Would you give birth in a midwifery led unit?

[Julie Doula]

Perinatal stats show that 97% of Victorian women give birth in hospitals under the Obstetric Model. Only 2% give birth in Birth Centres, and experience the Midwifery Model. However, these aren't strictly "midwifery-led units": unlike other countries, they are not independent, free-standing or midwife-led - the midwives do their best but are still bound by obstetric policy.
Only 0.3% of Victorian women experience midwifery-led care, those that choose homebirth. Of the 222 Victorian women who gave birth at home in 2005, 90% had a spontaneous vaginal birth, 80% had an intact perineum, 96% had no pharmaceutical pain relief, 16% transfered to hospital and 4% had a caesarean.

Women who obtain birth centre care, and/or Midwifery Model care, are a tiny, tiny, tiny minority in our current birth culture.

I'm not convinced that 97% of women give birth under the Obstetric Model because 97% of women prefer it. I think that the lack of opportunity, information, options and funding have something to do with it. By contrast - 80% of women in NZ choose one-to-one Midwifery Model care. It's not because they're a big bunch of hippies who love suffering. It might have quite a lot to do with the fact that it is funded in NZ, and because the first person most women see when they get pregnant is a midwife - not a GP.

I've heard from so many women that when making enquiries regarding birth options in early pregnancy, they get told their choice is between private and public. I.e. two versions of the Obstetric Model. Many doctors don't mention birth centres, most don't mention homebirth. ONe of my clients, when she informed her GP of her decision to go through a birth centre, was told, "Have you got any idea how many births they botch up???" I think that very few women are presented with the full menu of birth options. They get the censored, abridged version. That's not informed choice. That's not choice at all. If women really did have a choice, and Midwifery Model choices were as well funded and supported as Obstetric Model choices, I think it is possible that more than 3% of Australian women would choose them.

At any rate, those who are opposed to the Midwifery Model, and those who do not desire it out of personal preference or need, are certainly not in a place of duress or at any risk their preferences will become less accessible or less supported.