Birth By Postcode – Homebirth Rejections

postcodesHere is an interesting piece about Justine Caines (for all you Aussies midwives).

Congratulations to Justine on another great homebirth.

Congrats also to the Independent midwives. Having recently had a lift to the airport from one of them on my quest to fly from Sydney to be with a woman, I send love.

Muswellbrook hospital rejects home birth
22/08/2008 10:24:00 PM

MUSWELLBROOK Hospital has refused to allow a Scone woman to have a home birth despite a senior Hunter obstetrician giving her the OK and offering to send a midwife.

Justine Caines is due to deliver her seventh child today and sought a home birth through Muswellbrook Hospital.

But despite getting the all clear from the director of obstetrics at John Hunter Hospital Dr Andrew Bisits, who offered to send a midwife from Belmont Hospital, Muswellbrook Hospital has refused to allow her to have a home birth.

But Ms Caines said she only knew the hospital had refused her request for a home birth when she rang to check her booking three weeks ago and was told there was no record of it.

“They knew that at 37 weeks you can’t fight, “Ms Caines said.

“When you’re really close to having a baby you just can’t do it.”

Ms Caines, who has been a maternity advocate in the region for eight years, said she was upset that women in the Upper Hunter were given fewer choices when it came to delivering their babies than elsewhere in the region.

“As a leading advocate I hold dear the fact that there needs to be benchmark of safety and quality,” she said.

She said she had been forced to hire a private midwife for the birth, but not all women had that option.

“I can do that because I’ve got the resources but not all women do,” she said.

But Hunter New England Health director of nursing and midwifery Chris Kewley said Ms Caines did not meet the criteria for a home birth because she did not have a GP who would support her and she needed to have a midwife from the Upper Hunter area.

“Obviously the midwife needs to be within close proximity so a relationship can develop between the midwife and the birthing mother,” Mr Kewley said.

“It’s not a case of someone sending a midwife from somewhere else.”

Mr Kewley said the health service offered women a range of birthing options, but the criteria had been set to ensure the safety of the mother and baby.

14 responses to “Birth By Postcode – Homebirth Rejections”

  1. Rebekah Costello

    I’m a little lost. How can a hospital “refuse” to allow a woman to homebirth? I think things must work differently in Australia. I would have been FURIOUS. And why on earth would her GP’s opinion matter a rat’s butt? If her OB was supportive, that should be the opinion that matters (outside of the mother’s, OF COURSE). Ugh.

  2. Lisa Barrett

    In Australia there are a few midwifery models that support a woman to birth at home and are government funded so the service to the woman is free of charge. Belmont is one of those services.

    Jutine May just have lived outside the area, although there are many strict criteria that have to be met to get this service. This was Justines 7th baby so she may have fallen outside the guidelines because she is a grand multip.

  3. Laura Jane

    Its a pretty patronising system where a hospital ‘allows’ or not.

    Justine has had many homebirths, including her previous birth of twins (cephalic/breech). I’m sure she will birth well. But I recall that for her last birth she got a midwife who came from 10 hours away!

    Good on her for continuing to champion the homebirth cause. She is an amazing birth advocate in this country.

  4. Cinnamon

    So the more babies you’ve had the higher risk you are? The mind boggles. I would have thought she’d be a birthing expert by now. Obviously *someone* doesn’t think so. Pfft.

  5. Lisa Barrett

    Cinnamon, I’m not sure that’s the reason but in SA even though there is no homebirthing in the system at the moment there is a guideline out and you are excluded from the option if you’ve had too many babies.

    I think it’s because the rule makers are mainly people who don’t know too much about homebirth. The committee here had some great homebirth advocates on it but Obs have power that the rest of us don’t have.

  6. Janet

    I’m afraid I don’t really understand this article. Justine always hires two mws from Sydney as she did this time, and has done previously. I can’t imagine she would really want mws she didn’t know attending her anyway. Maybe there are better ways to make these things known, perhaps by women who genuinely are seeking homebirth through the hospital? *confused*

  7. Lisa Barrett

    Hi Janet, I suppose that being a public figure it is easier to highlight the random nature of birth at the hospital. Who cares about the average woman who has the exact same problem. We all know that birth with an Independent midwife is gold standard, however there should be publicity given to the crappy attitude of the system when it comes to good solid care, so they at least have the opportunity to address the problem. Even if it’s only as the result of the newspaper.

  8. Janet

    There are women, I can name at least one of my acquaintance, who have genuinely suffered as a result of this particular hospital policy. Maybe we could hear from them? I just feel discomfited by someone who isn’t actually seeking to access a service claiming otherwise especially when they have better care lined up anyway.

  9. Lisa Barrett

    It would be fantastic to hear from them. I’d be more than happy to get it out there about these women. To be honest sometimes they are the silent majority. Nobody wants to deal with this policy because they feel it’s better than nothing. I think that’s totally bull shit myself.

    Can you suggest what can really be done to change this. Nobody inside the system has the guts to stand up and say how crap it all is.

  10. Janet

    As you well know, I don’t see change coming from within the system at all since everyone is making too much money from the whole deal anyway, other underlying control and misogyny issues aside at this time. You don’t work within the System to change it either. ;-) Empowered consumers are the change so as you know, that’s where I put my energy.

    If Andrew Bisits was in favour of this hypothetical hb then obviously it can be made to happen. If one of the big wigs in charge doesn’t change the system, who will? Surely he’s able to create change from within given his powerful and public position. If not, then why would anyone think a few consumers (or even a lot of highly organised, motived consumers) complaining would have any effect?

    It’s also an interesting dilemna to be promoting a model for which neither you nor I have ever argued in defence. Even if women are lucky enough to get into the program in the first place, given the ludicrous obstetric hoops in place before they’re “allowed” to have midwifery care, they get dropped at term in what seems anecdotally, to be alarmingly high numbers. I have heard mws around Sydney and Wollongong are picking up clients from this happening fairly consistently. Since when do you argue in favour of publicly funded hb? This is a turn up!

  11. Lisa Barrett

    I didn’t think I was arguing for publically funded homebirth but for pointing out to people that it is very crappy. I agree completely that private midwives pick up lots of women who are either put off by the reality not reflecting the rhetoric or who cannot get the birth they were promised.
    Change could come from the inside if anyone really wanted it to happen, but they don’t really want it do they!!

    I don’t think that a consumer voice can change anything without political clout, as happened in places like New Zealand. Midwives who think the women have to be the ones to stand up and be counted are really just putting their head in the sand over the real political/power issue of maternity services.
    I was just interested in your point of view Janet.

  12. Anonymous

    I have to say, I am upset about this article. I don’t feel that Justine is the right person to be speaking about this issue.

    I have these questions for Justine:
    Did she *really* seek government funded homebirth for her last baby? Was she seriously prepared to trade the midwives who attended the births of all her other children, for midwives she had no relationship with? Or is this article perhaps a political tool for her? It seems to me like a privellaged woman is attempting to appear more like the average Joe, so as to gain support. How about encouraging an average Joe to speak instead? I don’t wish to have Justine represent me… and I am dubious she is using myself and others as pawns in her political agenda.

    I refuse to partake in a pity party for Justine, knowing that 1) Although in Scone, she has independent midwives who are prepared to travel hours for her. I don’t know many other women presently who are afforded that luxury 2) Justine seems to agree that ”who you know” may contribute to your chances of having a homebirth. I don’t think homebirth should be exclusive, and according to which well-known Obsteotrician you’ve rubbed shoulders with.

    I find it offensive that she is claiming to have been ”forced” into having to hire independent midwives. If we’re talking seriously about ultimatums here, let’s explore another case, perhaps my own.

    I sought a govt-funded homebirth via Belmont, and was refused, despite being 50 minutes drive away. I pleaded, and despite sympathy from the midwives, I was told that unfortunately, you have to be within 30 KM radius of Belmont Hospital to be accepted.

    Justine says: she was upset that women in the Upper Hunter were given fewer choices when it came to delivering their babies than elsewhere in the region.

    This is untrue. The Hunter Valley Region is a broad area- and much of the Lower Hunter is excluded from govt-funded homebirth aswell. As I said, even I wasn’t allowed access, being a mere 50 minutes away. And I am from one of the closer towns in the Lower Hunter. This isn’t a war between Upper and Lower Hunter. There is a small, select area that is considered acceptable for Belmont’s program, the rest of us have the options to birth at the centre itself, hire an independent midwife, or birth without assistance.

    I searched for an independent midwife, but at my time of birth, most were unavailable, and the few that were, thought I was too far away. I had never built up a relationship with any IMs so despite my pleading, I was left with no IM option within hours. Considering my first birth had been fairly fast, and I knew that if I hired an inter-city midwife, chances were, she wouldn’t make it in time. My previous birth had been a traumatic birth centre birth, so I was fearful of birthing within an institute again, therefore I knew that freebirth was my only reasonable option.

    Despite much effort on my part to prepare for a freebirth, and despite me doing as much work as I could to become relaxed and confident, I found myself ”freaking out”on my own during labour, and I ended up transferring.

    Ultimately I had to chose between a birth in a medical establishment, or an unassisted birth. I didn’t have the luxury of choosing an IM at all. If we’re going to talk about ultimatums and unfair maternity care, I think we should encourage those GENUINELY affected to speak out. Not a privellaged politician.

  13. Lisa Barrett

    Thanks for your post anonymous. I am encouraging you as someone genuinely affected to speak out about this. What did the paper say when you approached them? What did the consumer groups do to publicise this on your behalf? I will gladly print on my blog issues you would like to get out there.

  14. Kerrie

    I just wanted to come and appologise, many months later, for the public way in which I criticised Justine without contacting her privately first. Not that it's any excuse, but I was vulnerable having just given birth at the time, and Lisa you're right to imply I should become involved in the media myself. I wasn't involved in my local consumer group at the time but am now. Admittedly involving myself in the media wasn't something I wanted to deal with during pregnancy myself, so although I don't wish to promote government-funded homebirth programs at all, and I still have some concerns- I really should have spoken to Justine directly to discuss my concerns before making assumptions that she wasn't genuine. So I appologise. Kerrie from the Hunter.