homebirth general discussion #9

[HotI]

Can you not access it on-line in the US? i will find the link for you.

[meow]

iView has regional settings and you can't view it outside of Australia

[HotI]

Lateline - 26/04/2012: New insurance rules to affect homebirths



Transcript
EMMA ALBERICI, PRESENTER: Midwives are warning that proposed new insurance rules will put more women and their babies at risk if they choose to give birth at home.


Tomorrow state and federal health ministers will consider a plan to insure private midwives who perform low risk home births.


But that, say the midwives, means they'll be unable to attend women in riskier home births, leaving the field open to unqualified and unregulated practitioners.


This report from John Stewart and Candice Talberg.


JOHN STEWART, REPORTER: Kelly Lanfranca's first two children were born in hospital, both by Caesarean section. It was an experience that left her traumatised and angry.


KELLY LANFRANCA, MOTHER: I feel robbed. I feel like that very first birth, I wish somebody had have told me back then - because I was only 25 - I wish somebody had told me that the decisions you make for your first birth will forever impact what you do. Because I took the advice of somebody who was clearly more concerned with scheduling than my own journey, I guess.


JOHN STEWART: Seven weeks ago, Kelly Lanfranca delivered her third child, Ava. This time, she chose to birth at home with a midwife.


KELLY LANFRANCA: The person who was here caring for me was someone who I had spent 20 weeks getting to know, who knew me so well, who knew what I wanted from this birth, who knew my behaviour, my mannerisms, my personality, so she could tell the whole time that I was perfectly fine, perfectly comfortable, perfectly relaxed.


JOHN STEWART: Most home births are attended by a midwife, but most private practising midwives are not insured to deliver babies at home. From mid-next year, all midwives will have to be insured, in line with new laws for health professionals.


Tomorrow, health ministers will consider a new insurance model for midwives which excludes women considered to be high risk for home births.


Lateline has obtained a copy of the insurance model being discussed. It states that insurance, "... will only be available to those midwives who perform normal, low-risk birth at home, no vaginal birth after Caesarean, twins, breech or any other obstetric complications."


Home birth groups say that some women will be abandoned by the health system.


MICHELLE MEARES, HOME BIRTH AUSTRALIA: What we're most concerned about is that women are going to be left without care providers, and so women who choose to home birth who may have risk factors, maybe they've had a previous Caesarean, maybe they're overweight or over a certain age, we're concerned that those women will no longer be allowed to use a registered midwife if they choose to birth at home.


JOHN STEWART: The Midwives' Association says that midwives who assist a high-risk woman in a home birth will be unable to get insurance and may be penalised if things go wrong.


HANNAH DAHLEN, AUSTRALIAN COLLEGE OF MIDWIVES: Women will potentially be forced to birth unattended. Midwives will have to choose whether they support women to give birth at home with risk factors and therefore risk actually getting reported and losing their registration.


JOHN STEWART: Dr Andrew Peschser is an obstetrician practising at Westmead Hospital in Sydney. He says that high-risk women should not have babies at home.


ANDREW PESCE, OBSTETRICIAN WESTMEAD HOSPITAL, SYDNEY: Unfortunately in high-risk home births, the midwife can't really do anything other than to advise the woman to come into the hospital and can't assist in an emergency situation in any other way except resuscitating the baby.


JOHN STEWART: Dr Pescher says that ensuring Australian midwives to assist high-risk home births will encourage more high-risk women to birth at home and that could lead to a rise in infant deaths.


ANDREW PESCE: I think that midwives should be insured but the question then becomes: does insurance then underpin unsafe practice, which is recognised as unsafe, or whether insurance should underpin safe practice. And I think health ministers would probably agree that they should be underpinning safe practice rather than unsafe practice.


JOHN STEWART: The most recent data shows that in 2009 there were 863 planned home births in Australia, compared with nearly 295,000 births in hospitals. But what's not being counted is how many women are having babies at home in so-called free births, without qualified medical support.


HANNAH DAHLEN: What will happen is women will increasingly turn to free birth and to other unqualified, unregistered, unregulated health workers and that is simply going to increase risk.


JOHN STEWART: Kelly Lanfranca is planning to have a fourth child and wants another home birth, but she falls into the high-risk category and is worried about going ahead without a qualified midwife.


KELLY LANFRANCA: If you take away my right to a midwife, then it makes it dangerous, and do I want to risk myself and my baby? No. But do I want to go to a hospital where I'm going to face the same battle again and be treated like an invalid because of the fact that I've had two Caesarean sections, like a ticking time bomb basically? Well, no, I don't. I don't want to have my baby in a hospital.


JOHN STEWART: Tomorrow's meeting of health ministers will be closely watched by homebirth groups, obstetricians and mothers across the country.

[meow]

Ahh transcript of course! Thanks

I think it would probably have just annoyed me. I'm sick of the "high risk" birth thing.

[Jennifer13]

Apparently the govts are all meeting again in August on this issue, so I have time to email a few more in the meantime.

I would be 'high risk' according to the proposal put forward by the AMA. Pffft to them!

It's May tomorrow!! Sending peaceful birthing vibes for our May mummas.

[Cricket]

OK, my toenails are painted. The baby can come now.

I think I've got everything on the list from the midwife now, and pretty much everything that I wanted to have ready as well. Just have to double check and organize it so that it's ready when we need it.

How's everyone else doing?

[HotI]

I would probably be high risk too, ha ha. all our january babies came out just fine, thank you. at home. safely. and certainly in my case with less risks and much more enjoyable to my previous birth for my baby and me.

Yay, Cricket. new babies coming soon.

[Eenee]

Yay this is the month I'll get to meet Bub! So excited!

[Jennifer13]

Yay Em!!

Hot1, I think you'll find maybe as many women HBing are high risk as low risk. So many are refugees from the hospital system.

I still want to see the study that proves obs are good for birth, high risk or not.

[Cricket]

I read a US study a while ago (and I probably will never find it back....) that said that it would be unethical to continue with the medical model of obstetrics when the midwifery model gives much better outcomes for mom and baby. Of course there are definitely times when obstetricians are needed, and I do not want to deny that they have saved the lives of mothers and infants, but they are not necessary for the vast majority of women, who would be better served with a midwife.

[Cassius2]

Oh Em and Cricket I am so excited for you guys! So close to bringing these babies into your arms!

My name is Cassius2 and I am a hospital birth refugee and as for high risk who sets the parameters of high risk? twins? triplets? previous CS, previous PPH? Breech? given these examples i would still want to aim for a HB and in most cases the IMs that you work with have far more experience in dealing with these sort of 'high risk' physiological births than most OBs and hospital staff.

[meow]

Ugh. Found out that in California it is illegal for a MW to attend a breech or twins HB! Illegal. So the chances of even finding an unregistered MW who has experience in either of them is slim too. I hate how this "high risk" bull**** puts mothers and babies at risk because then our choices are freebirth or hospital birth, both of which I consider riskier for the majority of "high risk" births!

Anyone know any MWs around Sydney or Melbourne who will attend a breech or twins HB?

[Cricket]

Sorry - can't help you out too much there Meow...

So, it's a "super moon" this weekend - an unusually large, full moon. Sounds promising! By the way - are the moon phases the same here in Canada as they are in Aus? Pardon my astronomical ignorance...

[HotI]

Meow - i know someone in Melb who does.

[Cassius2]

cricket: i also have no idea but it does sound really promising for you! do you tend to go early?!!

[meow]

Thanks Hoti! Good to know- I haven't looked into twin friendly IMs before (Not that I'm hoping for twins but it's one of those things I'd like to know would be covered if it happened IYKWIM).

Yep- moon phases are the same the whole world over. It's just the moon is "upside down" for those in the southern hemisphere. Here's hoping for some supermoon babies!!!

[PumpkinZulu]

A bit OT but I had a lunar pregnancy with DD; conceived on a full moon, born on a full moon, 3 hours over exactly 40 weeks gestation. Thought that was cool. Not so for this bubba though. I don't even know when I ovulated this time!

Have been going slow with the midwife search. I really need to sit down with DH and think about exactly what we (and mainly I) want. I'm only in my 7th week, so I've got loads of time

Question? If you had an IM, did you also have a doula, or did you find your midwives support was adequate? Debating whether to have my doula again; she was fantastic and amazing, just wondering if I'll still need that extra support?

[meow]

I love my doula too (hi kelly!). But I didn't have her for my HB. My main reason for having her was to help me if I needed to go into battle in labour, or to provide me with continuity of care of I was transferred from the birth centre. It felt odd not to book her in second time around but it was an extra expense I couldn't justify as I had to already pay for two MWs (the one I chose attends births in teams of two) and they would transfer with me if needed.