ACM Homebirth Position Statement

WTF is this document? (apparently the ACM has been given government funding to develop this document due to John Hills issues with homebirth in South Australia,  Oops!)

Just when we thought midwives in Australia had so many rules and regulations that homebirthing had become just about impossible to negotiate, there is going to be YET another prescriptive document to prevent midwives from assisting women.  This document is being put together by the College Of Midwives, unknown to their own members. It is unsupportive of midwifery in the community and  completely ignores women.  Who asked them to do this? Why is it a secret?

Where is the document going and what impact will it have?  I can’t say for sure but I suspect it will become a legislated part of the homebirth code and will be magically announced after the COAG meeting in August.

So all you College Of Midwives members out there and all you midwives still braving maternity care in the community, what is in this document that will affect you?

They initially make the fundamental mistake of citing homebirth as a model of care.  HOMEBIRTH IS A VENUE. Model of care is continuity of midwife in a community setting.  The college, like everyone else in the country it seems, finds it hard to understand that the ONLY way to have your own midwife is to have an independent midwife.  Private practice midwives who work in groups do not provide continuity of care and midwives that work in public homebirth programmes do not provide continuity of care.  The only group they want to get rid of is the one providing gold standard care in the community.  This type of care should be available to every woman. Saying that low risk women are the only sort of client suitable for the best care is almost criminal.

Homebirth as a model of care

Homebirth is an appropriate model of care for women deemed to be at low risk of complications and who receive care from midwives with adequate access to support, advice, and referral and transfer mechanisms.

So,  lets move onto their rules around who can provide care in the community to women.

Midwives wishing to provide midwifery care to women planning a homebirth should be appropriately experienced in providing midwifery care in a home environment. Ideally, they should meet the criteria for gaining notation as an eligible midwife. In any event, they should have undertaken a period of preceptorship with an experienced midwife and have current competency to provide pregnancy, labour and midwifery care.

Where in the previous legislation did it say that a midwife HAD to be eligible?

• 3 years postgraduate experience,
• Currency across all areas of midwifery,
• completion of a professional review program
• completion of a prescribing course (or within 18 months under transitional arrangements). This part is impossible as there is no such program.

Is it now up the the College Of Midwives to tell us how to act?  Aren’t they supposed to be the body that support midwives not the one that controls  them?

Midwives guidelines
Midwives should adhere to the Australian College of Midwives National Midwifery Guidelines for Consultation and Referral (“the Guidelines”) when providing care for a woman planning a homebirth.

Aren’t guidelines just that – guides? Since when do you have to adhere to guidelines?  What happened to supporting the choice of the woman and using your skill and expertise to do this?  Oh I forgot we are so busy getting recognition and remuneration that we lost our minds along the way and are willing to let the Australian College of Mind controllers tell us how to act.

Midwives should develop and maintain networks and collaborative arrangements with a range of  health professionals and health services, including GPs, obstetricians and other midwives, to facilitate the processes of consultation, referral and transfer of care.

I love statements like this. It shows that pregnant women are the product and don’t even get lip service when it comes to decision making about their body, their birth and their baby.  Documentation is heavily mentioned,  I won’t bore you with it but it’s odd that although we have registration, regulation, insurance requirements and clients needs, the College still find it necessary to put their prescriptive measures into the mix. Everyone is fighting to be the ultimate regulator of midwives.

Midwives insurance
If a privately practicing midwife provides antenatal and postnatal midwifery care at home then appropriate PII must be purchased for that care. The Australian Government supports PII cover through an authorised insurance provider under the Midwife Professional Indemnity  (Commonwealth Contribution) Scheme Act 2010.  Government supported insurance, a midwife must be notated as an eligible midwife under section  38(2) of the National Law. The Board has a Registration Standard for Eligible Midwives.

I cannot understand why a homebirth statement from the College Of Midwives would include a prescriptive insurance notation. We know that there has just been comment given on the insurance requirements for midwives and with this in mind is it going to be that only the government insurance provides everything required to the standard?  This will obviously mean that every midwife who takes out insurance needs to be eligible.  This is the second time in the document where the college are pushing for midwives in the community having to be eligible.  The other thing about this is that the college were the ones that sourced the alternative insurance through medi-protect.  Why am I seeing a weird agenda here?

In order to facilitate transfer, midwives should also ensure that they are familiar with the protocols and guidelines for hospitals to which women in their care may transfer.

I love that just for fun they pop in some subliminal socialisation for us.

Please  midwives out there, get hold of this draft document for comment and make your views known so that the College Of Midwives are representing you and not dictating to you.  Also, if anyone knows the purpose of this document would you let me know?  I love to understand secret agendas and don’t want to wait until this is enforced to really get to the bottom of it.

7 responses to “ACM Homebirth Position Statement”

  1. Amy in Oz

    Why did it surprise me that the ACM are looking to further regulate (aka “drive underground” “stamp out”) homebirth? Especially when it wasn’t even a month ago that I read about Hannah Dahlen of the ACM, in the ANF magazine, a statement that said: “She is disappointed that home births haven’t been included for MBS funding under the reforms but says what’s happened is a start and in “ten years the new system will be in place and we will look back on this and say what was all the fuss about?”" What’s all the fuss about?! Ask a pregnant woman who wants a homebirth… Oh, I forgot, we don’t matter in the great push for “professional recognition”!

    Keep doing what you’re doing, Lisa! Heaven knows that the Australian maternity system needs people like you to stand up and keep calling out on these things.

  2. Hannah

    God they love to make it so fucking impossible don’t they?
    Eligibility, eligibility, eligibility.
    Makes practicing right out of uni with insurance (the only legal way to do it) looking a bit difficult now isn’t it? Hmm but don’t worry, I’m suuuuuure it won’t affect IMs practice *note sarcasm*.

  3. Laureen

    Wow. Just… wow. Birthing women, so dangerous their care must be regulated like the handling of explosives.

    Boom. heh heh heh.

  4. Niki

    *sigh* I’m somewhat glad this is my last baby….. I just hope that things are not this way when my children have children. For all that I am teaching them about normality of birth and home is safe, I would hate for them to feel pressured into going to the ‘right hospital’ because they no longer have a choice to birth at home.
    Sounds like the ACM are going to turn into some sort of political agenda to ensure ‘the safety and right of all babies to be born in hospital under suitable obstetric care’.
    No surgeon is touching my body if I can help it, that’s for sure. I really hope the same for my children and their partners in 15-20 years time.

  5. Krystal

    Us birthing women are just simple minded ewes to be guided, regulated, prodded and protected. How could we possibly make sensible decisions for ourselves? I couldn’t give a rat’s arse if my chosen care provider has insurance or not, I have PERSONAL RESPONSIBILITY. The government doesn’t seem to think so, typical.

  6. Meg

    OMG. As a consumer I am sooo confused reading this. Maybe the ‘secret agenda’ is just to increase the confusion levels so far that women will stop bothering to understand their rights and just lie back on the conveyorbelt like good girls. Much easier to get through your shift that way. *sigh*.

    1. Meg

      oh…and must say your point about homebirth being a venue is totally spot on. As long as the debate is focused on the relative safety of a venue, women will continue to lose. The venue isn’t the point, the point is quality of care. Only “homebirth” midwives provide real quality and contiuity of care right now. Which is why I hired an IM even though I wasn’t particularly fussed about where I ended up birthing. The irony is…now having experienced hospital ‘care’ nothing would never drag me back there. But again it’s not hospitals I”m scared of, it’s the medwifery staff, the culture of fear and denial and powerlessness, that gives me the heebies. They are crazy and these policies are part of their organisational psychosis.