Saturday, August 29, 2009

Birth your way

Where to give birth should be a woman’s choice, not governed by legislation




I am a firm believer in the old saying “better to be safe than sorry”. So when it came time to give birth to my daughter, I chose midwifery care through Cairns Base Hospital.
If anything were to go wrong, it would be only a matter of seconds before I’d be in the care of a doctor or obstetrician.
Even though I wanted a natural birth with no drugs, epidural or other intervention, I felt this was the safest option for me and my baby.
But let me be clear in that I also believe women have the right to choose where, and with whom, they give birth, and I do not believe home births to be unsafe.
In fact, research published in BJOG: An International Journal of Obstetrics and Gynaecology, has shown that home births assisted by a trained midwife are just as safe for low-risk mothers and their babies as a delivery led by a midwife in hospital.
The study of 530,000 women in the Netherlands found no difference in death or serious illness among either mothers or their babies if they gave birth at home rather than in hospital.
The Netherlands has the highest home birth rate in the western world at 30 per cent, thanks to a streamlined transportation and referral system that allows women who plan a home birth to access specialist, emergency obstetric care in hospital should complications arise.
This sort of care does not exist in Australia, so there is an increased risk of not getting intervention quickly enough if something goes wrong.



The other problem in Australia is that since 2001, midwives have been unable to purchase an indemnity insurance policy.
Home births have continued only because midwives have built up a level of trust with women choosing a home birth – otherwise they stand to lose everything.
Indemnity insurance for medical practitioners is subsidised by the Government with more than $500 million of taxpayer’s money spent to date, however the Government has made it clear it will not provide indemnity insurance to private practice midwives.
Furthermore, the Council of Australian Governments (COAG) has prepared draft legislation to establish a National Registration and Accreditation Scheme for all health professionals by July 2010.
This body will require evidence of indemnity insurance to secure registration. Midwives assisting in homebirths will therefore be practicing illegally since they are unable to get insurance and could face a $30,000 fine.
Homebirth Australia secretary Justine Caines said women would continue to homebirth but would now be forced to do so without the assistance of a qualified professional, and this could lead to an increase in deaths of mothers and babies.
“It is unacceptable and unsafe to force a woman into a choice that is not optimal for her, whether that is a hospital birth or a birth at home without midwifery support,” she said.
“Removing women’s rights to the point where we are back providing care in dark alleys or in back rooms is ridiculous in 2009.”
I personally know two women who have chosen home births.
One had two children successfully at home with a midwife and no complications.
The other, also assisted by a midwife, endured a lengthy and stressful labour followed by a rush to hospital for an emergency Caesarian.
The first mother’s story is a shining example of how home births allow freedom of choice, and free up our hospital system, while the second mother shows that if she had gone to hospital early enough, she may have been able to give birth naturally instead of in theatre surrounded by medical professionals (something she feared more than anything else).
Blind Freddie could see that the second mother, with her petite frame and narrow hips, would struggle to give birth on her own, but no one has the right to take away her choice to home birth.
Taking away freedom of choice is a breach of basic human rights. With this in mind, it is not important why women choose a home birth over hospital, though it’s common for women who have had a traumatic hospital experience to opt for home birthing.
What is important is that there are support systems in place for those who do make that choice.
The most recent data I could find was from 2005, which showed only 0.22 per cent of women in Australia chose to give birth at home. The rate has declined dramatically since 1991 due to the difficulty women face in accessing information and care for home birth.
If home birth was supported by the Government, the cost of insurance for home birth midwives could be off-set by the money saved in the health system by keeping new mothers and babies out of hospitals.
The Mother of All Rallies will be held on September 7 outside Parliament House in Canberra with the aim to stop this legislation. If you wish to support the cause, visit the Homebirth Australia website HERE.
You can also write to Minister for Health and Ageing Nicola Roxon (herself a mother) to urge her to reconsider her decision to exclude home birth from insurance schemes for midwives, or write to your local member of parliament with your concerns.

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