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Our Bodies, Our Babies, Our Rights – protest on Thursday

By 16 February 2010 49

Last time I posted about birth politics, there was a lot of discussion… so I thought you might like to know about this event.

This isn’t about homebirth vs hospitals, or doctors vs midwives. It’s about women having the right to choose their own healthcare provider.

If I have a sore back, I don’t have to ask a doctor’s permission before I visit a chiropractor. If my baby isn’t sleeping well at nights, I don’t have to ask a doctor’s permission before I go to a child health nurse for advice or referral to other services. If I want my pregnancy terminated in first trimester, I have the right to make that choice without a doctor being able to veto it. So if a normal, healthy woman wants to see a private midwife (which she will pay extra for), why does she have need a doctor’s approval?

This doesn’t happen in New Zealand, the UK or Canada – so why are Australian women not considered smart enough or trustworthy with the nation’s future population to choose their own healthcare provider?

Flame retardant suit on – fire at will.

Do you think Australian women, not Kevin Rudd should make decisions about their own healthcare? If so come and support us at 10am on Thursday 18 February outside Senator Kate Lundy’s office, Ground Floor of Law Society Building, 11 London Circuit, Canberra. This is part of a National Day of Action, with events around Australia.

Join the Facebook Group. Visit the MyBirth website for Campaign tools & Event details
- posters to download and distribute, banners for your website/blog and register to be notified of upcoming events in your area.

When having a baby do you want to make choices about your health care?

New reforms introduced by the Rudd Government were meant to increase support to women, giving them the option of choosing a midwife to care for them.

Many women have said they would love this care, especially because the care would come from one midwife from early pregnancy, through labour and birth and up to six weeks after the birth. The best part being, many midwives provide home visits! Pure Luxury.

Many Mums think this care is long overdue!

Enter the problem! The Australian Medical Association has decided that women will only be able to choose midwifery care if a Doctor agrees. This means if a doctor is not prepared to support the local midwives, then women will not have access to care. This also affects women in regional Australia and indigenous communities, who already have limited access to healthcare choices, because it is much harder for doctors and midwives to maintain good professional relationships when they are hundreds of kilometres away from each other.

We believe while women may seek advice and support from their doctor that ultimately they have the right to make decisions about their bodies.

There are events running in every State so spread the word!

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49 Responses to
Our Bodies, Our Babies, Our Rights – protest on Thursday
Woody Mann-Caruso 10:07 pm
16 Feb 10
#1

What a great argument! You open with three different examples of how a doctor won’t stop you seeing another type of health professional to provide very low-risk, non-critical medical support that won’t hurt the mother or the baby. You then use these examples to justify a fourth case in which a doctor might try to stop you seeing a hippy witch to oversee a highly risky procedure that could cost two lives if mismanaged. Come back when midwives are doctors, you have the same facilities as a hospital at home, and the data don’t clearly show significantly higher mortality rates for home birthed babies.

(Not that hospitals are perfect, either. An article just popped up over at ABC about a Canberra woman who…bugger it, too lazy to type, go read it. It’s pretty disturbing stuff.)

NeedHelp 9:31 am
17 Feb 10
#2

Haaaaahaha, hippy witch. Agree with Woody 100%.

If something goes wrong while giving birth at home, what’s your Plan B? I’d love to hear it.

Coach 9:33 am
17 Feb 10
#3

Go girls, I am one man who totally supports your right to choose a midwife. Whether I agree or disagree with your choice is not the issue.

I get so tired with the “We know whats best for you” attitude of our public servants and politicians.

Don’t get put off by the brain dead comments (hippy witch) like the first response to your story. When people live in a vaccum, have no desire to get their brain off the single train track thinking they are on, then such comments do not even warrant a response.

sepi 9:49 am
17 Feb 10
#4

Woody where is your data showing the dangers of midwife supervised homebirth?
One third of babies are born with midwives at home in Holland, and the system is very successful.
New Zealand also has a good, government run homebirth system.

You usually only get a midwife in a public hospital anyway, in Australia, so a dr isn’t strictly necessary.

Midwives are nurses, with specialisation, not hippies.

and as you say – Canberra hospital maternity areas are nothing to write home about.

deezagood 12:28 pm
17 Feb 10
#5

Sepi et al; honestly, don’t bother responding to BLOKES like WMC – there really is absolutely no point trying to convince them that birthing is natural part of human life that does not always require major medical intervention from highly qualified doctors, a sterile hospital enviornment, drugs, cutting, etc… I personally chose hospital births, because I wasn’t confident in my own body or the birthing process … (and also I’m a scaredy cat/ pessimist) – but I fully and wholeheartedly accept other family’s rights to choose how they deliver their own babies. I think that there should be choices and I do not accept the government’s right to, in any way, remove those choices from families. As for ‘plan B’; when home births don’t go according to plan, midwives (who are highly trained, certified medical professions who specialise in birthing babies – hardly hippy-witch-doctors) get the mothers to hospital – simple. Nobody in a home-birthing scenario wants to endanger babies or their mothers FFS. I honestly can’t fathom the level of ignorance on the issue of homebirthing.

shanefos 1:32 pm
17 Feb 10
#6

deezagood said :

Sepi et al; honestly, don’t bother responding to BLOKES like WMC – there really is absolutely no point trying to convince them that birthing is natural part of human life that does not always require major medical intervention from highly qualified doctors, a sterile hospital enviornment, drugs, cutting, etc… Nobody in a home-birthing scenario wants to endanger babies or their mothers FFS. I honestly can’t fathom the level of ignorance on the issue of homebirthing.

+ 1

astrojax 1:41 pm
17 Feb 10
#7

so woody, what training do these ‘hippy witches’ have then? go into a maternity ward and tell these highly trained nurses what they really are, see if you have to leave without a trip to casualty… and get someone to film it and post back here – be fun!

emd 2:36 pm
17 Feb 10
#8

These legislative changes will mean that when it comes to maternity care, unlike other areas of healthcare, consumers will no longer have the right to informed consent or right of refusal. What if the doctor is wrong? What if there is a conflict between what’s best for the mother (the patient in the doctor’s care, to whom he has a legal obligation), and what’s best for the baby?

I have great respect for women who make all kinds of informed choices when it comes to pregnancy care – these choices are made carefully, with the best interests of mother and baby in mind. All we’re asking is that our right to make our own choices be respected. Women listen to their doctors and midwives advice, but ultimately it is not for the government or the AMA to dictate our health care choices. These decisions should be made by the families, as they are the ones who have to live with the consequences of the choices they make and the treatment they receive – homebirth, hospital, elective caesarean, or whatever else they decide to do.

chewy14 2:50 pm
17 Feb 10
#9

Why should a doctor have to OK it?
Um, Insurance.
I have no problem with a woman choosing to homebirth, but if something goes wrong, you should forfeit any right to sue.
All research has shown that homebirths can have similar results to hospitals for low risk pregnancies but the mortality rate increases whenever any risk factors are present. So having a doctor OK the homebirth and midwives is a sensible step.
The only people who should be able to choose to homebirth are women who have normal low risk pregnancies.

Jim Jones 4:02 pm
17 Feb 10
#10

Woody Mann-Caruso said :

and the data don’t clearly show significantly higher mortality rates for home birthed babies.

The data doesn’t show this at all: http://www.crikey.com.au/2010/01/20/don%E2%80%99t-believe-the-home-birth-horror-headlines/

If you’d care to do some research, you’ll very quickly discover that the bulk of birth-related problems are caused by the over-medicalisation of childbirth.

Woody Mann-Caruso 4:27 pm
17 Feb 10
#11

Woody where is your data showing the dangers of midwife supervised homebirth?

Planned home birth in Australia is associated with a higher risk of intrapartum related perinatal mortality (death during labour or after birth owing to problems occurring during labour). You can waffle about Holland and New Zealand all you like – in case youhadn’t noticed, this is Australia. Choice quote: “Facilitating and funding home births in an autonomous setting would be contrary to the principles of evidence-based health administration.”

Sorry – I’ve just realised the expert who did the study is a BLOKE. Worse, if he’s publishing studies he must be an ACADEMIC. He must only care about reducing infant mortality so there will be MORE CHILDREN TO TOUCH, eh deeza? I also realise that press release is from the AMA, and they’re not quite as qualified to analyse the report as some Crikey blogger, because they hate women.

birthing is natural part of human life that does not always require major medical intervention from highly qualified doctors, a sterile hospital enviornment, drugs, cutting, etc…

Except when it does, and then you’re much better off in hospital than on your living room floor. No amount of Enya and whale song is going to save you then.

tell these highly trained nurses what they really are

Do you know what they call ‘highly trained’ professionals who specialise in providing medical and surgical services during pregnancy and childbirth? Obstetricians.

Let me ask you this: if you were in labour, and something went wrong, and you had a choice between an obstetrician with a surgery and a nurse with a hot compress, which would you want to help you? Here’s a clue – do it in a hospital and you can have both.

‘Our babies, our bodies’ says it all. It’s about treating your children as objects, and throwing a feminist tanty while you’re at it. “I dont want to give my baby the best possible care – I want to do what my inner womyn says is right!” Having your baby in hospital doesn’t deprive you of a midwife. Having it at home does deprive you of proper OB care, and places you and the baby at unnecessary, life-threatening risk.

imhotep 4:36 pm
17 Feb 10
#12

Jim Jones said :

If you’d care to do some research, you’ll very quickly discover that the bulk of birth-related problems are caused by the over-medicalisation of childbirth.

Well Jim, this extract is from the journal at the source of that article (Medical Journal of Australia (192 [2])

__________________________________________________________________________________________
Abstract: Objective:

To examine differences in outcomes between planned home births, occurring at home or in hospital, and planned hospital births.
Design and setting:

Population-based study using South Australian perinatal data on all births and perinatal deaths during the period 1991–2006. Analysis included logistic regression adjusted for predictor variables and standardised perinatal mortality ratios.
Main outcome measures:

Results:

Planned home births accounted for 0.38% of 300 011 births in South Australia. They had a perinatal mortality rate similar to that for planned hospital births (7.9 v 8.2 per 1000 births), but a sevenfold higher risk of intrapartum death (95% CI, 1.53–35.87) and a 27-fold higher risk of death from intrapartum asphyxia (95% CI, 8.02–88.83). Review of perinatal deaths in the planned home births group identified inappropriate inclusion of women with risk factors for home birth and inadequate fetal surveillance during labour. Low Apgar scores were more frequent among planned home births, and use of specialised neonatal care as well as rates of postpartum haemorrhage and severe perineal tears were lower among planned home births, but these differences were not statistically significant. Planned home births had lower caesarean section and instrumental delivery rates, and a seven times lower episiotomy rate than planned hospital births.

Conclusions:

Perinatal safety of home births may be improved substantially by better adherence to risk assessment, timely transfer to hospital when needed, and closer fetal surveillance.
__________________________________________________________________________________________

To me, the study indicates that pregnant women SHOULD seek advice from a medical practitioner before undertaking home birth (and I’m no fan of the AMA)

knuckles 4:41 pm
17 Feb 10
#13

As I said to my wife when she was having a whinge the day after our youngest was born, “millions of women all over the world have babies everyday without doctors, hospitals or pain relief, and then head straight back to work in the fields. Now stop your complaining, get out of bed and make my breakfast”. :)

deezagood 5:28 pm
17 Feb 10
#14

knuckles said :

As I said to my wife when she was having a whinge the day after our youngest was born, “millions of women all over the world have babies everyday without doctors, hospitals or pain relief, and then head straight back to work in the fields. Now stop your complaining, get out of bed and make my breakfast”. :)

LOL Knuckles!

sepi 5:53 pm
17 Feb 10
#15

If the government were at all serious about improving women’s access to medical services for birth, they would not be closing regional hospitals like Bega etc all over the place. This leaves many regional women with 2 hour drives to a hospital – many births are shorter than that.

and obstetricians may be the ‘optimum’ in trained healthcare for birth, but Australia (and Canberra) is actually in a shortage of them. Soon you will only be able to access one if you are a
millionaire, or having an extrememly complex and risky pregnancy.

In the ever growing expense of health services, it doesn’t make sense to add another layer or buraeucracy and expense to birth, which is a low risk setting can be easily and safely done at home.

OR – increase places in the Canberra birth centre, which is a ‘
home like’ atmosphere, inside a hospital building. It is over subscribed and most people love it. so what are they doing -= they forgot to plan for it in their new maternity area – the one they also can’t get any obstetrici
ans for….
giving birth in Canberra is not looking good into the future.

SpellingAndGrammar 11:41 pm
17 Feb 10
#16

I love this topic. Polarises so many. I ask the following:
1. Did anyone in Canberra notice how much private obstetric prices increased following the introduction of the Howard Government’s Medicare Safety Net? A mozza. If you read the independent review (http://www.chere.uts.edu.au/pdf/emsn_review.pdf), apparently 78c out of every dollar spent from that program ended up in the doctor’s pocket – what a surprise!! Let’s face it – our health system is geared around doctors. The greater the emotional/physical need = the more you will pay. Not because it costs more to provide the service, but simple supply and demand. Inelasticity of demand.
2. How many out there only go to a private obstetrician because they want the private room/private hospital? How often(particularly with a low risk pregnancy) does the private obstetrician walk in as the baby is delivered by the midwife, asks how you’re doing(required under Medicare rules to bill) and then goes back home. How often is the sweat factor really exercised?
3. And finally, to all the homebirthers out there – who the hell wants to clean up that awful damn mess afterwards. All nice and dandy to do it in your own home, but pulleeezze!!

Oh – and why do you think that the recent annual meeting of private obstetricians and gynaecologists included a session on being selfish is good for you and your patient, and another on maximising your billing?

No wonder we can’t get staff specialists in public hospitals – too damn lucrative in the private sector.

Bring it on!

Thumper 7:57 am
18 Feb 10
#17

Let’s face it – our health system is geared around doctors

Wow, that’s a huge surprise. I would have never expected that.

sloppery 9:57 am
18 Feb 10
#18

Seems like a kinda selfish view of the world if you ask me. What about the best interests of the child?

housebound 10:05 am
18 Feb 10
#19

This debate will probably never be resolved. Childbirth used to be a highly dangerous endeavour, but things have improved. Some of it is because of improvements in basic hygiene as germs were discovered as the cause of infection. Doctors probably saved quite a few lives too. That said, the females in this household all support the midwives.

deezagood 10:41 am
18 Feb 10
#20

sloppery said :

Seems like a kinda selfish view of the world if you ask me. What about the best interests of the child?

The primary reason that families choose homebirthing is to benefit their babies; which seems rather unselfish to me. Google ‘benefits of homebirthing’ and you will see that most of the reasons cited are based on improved outcomes for the baby. Homebirthers believe that a home birth is in the ‘best interests of the child’ (this belief is supported by some studies and research; of course there are other studies that show the opposite to be true, so it really does depend what you believe).

imhotep 11:15 am
18 Feb 10
#21

deezagood said :

Homebirthers believe that a home birth is in the ‘best interests of the child’ (this belief is supported by some studies and research; of course there are other studies that show the opposite to be true, so it really does depend what you believe).

Yes deez, it does depend on what you believe. I’m afraid from my reading, the studies (in scientific journals) overwhelmingly find that babies are safer when born in hospitals. Almost all the articles I’ve read to the contrary (not science journals) appear to have a home birth agenda.

You can certainly argue that it is your ‘right’ as a woman to give birth where you choose, but from what I’ve read you can’t argue that it is safer for the baby.

deezagood 12:35 pm
18 Feb 10
#22

Macfarlane A, McCandlish R, Campbell R.
Choosing between home and hospital delivery. There is no evidence that hospital is the safest place to give birth.
British Medical Journal. 2000 Mar 18;320(7237):798.

Kenneth C Johnson and Betty-Anne Daviss
Outcomes of planned home births with certified professional midwives:
large prospective study in North America.
BMJ 2005;330:1416 (18 June).
The study included prospectively reported data from more than 5000 women planning home births with Certified Professional Midwives in the year 2000 in the U.S. and Can, and found that outcomes for mothers and babies were the same as for low-risk mothers giving birth in hospitals, but with a fraction of the interventions

Olsen, O.
Meta-analysis of the Safety of Home Birth.
Birth. 24(1): 4-13, 1997.

Concludes: “Home birth is an acceptable alternative to hospital confinement for selected pregnant women, and leads to reduced medical interventions.”
urphy PA. Fullerton J.
[Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. pam15@columbia.edu ]
Outcomes of intended home births in nurse-midwifery practice: a prospective descriptive study.
Obstetrics & Gynecology. 92(3):461-70, 1998 Sep.
OBJECTIVE: To describe the outcomes of intended home birth in the practices of certified nurse-midwives. CONCLUSION: Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary. Intrapartal mortality during intended home birth is concentrated in postdates pregnancies with evidence of meconium passage

Olsen O.
Afdeling for Social Medicin, Kobenhavns Universitet
[Home delivery and scientific reasoning]. [Norwegian] Source Tidsskrift for Den Norske Laegeforening. 114(30):3655-7, 1994 Dec 10.
Doctors commonly assume that it is safer for all women to give birth in hospital rather than at home. Nevertheless, all statistical comparisons relevant to Nordic women today show that for healthy pregnant women it is at least as safe to give birth at home–and perhaps even safer. Furthermore, many randomised clinical trials consistently show that several of the elements which characterize home births make the births proceed much easier. The question is raised, in what ways it is possible to convince obstetricians that they should base their judgements and advice regarding place of birth on empirical evidence rather than on “well established” but pre-scientific dog-mas

imhotep 1:40 pm
18 Feb 10
#23

Deeza, I’ll see your articles, and raise you ten of my own. I’ll take your fist one though.

See where it says “outcomes for mothers and babies were the same as for low-risk mothers giving birth in hospitals, but with a fraction of the interventions”? I take it that outcomes were NOT the same for high risk mothers, although that bit is conveniently omitted.

And who should decide who is ‘low risk’? The mothers themselves? It is an important decision, one which I think should be made by a doctor.

Jim Jones 2:22 pm
18 Feb 10
#24

imhotep said :

You can certainly argue that it is your ‘right’ as a woman to give birth where you choose

A few people here seem to be arguing the contrary, which I find particularly appalling.

chewy14 2:37 pm
18 Feb 10
#25

Deezagood,
“outcomes for mothers and babies were the same as for low-risk mothers giving birth in hospitals”
“for selected pregnant women”
“healthy pregnant women “

This is what I mentioned above. For healthy women with low risk pregnancies, home birthing can have similar results to hospital births.

However this means that someone has to determine which pregnancies are low risk, and surely, as Imhotep says, a doctor is the only one qualified to do so.

deezagood 2:55 pm
18 Feb 10
#26

I know, I know imhotep; as I said, there are articles and studies on both sides of the fence. I don’t think though, that there is enough compelling, irrefutable scientifically-based evidence to suggest that homebirthing is a ‘selfish’ or irresponsible thing to do – as suggested by other posters here. I would also suggest that the trained midwives who are constantly monitoring all aspects of the pregnancy would be able to identify any potential risks; as they are trained to do. This is the primary point of the people who are protesting this decision. No midwife is ever going to allow a ‘risky’ birth to be undertaken at home; why on earth would they?

sepi 8:30 pm
18 Feb 10
#27

Under our current public hospital maternity system, mothers do not see an obstetrician unless the midwife decides they need to, as they are high risk. Many, many low risk mothers go through their entire pregnancy supervised by hospital midwives only.

So why should this be any different for home birthing mothers, supervised by qualifed nursing midwives?

Anna Key 9:33 pm
18 Feb 10
#28

Sorry Deeza. Are we talking about midwives who decide you aren’t going to have an epidural, because SHE doesn’t think you need it, or a midwife or starts an induced labour diregarding the obstetrician’s intructions, and then lies about it, or a midwife who belittles your attempts to breastfeed.

And finally, you have once again made a complete misrepresentation of the facts of this matter. The issue is one of insurance, not allowing them to practice. But I imagine in 15 years time, when your stuffed up delivery results in complications and you choose to sue to recover massive medical and care expenses, will you console yourself knowing that your right to choose a midwife to perform an unnecessarily risky procedure was respected.

Anna Key 9:34 pm
18 Feb 10
#29

PS sorry about the typos, I’ve an ancient keyboard

WanniAss 9:41 pm
18 Feb 10
#30

So if it is Your Body, Your Baby and your right, I assume you want fathers cut out of the process, inlcuding child support later. Or is it then suddenly his child too.

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