Midwife Lisa Barrett tells inquest mums will go it alone if homebirths get regulated

[HotI]

Midwife Lisa Barrett tells inquest mums will go it alone if homebirths get regulated | Adelaide Now

Midwife Lisa Barrett tells inquest mums will go it alone if homebirths get regulated

A MIDWIFE at the centre of a coroner's inquest into the death of two babies has defended both her actions and the practice of home birthing.

Private midwife Lisa Barrett told a court yesterday those tragedies had not tarnished her passion for homebirthing and the rights of mothers.

She warned the Coroner's Court that, should the practice be more highly regulated, mothers would be forced to go through the delivery of their children alone.

"(Women) shouldn't be forced by government to do it themselves," she said.

"They'll be left without a birth attendant at all and will be left to go it alone."

Ms Barrett was giving evidence at the inquest into the deaths of Tate Spencer-Koch and Jahli Jean Hobbs.

Supporters and babies filled the court as Ms Barrett said she had fulfilled her responsibility as a midwife in both births.


Neither Tate nor Jahli was breathing, nor had a heartbeat, when delivered but medical experts said both showed signs of electrical rhythms, or Pulseless Electrical Activity.

Ms Barrett has been involved in homebirthing for 22 years but no longer is a registered midwife but a birth advocate - a support role for pregnant women and mothers similar to that of a midwife but without any clinical duties.

When Deputy State Coroner Anthony Schapel asked Ms Barrett who gave mothers the right to choose homebirth in situations where there were known risks, supporters in the body of the court gasped.

"The law says so, it's freedom of choice," she said.

She told court both mothers knew of the risks involved, especially in their circumstances where both previously had had emergency caesarean sections.

Tate also was considered a large baby, weighing 4.79kg, making her more susceptible to her shoulders becoming stuck as occurred in delivery. Jahli was breech, meaning her feet would be delivered first.

Ms Barrett said the complications of Tate's birth in July 2007 were common and she tried every manoeuvre possible to loosen the baby before calling on an observer to try to pry the baby free.

In April 2009, Jahli's delivery occurred smoothly but she was born unresponsive. After administering CPR for a short time, Ms Barrett said a volunteer ambulance service arrived.

The inquest continues.

[Artechim]

That is what scares me with the policy/insurance changes that are making it hard for midwives to attend home birth. I haven't found any statistics to say that a low risk pregnancy is any more dangerous when the the baby is delivered at home vs hospital, but if woman have the home birth option ripped away there are going to be some that opt for free birth. Then it will get dangerous. Midwives come with drugs to treat bleeds etc, and experience to deal with things like cords around the neck and to know when it is time to transfer for the safety of mum or baby.

Taking away the option of a qualified carer is like a self-fulfilling prophecy - it is what is going to make home birthing dangerous!

[zrieka]

There is a distinct difference about regulation and limiting women's ability to homebirth. Regulation is about setting standards and holding practitioners accountable for their failings. It is also about having insurance to compensate clients when things go wrong.

To say that any regulation will hinder midwives hints that the midwives might not be up to standard.

I for one am scared that there might be substandard practitioners out there, operating outside a supportive medical system. That is a much scarier thought than limiting home birth.

[onthefly]

The thing is, this isn't about shoddy practitioners or regulations, this is about one group of professionals trying to put another group out of business, leaving women with fewer choices in the end. This all seems to be based, not on bad practices, but the perception that trained obstetricians know better than mothers what is good for them and their babies.

If everyone would just get on with teh job at hand - actually trying to help mothers birth - then we could concentrate on making sure that all mothers would be cared for in safety and with respect.

If we press ahead with rules that don't work - IMs can't get insurance, very few OBs will form collaborative agreements - then women wanting to home birth (some of whom feel far too unsafe in hospital because of prior experience) will do so in potentially unsafe conditions. What's more, we will have taken a step backwards in regards to the care offered to mothers. As women, as mothers, we are capable of making decisions for ourselves and our babies. That fundamental right should always be respected. Very often, it isn't at the moment.

[zrieka]

The thing is, this isn't about shoddy practitioners or regulations,

This media coverage of hb has arisen because of the coronial inquest into several homebirth deaths attended by the same midwife/birth advocate. At some point, you have to call the practitioner's expertise into question.

Of course women deserve more choice! They also deserve safety and standards to regulate the professionals in whom they place their trust (and money)

[Trillian]

This media coverage of hb has arisen because of the coronial inquest into several homebirth deaths attended by the same midwife/birth advocate. At some point, you have to call the practitioner's expertise into question.

Of course women deserve more choice! They also deserve safety and standards to regulate the professionals in whom they place their trust (and money)

Sounds like you drank the kool-aide Lisa Barrett is being hunted down and villified for things that were beyond her control. There was nothing at all wrong with her work, her skills or her expertise. These babies would have died in a hospital setting but because they were born at home, the Coroner had made it his mission to hold her for account. I'd like to ask you, what of the Doctors who also attend stillbirths in a hospital setting? Do we ever see them put through what Lisa Barrett is currently being put through? No, we don't. I wonder why that is?

[loulabelle]

Sounds like you drank the kool-aide Lisa Barrett is being hunted down and villified for things that were beyond her control. There was nothing at all wrong with her work, her skills or her expertise. These babies would have died in a hospital setting but because they were born at home, the Coroner had made it his mission to hold her for account. I'd like to ask you, what of the Doctors who also attend stillbirths in a hospital setting? Do we ever see them put through what Lisa Barrett is currently being put through? No, we don't. I wonder why that is?

^^ this. These deaths have nothing to do with the fact they were at home. They are terrible tragedies that would have happened regardless. The families of these babies continue to be huge supporters of Lisa.


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[Novella]

Im in two mids about this.

They actually had to go to court to change the defenition of still birth to allow for the coronial inquest to occur as prior to the change babies born not breathing are considered still born and the coroner had no power to investigate, so I do believe there is a witch hunt at the moment that has Lisa Barrett in its sights.

However I think Lisa may have unwittingly pushed the home birth movement backwards when she has taken on some higher risk births. A footling breech is not a low riske birth nor is a twin home birth that has >24hrs between delivery of twin A and twin B (if you check her website out she had these births on her site as well as some great empowering home births). I understand she states these women were informed of the risks/benefits

I absolutely beliee that women should have the right to home birth and I also believe that like any helath practitioner and any health serviceIM should have a standard of work and a framework to work within. I believe that the standard needs to be discussed between the collage of midwifery, midwives and based upon the most current evidence based practice.

I also agree that women will chose to free birth without multiple birthing options

[Bumperstump Cummerbund]

Correct me if I'm wrong, but didn't the Coroner have to change what constitutes life to be able to prosecute her? I mean, they had no heartbeat and no breathing, so he used the 'electrical rhythms' to try and prove they were killed through her actions, rather than being born still. I'm sure I read it somewhere, perhaps on her blog....

The thought of women freebirthing REALLY scares me, especially for first births. But I understand that women will choose it if they can't get a properly attended homebirth. As for the crap about 'collaborative agreements', here's an experience for you - a friend of mine wanted a homebirth, and went to an OB who was listed as being pro-homebirth. When she got there, the OB told her that there was no way she would allow a homebirth because they are dangerous and irresponsible, and the only reason she was on that list was to stop women birthing at home. My friend ended up birthing in hospital, a water birth which was progressing very well up until they discovered the baby was breech, at which point they immediately did a c-section, despite no distress on mother or baby.

Not very collaborative.

[e_p]

Correct me if I'm wrong, but didn't the Coroner have to change what constitutes life to be able to prosecute her?

Not very collaborative.

When the RANZCOG specifically state they do not support homebirth, it absolutely boggles my mind that the Govt. would expect that OBs would collaborate with independent midwives attending homebirths

As far as I'm aware, the coronial inquest is into the deaths of 2 babies where Lisa Barrett attended the birth. In the same year in Adelaide 2 babies died under the care of the same obstetrician when he attempted to use a ventouse. No inquest (I'm
assuming because the babies were born still), but also no media attention, no outrage about the danger of ventouse delivery, no blogs setup to slander the obstetrician.

[onthefly]

This is a witch hunt. And mothers have been similarly attacked. Disgusting.

There was a great article in Birthing Matters recently on what we need to do to make mothers safe - wherever they birth - and not only in a strictly defined, medical sense. We need to feel safe emotionally and physically - to know that we are being cared for with respect and dignity, not simply alive at the end of it.

Some mothers & babies might well be better off with the backup of hospital expertise. We need to make them safe there - it's not enough to criticise women for making "stupid" decisions, we must ask WHY and then HOW can we help them get there. And if they don't want to.... we must respect that. And the flip side is that many births would be safer at home. Lets work to make all mothers and babies as safe as can be, wherever they may be.

Some doctors (and others!) feel they have the obligation to speak for the baby, as though mothers are unable to do that. And in the process ride roughshod over a woman's right to autonomy over her own body, all in the name of the baby's rights. But it is absolutely ludicrous to claim to work in the interests of the baby if you are not also protecting the interests of the mother. They come as a package.

I'm really wary of the move to limit the scope of independent midwifery & home births - limiting options to those only considered lower risk.
There's a real risk that the mode of care itself will be totally undermined in this attempt to protect it from this pressure. And, prehaps more importantly, it still overlooks the person at the centre of the birthing process - the mother. Again, it should be about working with and for the mother to help her achieve the best birth for her baby.

[Shades]

Part of me thinks they shouldn't be allowed to 'limit' the scope of a midwife to attend even high-risk homebirths as long as the mother is informed that it is considered such - after all - a women can theoretically refuse any intervention at a hospital anyway? So why insist that she be put in an environment she doesn't want to be in in the first place just so that it's easier to offer things/impose timelines she'll likely want to refuse/buck anyway? Seems far safer to just let her try at home, fully informed and attended by a professional, than having a woman attempting freebirth or birthing with a midwife working illegally who would then be far more reluctant to transfer to hospital than someone allowed legally to attempt it at home.