Would you give birth in a midwifery led unit?

[BellyBelly]

The Daily Telegraph are doing a story on this tomorrow - make sure you grab a copy Thanks to webbmeg for being interviewed as a case study too

[Mumma2three]

Wee hee!! thanks Kelly!! Just had our photo shoot and Coco did not smile for ONE pic!! GGGRRR. That's 2.5 year olds for you!! (usually such a performer)! Anyway, looking forward to the story tomorrow!! xo

[BellyBelly]

Hopefully it will be online Else I will go to a newsagent that has interstate papers!

[sacha88]

i agree with you Trish!

[Toomanytoomany]

Following on from this Obstetrician's comment:

If you had a choice, would you choose to give birth in a midwifery led unit (where there is emergency transport available and hospital closeby), or would you prefer an obstetric model of care? I wonder if 10% is reflective of the BellyBelly membership?

I'm pretty sure that I've *had* that guy as an OB! And I'm not sure I'd prefer him over birthing in a barn, let alone a fully equipped midwifery unit!

The ironic thing is, at Wodonga hospital, the midwives manage most of the labour and delivery anyway, even the inductions!!

It's a vicious circle with mid centres, even homebirth - the fewer of them there are, the less normalised they are, the more nervous women are about using them. You offer the services, more people use them, and then it becomes more normalised and people want to use them more.

You just have to look at the demand at birthing centres to see how much in practice women want to use these services.

I'm hoping to use midwifery care, but it will probably be at either a birthing unit attached to a hospital.

[BellyBelly]

It's a vicious circle with mid centres, even homebirth - the fewer of them there are, the less normalised they are, the more nervous women are about using them. You offer the services, more people use them, and then it becomes more normalised and people want to use them more.

You just have to look at the demand at birthing centres to see how much in practice women want to use these services.

Too true. And you just have to look at how booked out our birth centres are to realise women do not actually have choice! They end up in the public system because the birth centres only take you if you found out you were pregnant yesterday. So many missing out on what they want.

At the end of the day it doesn't matter if only 10% wanted to use these services, the fact remains that there is not choice for women, and those 10/20/30 - whatever percent - deserve choice.

[Trillian]

So the magical 10% that's being spoken about is basically just the amount of women that actually get into, and then birth at a birthing centre, and this guy has taken that paltry number and ran a mile with it, not explaining or caring to explain to everyone that in reality, the 10% isn't because that's all that want it, but that's all that can be catered for. So the reality is that there is likely to be far more than 10% wanting to have this mode of care, but due to limited places or being excluded for reasons such as the oh-so-dangerous gestational diabetes, high blood pressure and a myriad of other maternal issues.

[Pandora]

Definitely.
I rang and registered for a caseload midwifery program athe day after I got my BFP and am 100% sure of my choice, even though it means travelling an extra 20 minutes for appts and to the hospital.

[Sass]

I was able to chose this option as a fluke from living in the right postcode. The state government originally funded a midwife practice to run for indigenous mothers in the area and when there weren't as many of them they expanded it to include other mothers in certain postcodes.

All of my antenatal care was through my midwife's practice and one of the midwives from the practice was there for my entire labour (they're only allowed to work for 12hr shifts so they swapped and my main midwife managed to be back just in time for both of them to be there for the actual birth).

I have private health insurance but the only way I was allowed under this model of care was as a public patient - to book in as a private patient I had to go under an Obstetrician.

I ended up with an emergency c-section in the end, but the care from my midwives from start to finish was nothing more than brilliant. Not only that, the only reason I got to have my son in recovery with me was because my midwife was there and thus there was a nurse for the baby. Normally that isn't the case and they're not staffed for infants so the mothers are in there alone.

I'll also say that the post-operative care on the wards was abysmal and the only decent care I got was from midwife who came to check on me every day and a night nurse that was there for one night.

I am not a good candidate for a VBAC, so I'm staring down the barrel of a scheduled cesarian for any future births and that means I have to go under an Ob, but I'll be trying damned hard to find a practice that will allow me to have shared care with a midwife team again.

Edited for clarity - the midwife unit was attached to the hospital as one of their modes of care, so while all my antenatal and postnatal checks were done with the midwife group (and my labour would have been only attended by them had it all gone to plan) it was still attached to the Birthing Centre at the hospital, so I never had to chose between midwife only or hospital care

[cindyb]

definately would and did with my 1st in QLD - never saw an obgyn at any stage of preg or labour / birth

[melt]

I am planning to have my first birth at home with midwives, my second choice would be to go to a midwifery led unit. It's dissapointing that we are not very progressive when it comes to midwife based care in birth. A government funded programme for midwives in homebirth would be an amazing step forward. The only two states in Australia that currently offer this are W.A - if you live in Perth and South Australia - if you live in one of two suburbs! the other thing I have found is that women often do not realize what options are available to them outside of the medical model, especially first time mothers. Maybe one day we will have a model closer to that of new zealand where birthing with midwives at home or in midwifery led units is the norm. i hope so.

[Trillian]

It would be nice if that were to ever happen, but for those of us living west of the blue mountains or in other rural areas around the country, we are flat getting enough midwives to staff a hospital roster let alone run a birthing unit. There is no other choice out here other than the hospital model of care and I can't see it ever changing.

[Smoke Jaguar]

Yet, if midwives in hospitals were experienced in homebirthing and allowed to practice either attached to a hospital or funded by the government to provide services to rural and regional women, this sensible option would make a lot of women very happy with their birthing experiences
Still, as long as the AMA is going to bully women into believing that doctors are the key to live babies, insurance companies and the government are also going to believe this

[Tobily]

Yet, if midwives in hospitals were experienced in homebirthing and allowed to practice either attached to a hospital or funded by the government to provide services to rural and regional women, this sensible option would make a lot of women very happy with their birthing experiences
Still, as long as the AMA is going to bully women into believing that doctors are the key to live babies, insurance companies and the government are also going to believe this

And I think that that's the fundamental problem we have here.

Australian midwives are not experienced in homebirth on the whole, they are trained, and work in hospitals. So they are subject to a very medicalised, obstetric view of birth much of the time.

In NZ there is no obstetric lobby group scaremongering women into hospitals. The AMA and the RANZCOG are very vocal, and very powerful here. And while ever that is the case, a NZ type model will remain a pipe dream.

[Smoke Jaguar]

EzAckly, Tobily! Still wondering where they put all those dead, deformed, disabled babies in NZ...It's not a very big place...

[Trillian]

But it wouldn't matter if there were enough midwives in a lot of cases because of the sheer distance some women are from a hospital, if something did happen to go wrong and further medical intervention was needed you are a minimum of 2hrs from a hospital that can do an emergency c/s. Like for my situation - I am 80km from the nearest hospital that has a functioning maternity unit. Due to that unit only being within a small district hospital women can only birth there at term (being 37-42wks - if you show up in labour earlier than that they ship you onto the next hospital up the line but naturally if there is no time for that then you birth there but there are no facilities available if baby is unwell at birth) and if an emergency c/s is needed it can be done (as are elective ones). BUT if the mother presents with twins, they cannot be birthed there - they have to go onto the next hospital, which is a larger base hospital and even then they can only handle births after 35wks gestation - anything earlier than that and you get a trip to Canberra.

Even when I had Alister last year, there was a huge dilemma when my Dr decided to leave town - he was the only anaethetist and one of two GP Obs in that town. Now if any women went there to birth and required and emergency c/s, she would have to be rushed to the Base hospital 1hr away in an ambulance - mothers and babies can die in an hr and if the situation was bad enough, that was a real possibility of happening.

I just don't think that those of you in metro areas fully appreciate the choices you do have. Even though some of you may find it hard to get into a birthing centre, you still have that choice, you have the choice of a homebirth, you have a choice of a public hospital birth, you have the choice of a private hospital birth. So compared to us, you are SPOILT for choice.

[richsaralex]

I agree mostly with whats been said so far... tho I should add that the reason midwifery care disappeared from view for a while was because their insurance premiums went through the roof!! They used to practice independently, but were forced into working in 'units' in hospitals etc so they could afford to still practice as midwives!

The other main problem though is the medical profession! They have this 'god' complex where they beleive that nobody other than a trained doctor could know what they are doing (I mean this in relation to EVERYTHING health related) If they just stopped their scare-mongering then alot of health issues could be so easily solved! There would be no need for all these drugs and sometimes even surgeries!
My midwives were very certain that alot of intervention in labour is so easily avoided through some very very simple techniques! Even just considering the power of thought - avoiding an induced labour or c-section through sorting out any emotional issues you might have about the birth of your baby! Its amazing stuff and I honestly beleive I would have ended up on a surgical table in my birth if not for my husband talking very strongly to me, and talking me round to accept that I really was capable of delivering my baby naturally.

Its incredible that there exists the number of natural therapies and techniques for any number of things, yet you will be hard pressed to find a doctor who has an open enough mind to support anything outside his/her immediate education.

Until the medical profession changes - and this wont happen until the people demand it - then of course we wont see change!! People need to educate themselves (the internet is an amazing resource & should be more utilised in making educated health decisions), make their own decisions and stand up and say "no" to the medical profession when its obvious there are other more viable alternatives.

[BellyBelly]

Has anyone seen this in the Daily Telegraph? Supposed to be in today but I cant see it online.... anyone got a copy?