Julie Doula - I LOVE your work...

Caro: I am not sure who said that obs are greedy - I don't recall reading that. Undoubtedly they are very expensive as is private health insurance. I am a nurse and am fully aware of the HUGE insurance bills faced by obstetricians. I also would like to make a little point.

When you see an obs (trust me over the past couple of years I have seen my share!) it is a quick 10-15 minutes. When you see a professional midwife your visit extends sometimes up to an hour and sometimes more! A doctors visit for that 15 minutes costs around $120 at my obs - with during a 40 week pregnancy requiring perhaps 15 visits that's about $1800. On top of that you have the delivery costs and the insurance costs that are passed on to the client. This is now packaged as a pregnancy maintance fee or some other such wording. My obs charges $2500 for this... Then for a routine delivery the cost is another $1200 so tht takes us up to $5300. Of course the fees will vary between obs and obs and depending on where you are situated. A friend of mine was charged $4000 from a Melbourne obs for her pregnancy maintainence fee. So clearly the fees are high. The fee at my obs will depend on the risk of the delivery. A "complicated" delivery will cost more - having a condition such as GD will mean I am a "complicated delivery" and with this I was charged an extra $500.

An independent midwife will charge a set fee. What she charges will depend again on where she is situated, where you are situated etc. An independent midwife in my area charges approx. $3000 for a birth (including antenatal and postnatal care) The midwife will come to YOUR home and visit you before during and after the birth. She will bring her practice to you. She will spend at LEAST half an hour (often more) with you and talk to you about your joys and fears. She will palpate your baby, talk to your baby, listen to your baby, watch your baby grow safely... She will massage you and get to know your husband and other children. She will refer you on if a dis order rears its head. She will come when you phone her when you are in labour when you need her to. She will stay with you and support you at home or in hospital wherever your preferred birhing place is. The costs involved with this vary from midwife to midwife. However, the cost is less than an obs and the time she will give you is much more.

An obstetrician is a doctor. He treats dis order. His role is to care for women who need medical assistance. As many of the women have said in here THANK GOODNESS that we have access to them if we need them. I personally have never required a doctor for any of my births. (However I do require one now for my pregnancies due to a dis order I have.) Most often an obs will come only when birth is imminent. He/she has many more clients than an independent midwife they simply haven't the time to labour with you or to come to your home.

Someone mentioned not comparing apples with apples. We can't compare midwifery care with obstetric care as they are very different. The charges are different because the service is different. One is treating dis order and one is caring for women during a natural process.

Tara: You had a harrowing experience and I am so sorry :hugs:. There are certainly midwives out there like that, I have come across some too . I hope your next birth is all that you want it to be. Choosing a birthing centre with midwives that you can get to know and can get to know you is a wonderful way to get the birth you chooose.

Safe birth is about INFORMED choice. Not choice made from a perspective of fear and not choice made from a perspective of "it won't happen to me". We do need balance as Julie Doula has so beautifully put.

My concern is that women are very often not independently seeking out the truth. Women are fed images from the media about "what goes wrong". We get images of those over the top movie stars that are "too posh to push". We are fed fearful stories by our mothers and grandmothers who often had APALLING birth stories to tell. It was the norm in the 60's and 70's and even in the 80's to be drugged and in stirrups.
We think that we are safer in the hands of a doctor that we will get a better outcome. The stats just don't support that. Statistically you will have a better birth outcome if you are supported through pregnancy and birth by a woman known to you. Women who educate themselves about the birthing process generally care for their bodies, minds and spirits. They read and educate themselves, they connect with other women. This is what we need to have an empowered birth.
Yes, you can have that and still be under the care of an obs. But you need to make some choices. If you are laboruing under the care of an obs you can ask for what you need. I laboured with my last child under the care of an obs but I had my own midwife. I asked that the obs did not enter my birthing space unless there was a medical indicator. I found an obs who would do this. He sat outside and read the paper and ate donuts. I needed to protect my birthing space. That to me is sacred. I made it my own with oils, and candles and music and my children around me. Someone mentioned that to birth we need to replicate the conception space. This is so very true. No one wants to get jiggy with it on a stainlessteel bed. No womb feels like giving up it's baby in a sterile environment. Many new hospitals recognise this and birthing centres where there are lamps and soft furnishings. These things (meaning a homley environment) are incredibly important. OUREHEADS ARE THE MOST IMPORTANT BIRTHING ORGAN. When are head is right so are our cervix's.
Who wants to make love with strangeers watching? Not many of us. The same with birth - we need to have a connection and a relationship with those that are in our birthing space. We need to move freely. We need to vocalise. To squat to swivel to dance to cry...

African women are not the same as white Australian women - Indigenous women face third world conditions too unfortunately in this land of plenty. Women of spirit are bundled off to the stainless steel rooms to birth their babies - often these women have terrible experiences. They don't believe it is "right" to birth away from the land. We can learn an awful lot from our indigenous sisters. They know about instinct and position and about woman love and support. Yes, they need a little help sometimes too just as white australians do but they very often haven't lost their inherited "knowing" about birth.

Someone mentioned that a midwife led birth isn't for everyone. I wonder why that is? Clearly it's not if there is a medical problem. But apart from that I believe that many women don't choose a midwife because they don't really understand what a midwife can do. They have experiences in hospital where a different midwife comes on each shift and you need to get into a new rythum with her. This isn't what is should be like. Birth is a sacred event. It should not be at the whim of a shift change. Women should labour with a midwife that they know. This has been proven to have incredibly good outcomes.
We can learn much from countries such as NZ and even the UK.

We need to ask for what we want. There will always be women who want a medicalised birth. What I fear though is when women make this choice without an educated decision. This decision is often made from a perspective of fear. This troubles me greatly...