My submission

Thought I would post it here if anyone is interested!

Dear Senator Moore and Committee Members,

I write this submission with deep concern regarding the Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills, as proposed by Minister for Health, Nicola Roxon. I am opposed to the amendments that have been introduced to the above bills that would require midwives to enter into formal collaborative arrangements with medical practitioners.

In a matter of days, I will be a birthing partner to my best friend and her husband. I have not yet had children of my own, but hope to do this in the near future. I have recently been struck with a sense of fear and uncertainty surrounding the options I will have when I start my own family.

My mother carried, nurtured and birthed four children. My two brothers and I were born at hospital, and my youngest sibling, a sister, was born at home when I was seven years old. My parents employed a qualified and accredited independent midwife as their care giver. My mother firmly believes that the care she received during the pregnancy, birth and after of my sister was the only pregnancy where she received gold standard maternity care. Like most people I am not able to remember a lot from my early childhood, but one event that remains etched in my memory is the birth of my sister (I hardly recall my mother being pregnant). I recall my mother labouring quietly; I hugged her belly and helped to rub her back, excited that I was allowed to stay up past my bedtime so I could meet my new brother or sister. After seven hours of labour, my sister was born into water – she swam on to my mother’s chest, looked around our lounge room and took her first breath as my father, our midwife and I looked on. My sister breastfed within minutes and didn’t cry until she was three days old. My mother gave birth to a healthy, peaceful baby, without unnecessary interventions and with the support and guidance of a skilled and professional care provider.

As I’m sure you’re aware, the Maternity Services Review Report acknowledges that the care of a midwife from early pregnancy through labour and birth and the early post-natal period has considerable benefits. These benefits can be measured financially through a reduction in unnecessary surgical birth and other interventions. More subtle but important benefits are increased rates of bonding and breastfeeding, lower rates of post-natal depression and greater satisfaction with the experience of childbirth. This greatly assists a woman entering motherhood.

The Australian Nursing and Midwifery Council defines a midwife as a person who is recognised as a responsible and accountable professional who works in partnership with each woman to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in Mother and Child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.

Independent midwives are educated, experienced and competent caregivers who should not be under the control of doctors and obstetricians. To achieve gold standard care and to maintain choice for women, it is imperative that effective collaboration between midwives, health care professionals, hospitals and doctors exists. Requiring midwives to enter a collaborative arrangement with a specific doctor as a condition of registration is not acceptable. The ability of a midwife to practice privately, or through the public system, ought to be regulated by an independent registration and licensing body. By awarding doctors the power to decide whether a midwife shall be permitted to practice, the option for a woman to employ an independent midwife to provide her maternity care will be eliminated. The AMA and the RANZCOG have made it clear they do not support homebirth and it is unrealistic to expect that members of these organisations will readily enter into genuinely collaborative arrangements with midwives who provide care and support for women who want to birth at home.

I desperately want and need the option to access an independent midwife when I have children. After conductive extensive research, I believe that this will be the best way for me to achieve a natural birth free of unnecessary intervention. Of course, if I were to experience a serious medical condition during pregnancy or birth that was not able to be managed or treated by a midwife, I would seek advice and support from an obstetrician or other appropriate care provider. If my choice is removed as a result of the proposed legislation and amendments, I will choose to birth at home, supported only by my husband and perhaps a birth support person or doula. I will birth unassisted as I am more confident in my body’s ability to do what it was designed to do than I am in my local hospital’s ability to assist me in achieving a birth free of unnecessary interventions, where my preferences are respected and I am provided with evidence based care.

Yours faithfully,

e_p