Medical Veto – We Own Your Birth

After lots of births I am rested enough to blog.

There have been a number of blows to midwives over the past few weeks:

  1. The government gave medical veto over women/midwives to the medical establishment.
  2. The Nurses Board of Australia backed it up by forsaking the very crappy recommendations of the Government and adopting the even crappier rules of the MIGA insurance. This means that no matter what policy you take up (choices are: very expensive and unworkable MIGA insurance OR very cheap and unsuitable VERO insurance) you have to either have a collaborative agreement with an Ob or a private hospital OR provide a detailed transfer plan with all the woman’s details and private information.

PWNED – Your Births, Your Children’s Births – Forever!

I would like to believe the government just didn’t think it through. It’s just a big mistake and a bad dream. However that would assume our country’s leaders are stupid and easily manipulated by the AMA. It is far more likely that they allowed the medical model to take ownership of the reproductive health of the nation for some other reason. Money, power and control spring to mind.

Up to now I’ve had a good collaborative relationship with the WCH (Women’s & Children’s Hospital), something I’ve developed with both midwifery and obstetric staff. Apart from one obstetrician who has made my life hell by reporting me to the nurses board for no other reason than harassment, I’ve enjoyed the ability to consult and refer as necessary.

What this legislation does is remove control (hence choice)  from the woman and hands it to the medical establishment. A women cannot chose to birth at home with a midwife unless she she is considered obstetrically suitable and uses a midwife who has embraced the thousands of constraints that are now a requirement of her professional registration.

Doesn’t the government understand that women will now only be able to get the care of their choosing through unregistered care providers? They are listening to the wrong people. Many of the midwives undertaking the negotiations are selfishly pursing their own respectability, abandoning the women who want to homebirth with a midwife and forcing any midwife who wants to birth with women at home to work outside their registration requirements.

Labour – Isn’t working

There are many reasons why collaboration as defined will not work. For example:

  • A woman VBAC after 2 sections. No midwife will find an Ob who wants to let this woman birth through her vagina let alone at home. And if they do how does the Ob’s insurance line up with them working with a midwife who is not insured for the birth as a free referral service?
  • A transfer plan could mean being reported to the nurses board for breach of guidelines.
  • A client won’t be able to have their private midwife at hospital since no hospital gives practicing rights to private midwives.

Almost any scenario can be seen in the same way. Over 42 weeks, 5th baby, previous pph, previous pre eclampsia, diabetes, baby too big, baby too small, platelets too low, temp too high, not enough testing, etc etc. The list is endless and every woman will be told the same thing and every hospital (most of which have no idea about all of this) says the same thing.

Too Many Spineless Midwives

Today there was a debate between a midwife and an Obstetrician about collaboration. It’s available as a podcast but I honestly don’t care to link to it. One of my clients heard it today and thought the midwife was wishy washy and didn’t actually say anything. I think almost all midwives are like this. All afraid to stand up and say it is not workable and we won’t stop supporting women. To each midwife who has paid $7,500 for useless insurance, I have no sympathy. If you sell out the women in your care your pocket deserves to be hit. I only wish a few more Obs would get into bother.

Personally when I listened I thought it was the same old bullshit. Obs making out like it could work , midwives making excuses and everyone making it about funding instead of making it about a woman’s right to chose who she births with, who she shares her information with and where she births.

I think midwives and women should stand together and say “NO – this is not workable and we cannot comply, we will stand together to the end to protect normal birth.” However this won’t happen as too many people have a vested interest in the future of this legislation.

I am being chased so heavily in South Australia that it is sickening to think about the future. I doubt whether I will have a long term one in this climate. However I will not lie down and accept the medical veto and I will not go without a fight.

My mother is convinced that Julia Gillard will rush to our aid (and mine especially) because she is Welsh. That’s the thing with real Welsh people, it gives them the heart of a dragon and the faith to move mountains. I tried to explain that being Welsh is not the same for everyone!!

20 responses to “Medical Veto – We Own Your Birth”

  1. Laureen

    Lisa, you freaking inspire the heck outta me. I am serious. I’m all the way over here on the other side of the world, grinning from ear to ear. I love you for your fight. For the feral you, that won’t stop swinging. Hell, you make me want to *be* a midwife, so I can stand up next to you and say “F*** yeah! What she said!!!!!”

    Look, in another two years the global economy is gonna collapse, taking governments and the mediarchy with it. And then that happens, none of *them* will be left standing to tussle with you. You just get out your stompy boots and do your thing.

  2. Kathryn Williams

    I’m with you all the way Lisa. If you want a list of midwives that are willing to SAY NO to all of this,- put my name on it.

    Kathryn Williams

  3. T

    Amen! Another person waiting for collapse of the world so we can start again with common sense! Birth rights to the mother all the way! Ive had 3 births (altho at hospital) which i am very proud of. I’ve been lucky to have midwives (in a public hospital) allow me to birth how i like, according to my plan/wishes without intervention or drugs. :) I’d always like an option for a home birth for no#4 when she/he arrives.

  4. Rachele Meredith

    I’m with you all the way Lisa. xx

  5. Merrie

    here here Lisa, I’ll never fit the guidelines to birth at home now. I’m too fat and I gestate too long apparently. No one is going to stop me birthing at home next time though. If I have to birth without a midwife then so be it but I hope I can find one to support me. My birth belongs to me and I am the only person who can decide where it is safest for me to birth. I don’t want any hospital knowing anything about me. It is not my responsibility to conform with unjust laws and I wont do it.

  6. Angela Wicks

    I am 21 weeks pregnant and my husband and I are really looking forward to our home birth this December 2010 with midwife Julie Garratt and reading this and feeling the ferocity of your passion makes me feel even more so empowered for my baby’s forth coming wonderous birth at home surrounded by peace, comfort and love! – also I now can’t WAIT to birth the way we want and say ‘f&%K yeah’ see that- birthed the way I WANTED!!

    If I was a midwife I would stand up all the way with you!!- all power to you

  7. loz

    Another woman who is saying NO to this blatant breach of human rights, who does this Government think they are thinking they have the authority in MY birth and the authority over MY body.

    We really need to be chanting ‘United we stand, Divided we fall’ as the only way forward which maintains our workable professional relationships is to stand up and be counted in saying we will NOT back down there is too much at stake.

    Geez insurance would be a great thing, even national registration has its perks but the hoops midwives are needing to jump through is bullshit let alone the midwives willing to jump through them at the expense of women who need them the most.

    Sorry love Julia Gillard ain’t gonna help us out of this one :P

  8. Mary

    Here here.

    Except for my rapidly advancing age, I would be a perfect candidate for homebirth right up to the end. I gestate too long apparently. Last time I was scared into an induction because “your baby is twice as likely to die if you continue”. Way too many constraints on women. I can’t even birth my next one at my nearest hospital because they only do low care and ship you off to a hospital nearer the city (which would be my nightmare as I have only ever heard one good story come out of that hospital in the last few years). All this legislation and the scarcity of midwives is just going to mean more women freebirth which is more dangerous than having a qualified midwife on hand. When things go wrong with freebirth, all we are going to hear is “told you so”. Arrrgh makes me so mad. Maybe I should move to New Zealand for my next baby where they actually have a clue.

  9. Adrienne

    You better not go without a fight lisa, we would rather have you with us when we have this baby than be in a hospital any day of the week.

    Our last baby’s birth was a pointless 8 hr trip to the hospital of which 16 minutes were spent in actual labour. Given that the previous 32 hrs had been at home, it was like an unwelcome interruption to have to go to the hospital just for the ‘popping out’ of the bub. Hospital just seems to be in the way – only sick people should be in hospitals really

    we are excited about this 2nd baby being born at home, where there are no buzzing lights and there is very few people. just me, manda and Lisa (hopefully) and maybe our other little one running around.
    U rock lisa, we need more midwives like u!

  10. NavelgazingMidwife

    Very important words you share, Lisa. Far deeper than just the surface crap that’s going on. The divides between all of us who *seem* to have, if not the same, at least *similar* agendas, is giantly awful and the bridges are made of spider webs.

    I’m hoping you can find a way to withstand the storm. Too many wonderful midwives are bowing out of the constant barrage of legislation and assaults on their character and practices. While I would hope I could stay the course, to be honest, I wonder myself.

    Know that you are loved.

  11. Andrea Juszczak

    Hi Lisa,

    I share your feelings and I appreciate your honesty and words of passion.

    I however don’t think I am selling out on women by purchasing insurance, I purchased the cheaper one that didn’t have any rules. According to new rules I am supposed to send in care plans, because I won’t stoop to a collaborative agreement. But I respect women enough to let them know this information, and would never dare break my confidentiality with a client if she asked me not to send a care plan in… that is not on.

    I think Many midwifes need to experience being on the outside of the rules to appreciate what it feels like to be abandoned. For my 1st pregnancy I was absolutely normal and boring, I’m sure I could fit every single criteria imaginable, until I refused all testing and then I got to 43 weeks, and then I had a 5kg baby which I birthed at home without any drama. However this then would have put me in the “high risk” basket because of previously large baby. Luckily I saved myself the whole drama because I chose fabulously supportive midwives who were there for me and respected my decisions without fear mongering or coersion. For this reason I could never do that to another woman, I could never abandon a woman in the way the government, the AMA and many Midwives are feeling we should. I want every woman to experience the fabulous support that I had and that every woman deserves.

    I know you are that supportive Midwife Lisa.


  12. Gloria Lemay

    Whatever you hold dear, they will try to wrest from your arms. “Mama, don’t let your daughters grow up to be midwives.”

  13. Janice

    Is there any way to appeal this under British law? It smells to me that if the Gov. General has to sign our laws before they can come into effect, like the new midwifery regulations, that we are really living under the British umbrella, and should be entitled to the services and rights provided to the Brits. which include the right to a midwife. The facts are that this country is run by a corporation of which we are members, and as ground level corporate members we have highly limited rights including no right to a trial. BUT- if this is still a British territory let’s appeal to the Queen to intervene since our board members are out of control and have forsaken us and our human rights.

    1. Adrienne

      RE Janice’s comment:

      Unfotunately no – the appeals to the privy council (house of lords in england) were abolished by the passing of the australia act 1986. Therefore the High Court of Australia;s court of appeal full bench is the highes court in the land for Australia.

      (law student here who just had to cram all that for her exams.)

      so no appeals to england.

      the governor generals role is largely ceremonial

  14. Noel Victor Comley

    I’m a fathr who a been at the birth of eacch of my 5 children: 1968, 1972, 1992, 1994 and 1995. I had to fight to be there fr the first 2 and it was almost compulsory for the last. No home births – alhough it as nearly or the second as we left our run to the hospital a bit late – but birthing centre for 1994 and 1995. We started in a birthing centre in 1992 but problems set in and we were moved to a labour ward. After the birth in 1995 my wfe was rushed from the birthing centre to surgury and we would have lost her if we had been at home. Having said that, and having chosen to be in a hospital birthing centre with family and a midwife and a hospital outside the door I deplore the activites of Insurance companies (and the accountants) and the medical authorities in tryng to impose their standards on everybody. I support you in your struggle or the right to choose.

  15. Gloria Lemay

    Sorry, my first response to this was rather sad and cynical. . . I hate that my friends have to endure this political fiasco.

    Second response:
    Wise legal minds are careful to avoid the things that will happen here:
    1. making martyrs and heroes out of midwives who defy the (stupid) law
    2. making laws that are unenforceable (you can’t put a cop in every bedroom of the nation, can you?)
    3. making laws that drive fringe groups of pregnant women (e.g. drug addicts, single teens, women with English as a second language) underground. Encouraging a broad range of care options keeps them from getting into the horrible “burying a baby in the backyard” scenarios that look very bad for the system.

    The strategic actions that midwives need to master are:
    1. making easily understandable requests and promises
    2. maintaining the confidence in “doing the right thing at all times”
    3. reducing dramatic talk to a minimum. . . just the facts.
    4. taking every opportunity to point out the unworkability of flawed legislation prior to it becoming enacted (as the Aus mws have been doing) because, once it’s passed, it’s bloody hard to undo it.

    I’m really proud of you, Lisa. It will all come out right. With love, Gloria in Canada

  16. Kate

    I’m wanting a HBA2C. Had two midwives who pulled out at 25wks because they were scared of being reported. I then found another midwife willing to take me on and told me that ‘there are ways around this’ where I can choose homebirth, have all antenatel care through her etc as long as we meet with the Ob unit at the hospital, explain what we’re doing and that I’m aware of any ‘risks’ etc. BIG mistake. Head of OB unit replies that HB isn’t recommended, that the midwife would be operating outside the guidelines of RANZCOG & ACMI and that it’s recommended that I have this baby in hospital. Now this midwife, who seemed so defiant is also spooked. Feels his wording states that she’s on his radar and she’ll be reported, so, if it’s alright with me, can I have antenatel care through the hospital system, tell them I’ll have baby at hospital with my IM but ‘accidently not make it there on time’. This is a game I never wanted to play. I’m forced to go through the obstetric unit at the hospital because I’ve had 2 cesars, so hospital midwife care is out as an option. I’m back to having lost choice, with a midwife who is scared. Shame on the government! Relying on Julia is pointless. Now I don’t know where this leaves me. I just want to have my last baby at home. It’s my body, my baby, my choice. That’s the way it should be but now I feel like big brother is watching my every move too. I won’t freebirth. What am I to do?

  17. Renee Grootenboer

    Hi, I’m not a midwife but am apalled at the recent attack on your profession. I understand that the male dominated medical profession is pouncing on the small number of home births which have complications, whilst ignoring their much higher ratio of adverse events during hospital births (am I correct?), and by skewering this information are attempting to discredit and disempower the profession altogether (am I still on target ?)

    I don’t want this communication to you published but wanted to contact you privately (I don’t go on facebook etc, I’m an old fashioned granny who values her privacy). I wrote a paper on the professional evolution of Developmental Educators, and when I started researching the dynamics of male gender power and the effects exerted on women in the medical profession in particular, I became aware of the depth of the meaning around the battle for midwives to keep their professional autonomy. I would like to share my paper with you if you want to slog through it, otherwise you could just read the chapter where I use the gender power struggle in the area of medicine to illustrate my point. This looks to me like a CLASSIC example of a gender power struggle. Let me know if you want to read my paper by emailing me. Hopefully you will get through, as my spam protector is a real nazi. At any rate, keep up your courage, I do admire your spirit..
    Cosmic Granny