Babies by the dozen but medic says home birth too risky
Babies by the dozen but medic says home birth too risky
Julia Medew
December 6, 2010
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MORE than 50 Victorian women have safely given birth at home this year as part of a state government-funded trial that provides hospital back-up, but some say the scheme is too risky to go on.
Wodonga obstetrician Pieter Mourik has called for Victoria's home birth trial to be dropped after a study of more than 37,000 births in the Netherlands found women cared for by midwives without doctors present had double the risk of their baby dying, compared to those who gave birth with doctors.
Dr Mourik, a known opponent of home birth who was named Australia's rural doctor of the year in October, said the study published last month in the British Medical Journal showed any birth at home under the care of midwives was unsafe and should not be supported by governments.
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''I think our new health minister should look at this very closely,'' he said. ''It's only a matter of time before something goes wrong.''
Last year, the Brumby government provided $400,000 for a home birth trial to run out of Casey and Sunshine hospitals. A regional hospital was also going to be involved, but the department of health has not found a suitable one.
Under the trial, women with low-risk pregnancies can be cared for by midwives employed and insured by the hospitals with the option to transfer to the hospital's maternity wards if complications arise during labour.
Director of obstetric services at Southern Health Professor Euan Wallace said about 15 women had participated in Casey Hospital's program with no complications or transfers to hospital. If the program is found to be safe after an evaluation next year, he hopes it will be expanded.
''It's all gone very smoothly … I don't see any hurdles in continuing this,'' he said.
Midwifery group practice mentor at Sunshine Hospital Patrice Hickey said about 40 women had given birth with Sunshine's trial this year, with another 40 booked in before July. She said all of the deliveries had gone well and that only one woman who suffered a postpartum haemorrhage (vaginal blood loss in excess of 500ml following childbirth) needed to be transferred to hospital for further care.
''The midwife put in an IV [drip] at home, an ambulance arrived within three minutes and she was taken to Sunshine Hospital. Everything was OK,'' she said.
Another woman opted to be transferred to hospital after going into labour because she decided she would prefer to be there, but Ms Hickey said all participants had been thrilled with the trial which was safe and should continue.
''If there are terrible outcomes, I'm sure they will stop it but there haven't been any adverse outcomes to date,'' she said. But Dr Mourik said catastrophic changes could occur during labour which needed specialist attention within seconds, not minutes or hours.
Dr Rupert Sherwood, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said the college did not support home birth - with or without close hospital back-up - because there were safer options available.
Melbourne mother Monique Buggy, who gave birth to her son, Jarrah, at home as part of Sunshine's program in April, praised the midwives involved and said she felt safe knowing that she could go to hospital if necessary.
''It was so beautiful to take my baby boy into the next room and be able to rest in my own bed without having to get into the car or anything,'' she said.
''I would love to see many other women who want this option to have it there.''
Victoria's new Health Minister David Davis said he would wait to see the evaluation of the trial before making a decision about whether the program should continue and expand.
