Ban on homebirth?

[MrsBexie]

I was talking to my sister in law the other day about the possibility that I would consider a homebirth for our next child depending on where we were posted and the hospital there.
She's totally not for homebirths and told me the government have banned home births after 2011 or something.. Maybe something about not insuring midwives to do homebirths??

Does anyone know what she meant and if this is true? What does this mean for HB? Are they not an option after 2011?

It annoys me that people are so against it and the government could even try to ban it!!! How I Birth should be my right to choose... However that may be!! I'm not even completely sure I want a HB but it makes me angry that my choice can be taken away by some ill informed politicians!!!

[onthefly]

I'm not 100% sure what the situation is right now, I think it's still technically under review (?) but I think that independent midwives will be required to form cooperative relationships with obstetricians in order to offer home births (know any OBs who would support a home birth...?) and the requirement to have insurance (which no insurer offers) will come in from 2012 (?).
There are still hospital-based & state-funded HB programs in some areas which will still be available. The AMA and FRANZCOG are working very hard to get homebirths banned, yes. It's very disappointing.

[Midwife Melissa]

Homebirth is still legal. It doesn't require a collaborative agreement with an obstetrician. Essentially, for homebirth nothing changes. If you would like to claim medicare for pregnancy and postnatal care, your midwife would need to have a collaborative agreement with a doctor. This is optional, ie, if no medicare, no agreement is needed.

There is no insurance for homebirth but this has been the case for many years now. There is insurance for pregnancy and postnatal care associated with a homebirth, but no insurance for the actual labour and birth at home.

[Loula]

(know any OBs who would support a home birth...?)

My OB! he is a huge supporter of HB! in fact he thinks only high risk women sould see an OB, im sure he thought i was wasting his time, but i told him i might not be high risk but i am high maintainence! lol (but there are more HB in UK which is where he is also from)

[Tanya]

Absolutely not, they will not and can not ban homebirths.

[PumpkinZulu]

They can just make it a damn sight harder for midwives to privately practice homebirths, which in turn makes it a damn sight more expensive for women to access, but no, they can not ban homebirths, just heavily restrict how accessable they are, and put fear into anyone considering it.

[MrsBexie]

stupid government!! I bet it is a room full of boys making the choices too!!!

[Jennifer13]

It's about whether midwives can access insurance, not whether mothers are 'allowed' to have homebirths.

FWIW there is still coverage for homebirth with some private health insurers, so there's no way it's illegal! Pity it can't be that easy for midwives. I'm pretty sure the govt will come up with a bridging agreement in 2012 until they can figure it out anyway.

I'm planning on a HB in 2011.

[Ozziehoffy]

Homebirth is still legal. It doesn't require a collaborative agreement with an obstetrician. Essentially, for homebirth nothing changes. If you would like to claim medicare for pregnancy and postnatal care, your midwife would need to have a collaborative agreement with a doctor. This is optional, ie, if no medicare, no agreement is needed.

There is no insurance for homebirth but this has been the case for many years now. There is insurance for pregnancy and postnatal care associated with a homebirth, but no insurance for the actual labour and birth at home.

What does this mean? When you say collaborative agreement? Do you need to be doing shared care or something? Or is there just a letter needed from your GP or something? Would it mean you can claim some of the IM costs through medicare?

[Midwife Melissa]

What does this mean? When you say collaborative agreement? Do you need to be doing shared care or something? Or is there just a letter needed from your GP or something? Would it mean you can claim some of the IM costs through medicare?

There are several options for collaborative agreements; possibly the best thing would be to talk to your IM about which options s/he is using and how this would work in practical terms. If your midwife has been approved as an eligible midwife and s/he has a collaborative agreement and a medicare provider number, then you can claim the cost of antenatal and postnatal consultations. You may still be out of pocket but the benefits are generous.

[HotI]

I thought i read that no collaborative agreements have yet been signed off.

[Midwife Melissa]

I thought i read that no collaborative agreements have yet been signed off.

That might have been the case in November but there is now at least one agreement. As I said though, a signed agreement is onyl one form of a collaborative arrangement; there are four options.

[thepixie]

As I understand it, the reason why it is said that homebirth will be illegal is this:
At the moment there is an exemption which allows a midwife to attend a homebirth without insurance. When the exemption expires, my understanding is that under the existing rules it will be illegal for a midwife to practice without insurance (it is a requirement of registration to have insurance). However, it is not currently possible for a midwife to obtain insurance that covers attendance at homebirths. Hence the catch-22. When I last asked the DoHA about this (in September 10) they said it was 'currently under discussion' but query whether that is actually true or just a standard answer.
It is theoretically possible that obstetricians or GP obstetricians may enter into collaborative agreement which allows midwives to attend homebirths but it is not clear how this would work exactly - what kind of 'supervision' would be required from the OB, and whether the OB's insurance would cover the homebirth. It doesn't seem that likely to me, as it would probably result in a large loading of premium that the OB/GP OB would have to bear, so at the moment I am not sure how they will get around this.

[Midwife Melissa]

As I understand it, the reason why it is said that homebirth will be illegal is this:
At the moment there is an exemption which allows a midwife to attend a homebirth without insurance. When the exemption expires, my understanding is that under the existing rules it will be illegal for a midwife to practice without insurance (it is a requirement of registration to have insurance). However, it is not currently possible for a midwife to obtain insurance that covers attendance at homebirths. Hence the catch-22. When I last asked the DoHA about this (in September 10) they said it was 'currently under discussion' but query whether that is actually true or just a standard answer.
It is theoretically possible that obstetricians or GP obstetricians may enter into collaborative agreement which allows midwives to attend homebirths but it is not clear how this would work exactly - what kind of 'supervision' would be required from the OB, and whether the OB's insurance would cover the homebirth. It doesn't seem that likely to me, as it would probably result in a large loading of premium that the OB/GP OB would have to bear, so at the moment I am not sure how they will get around this.

You need a collaborative arrangement for medicare but not for homebirth. The definition of collaborative arrangements does allow for homebirth to be funded by medicare (ie, antenatal and postatal care). Not all midwives are eligible for medicare and not all midwives will participate in a collaborative arrangement.

[thepixie]

I don't understand how homebirths will work when the insurance exemption expires though?
Insurance is not available for it, and midwives will not be permitted to practice without insurance which would rule out homebirth IYKWIM?

[Midwife Melissa]

I don't understand how homebirths will work when the insurance exemption expires though?
Insurance is not available for it, and midwives will not be permitted to practice without insurance which would rule out homebirth IYKWIM?

I don't think anyone knows that answer ... I'm sure it will be a source of great anxiety for women and midwives as that time approaches. TBH, I personally don't think they'll make it illegal, but I do think they'll put strict guidelines around the sorts of births that midwives can and cannot attend at home. They have done that in other parts of the world - eg Netherlands, Ireland, Canada etc. Just my opinion though.