception and waited another 12 hours to be examined. I was never offered grief and loss counselling, never seen by a social worker, and not even referred for genetic counselling . The stress of being left to miscarry on my own in the waiting room has contributed greatly to the grief and loss I have suffered. The Coffs Harbour Pregnancy Care Service is brand new – I had children in Coffs Harbour in 1988 and 1992 and there was no ante-natal clinic there at that time, one of the factors that led me to have a home-birth with my youngest, as I received more care from the homebirth midwife than I had had from my OB with the twins in 1988. Another was the distance to a birthing unit – we lived 30km out of Coffs Harbour at the time.

I believe the Pregnancy Care Service is vital to the wellbeing and safety of the women of Coffs Harbour. I have struggled through three miscarriages so far this year to receive continuity of care, in a town where there are very few OB’s and at $180.00 per visit plus a six-week waiting list, are out of the price reach of most families in this low-income area. I am still trying to access specific grief and loss counselling, and follow-up care for complications arising from miscarriage and an ageing reproductive system. Lack of access to care is a primary reason why some women are choosing to not have children and particularly those of us in the older, high-risk category.

The bottom line is, if women cannot access suitable support services, they are being put at risk in their pregnancies.


Thank you for your time.

[~clover~]

Dragonfly - I had both my girls at CHHC. I lived in Nambucca Heads at the time, but couldn't go to Macksville.
I don't know about your experiences with the Coffs Obs, but I had the 3 that were around at the time & wasn't impressed with any of them.
But in saying that I had a much better experience there than in Dubbo - 2 hours away from where I am now.
In 2001/2 & 2004/5 I was never advised of any ante natal clinic in Coffs either. An Ob was the only choice. Which, yeah, cost a fortune. (One of the reasons I didn't see one with DD2.)

[~Aveta~]

Dragonfly - I had both my girls at CHHC. I lived in Nambucca Heads at the time, but couldn't go to Macksville.
I don't know about your experiences with the Coffs Obs, but I had the 3 that were around at the time & wasn't impressed with any of them.
But in saying that I had a much better experience there than in Dubbo - 2 hours away from where I am now.
In 2001/2 & 2004/5 I was never advised of any ante natal clinic in Coffs either. An Ob was the only choice. Which, yeah, cost a fortune. (One of the reasons I didn't see one with DD2.)

up until may this year there wasn't any such thing as an antenatal clinic in Coffs. when i was having the twins in 1988, there was two OB's, Garland and Ghosh, and two GP's who would attend a birth. I was passed from doctor to doctor until i moved back up here from Wollongong, and had Ghosh for the last few weeks of the pg, whereupon he went on holiday and left me int he hands of an inexperienced locum. needless to say i had a horribly intervened-upon birth that nearly resulted in the death of myself and my son!

Garland is still practicing, and still prefers to do c/s than let a mother birth. the other two OB's are much better, Harvey Ward (who also is the Sydney IVF outreach) and Marylin Clarke, who works for the Pregnancy Care Clinic (the antenatal at the hospital) as well as her private practice. both are too expensive for me.

i chose a VBAC homebirth with my youngest, with a hospital trained English midwife, and it was the best choice i could have made. having said that, it was always onthe cards that i would rupture or have complications, and 30k from hospital was a worry, but i trusted her and my body/instincts, and it went smoothly.

[~clover~]

Garland, Goldman (Goldfinger) & Brimsmeed.

They are the three I met.

I was under DR Goldman (with the lovely nn), but ended up in labour with DR Garland for DD1. If you read my birth story he did want to take me for a ceaser coz it was taking too long!! I had DD1 myself a bit over an hour later thanks to my MIL saying no!

Goldman wanted to induce me 2 days before I was due to have DD1.

Never gave Brimsmeed a chance. I booked under him, but just saw my GP right up to the end. He came in after the birth of DD2, decided I didn't need stitches & that was it!

[~Aveta~]

it's all new to me, lol, i never thought i'd have a chance to have another as my ex didn't want any more kids. they're 20 and 16 now! lucky for me, DF is ready, willing, and able

still, living in a country town means that now Baringa Hospital has no birthing unit, there really isn't a choice at all.