Yesterday there was a community cabinet held here in SA and a few of us got seats to attend. The Homebirth network also got an audience with Nicola Roxon afterwards as did another midwife.

There were two questions fielded on homebirth and Nicola refused to say the words independent midwife or illegal although she skirted the issue by saying there is a small part of the community who would be affected by the change. She also smuggly put in the issue of safety and how they have to regulate us for safety. I thought that’s what the Nurses board did. Seems like it’s her personal crusade to ride the country of midwives with independent thought mind or any idea that the woman is important, in favour of midwives that have to work inside the guidelines regardless to what women may prefer.

Thanks to the Homebirth Network of South Australia, here are the written points they gave Ms Roxon at their meeting. (which by the way was a whooping 10 minutes long.) I was surprised she didn’t stop off to say hi, my blog seems to be regular reading for the health department. Maybe I’m the midwife with independent thought that they want to be rid of!!!!(duh).

Summary of Key Points for Nicola Roxon

Legislation for national registration and insurance requirements for private midwives.

Homebirth is currently taken up by a small minority of women who make an informed choice. It is not our desire to see all women choosing homebirth, however, we do want all women to have the full suite of choices available to her as to where and with whom she births.

• The passing of the proposed legislation will entail significant financial burden to the Government:
  • Vaginal birth in hospital ~$4,000
  • Caesarean birth in hospital $10,000+
  • At the moment, >2,000 women in Australia plan homebirth, and in SA, at least 92% of them achieve a safe vaginal birth at home. Rates of spontaneous vaginal birth at home in other States is lower, around 75% (with most transfers for pain relief and augmentation, NOT for emergency care)
  • If those women were forced into the hospital system, statistics show that at a bare minimum, 33% of them would have caesareans, so predicted costs:
    • 660 caesareans = $6.6 million, 5 days bed use per woman = 3,300 beds
    • 1,340 vaginal births = $5.36 million, 2 days bed use per woman = 2,680 beds
    • A total of almost $12 million greater cost to the Australian healthcare system, plus 5,980 beds used.

• It would cost much less than $12 million to underwrite appropriate insurance for independent midwives.
• Amnesty International’s campaign (Stop Violence Against Women) states: women must be able to exercise their sexual and reproductive rights free from coercion, discrimination and violence. Women have the right to not be denied maternal health care, which should be accessible, affordable, adequate and of sufficiently high quality, taking into account their cultural needs. They have the right to access health care without discrimination. This statement echoes that made by the International Federation of Gynaecology and Obstetrics (FIGO) in their Resolution on “Women’s Sexual and Reproductive Rights – A Social Responsibility for Obstetricians-Gynaecologists”, Chile 2003: The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence, as expressed in human rights documents.
• The proposed legislative reforms (in their current state), whilst benefiting substantive sectors of the community also pose a significant threat both to the civil liberty and safety of other sectors of the community. In a ‘free’ society the reproductive right to exercise privacy and bodily autonomy in childbearing is not the province of “the state” or government to regulate, nor to assume upon itself the role of ‘sole provider’ of service options.
• Indemnity insurance is currently available for people such as Dr Charlie Teo who does highly experimental and risky neurosurgery (on a very small portion of the population).
• In UK, a woman’s right to choose her place of birth, regardless of risk, is enshrined in policy; 20,000 women per year birth at home in the UK, this frees up precious hospital resources for those who genuinely need it and helps prevent babies and mothers from being exposed to drug-resistant bacteria and unnecessary intervention.
• Government homebirth via hospitals cannot meet needs of all women due to geographical location and lack of skill set in hospital midwives to support women at home. It also does not address the needs and preferences of those who wish to make the informed choice to birth outside of hospital policies.
• Childbirth is the single greatest reason for hospitalisation each year, yet 80% of women and babies are healthy and at low risk, and could be safely supported to remain in the community rather than using our precious hospital resources.
• Private health insurance companies have and do cover some or all of the costs associated with birth with a private midwife, indicating it as a sound financial decision and that those companies have confidence in the safety of outcomes.
• In a ‘free’ civil society citizens may exercise their rights to take up either public or private services. Currently every Australian taxpayer subsidizes privatized obstetric / medical insurance premiums, including this sector of the population’s “choices” whether they wish to or not. Providing access to certain “private” childbirth service options whilst legislatively impeding others (either intentionally or unintentionally), smacks of restraint of trade/ restrictive trade practice and anti-competitive behaviour and should be challenged socially and legally on these grounds. Government interference that deprives citizens of fundamental freedoms/civil liberty and endangers citizen access to safe service options in childbirth (ie: qualified, registered, indemnified midwives in the private sector) should not be tolerated, moreso where it is not supported by either the scientific evidence or practice consistent with other comparable western health systems.
• The lack of indemnity insurance for private midwives is due to the small pool of midwives in professional private practice, and not about risk.
• It is unethical, immoral and intolerable for any minority group to be discriminated against, either in law, or in practice.

Related posts:

1. Insurance for Midwives
2. Homebirth Underground
3. Homebirth – The Manic Midwives
4. Government Reform for Midwifery
5. Exemption!