Women tell Julia Gillard "My Body, My Birth, My Right"

The Government are behaving like a “Big Brother” So to speak, if it looks like there could be an issue arising worth sueing they’ll squash out all possibilities of it by putting in legislations!! So I’m sorry public but again its the minority that ruin it for the majority!! Those people out there wanting to sue for any god damned reason (just so they dont have to work and get more money) are the reason why the Government are wrapping us in a tighter bound of cotton wool!! We lose more and more “freedoms” thanks to those Lazy, Pathetic people who are schemers and con artists!! Squash those people and take everything aways from them so they can understand and appreciate things they actually have to work for LIKE EVERYONE ELSE!!! Rant over, thanks.

astrojax said :

Anna Key said :

emd said :

The safest location depends on the individual medical history of the woman, and where she feels safest. this is a decision to be made by the individuals involved. Not something government should seek to legislate for all women.

And who decides whether a woman’s medical history supports this option? Sounds like we need a doctor involved

for fred’s sake, yes, of course we need ‘a doctor involved’ – but that doesn’t have to imply a doctor is needed in the actual birth process; you i hope see your gp regularly enough for a check up and can pretty well guage your health. similarly, a pregnant woman can consult a gp, an obstetrician and midwifery care for a running check on how her general state of health is. don’t conflate this with the need for medical intervention in the birthing process, not helpful in the context of the discussion…

Under the legislation, a homebirth does not require a doctor/ob to be present at the birth process. And for someone accusing me of haivng issues with logic, I would have thought my use of ‘supported’ in the context of this discussion was quite straightforward, but for the sake of clarity, supported by having a medical opinion over the health and safety or otherwise of the mother and the child.

And no idea what the captain raaf reference means….

Anna Key said :

So any woman that doesn’t want a homebirth option is insane, unintelligent and uninformed…

The federal government did step in for midwives, just not for unsupported home births

you really have difficulty in disentangling straight forward logic, don’t you? ‘sane, intelligent and informed women’ can apply to a number of coteries, so no, it doesn’t in the least imply that women who want something different to this are the inverse…

and as for the second sentence, the definition of ‘supported’ is entirely what is at issue. how does this intejection advance the discussion?? are you really just captain raaf on mogadon?

Anna Key said :

emd said :

The safest location depends on the individual medical history of the woman, and where she feels safest. this is a decision to be made by the individuals involved. Not something government should seek to legislate for all women.

And who decides whether a woman’s medical history supports this option? Sounds like we need a doctor involved

for fred’s sake, yes, of course we need ‘a doctor involved’ – but that doesn’t have to imply a doctor is needed in the actual birth process; you i hope see your gp regularly enough for a check up and can pretty well guage your health. similarly, a pregnant woman can consult a gp, an obstetrician and midwifery care for a running check on how her general state of health is. don’t conflate this with the need for medical intervention in the birthing process, not helpful in the context of the discussion…

Ah no.
What I meant is that if a number of sane, intelligent women want access to homebirth, they should have that option.

It is very nanny-state to just ban it outright, for people’s own good.

Leinna, thanks for the link to the journal article. I appreciate it.

As you mentioned, I note that the study is not comparing like to like. Specifically, it is comparing all hospital births to all homebirths. And the complicated/risky/dangerous births go to the hospital.

If the study was comparing the two locations fairly, it would look at all homebirths vs all low-risk hospital births. And the results would be poorer for homebirth safety than what the Kennare study already shows.

Does anyone know of any other similar research that has been done?

So any woman that doesn’t want a homebirth option is insane, unintelligent and uninformed…

The federal government did step in for midwives, just not for unsupported home births

The market does not want to insure obstetricians either, but the federal government quickly stepped in to underwrite them. I’d like to see that protection for midwives too.

The differences in safety between home and hospital are very low, this is why it is different to measure. Different hospitals have different safety outcomes too, but noone is insisting that all women go to a single hospital.

We should support access to safe, midwife supported homebirth, because sane, intelligent, informed women want this option.

sepi said :

How about you provide some evidence to convince me that homebirth is unsafe?
While you’re at it, you can convince the College of midwives, the governments of Europe, and hospitals and goverments in 5 states of Austraalia, who all practice and support homebirth.

You could even convince our Federal Govt, who are not actually banning homebirth, or making it safer, they are just making it administratively impossible, due to insurance clauses.

The issue is not about the safety of homebirth, but rather the practicalities of ensuring indemnity insurance for private midwives.

Or maybe you could explain why 5 states apparently support homebirth, but it is state legislation that requires midwives to have insurance. And the market has decided that insurance for midwives is either too risky a product to provide or it would be so expensive, none of them could afford it anyway

emd said :

The safest location depends on the individual medical history of the woman, and where she feels safest. this is a decision to be made by the individuals involved. Not something government should seek to legislate for all women.

And who decides whether a woman’s medical history supports this option? Sounds like we need a doctor involved

Well here’s a study from South Australia of 300,000 births, of which 0.38% were home births. This was published in the Medical Journal of Australia.

http://www.ncbi.nlm.nih.gov/pubmed/20078406

Summary:
Similar risk of perinatal death (7.9-8.2 per 1000 births)
Home births were seven times more likely to result in death of the baby during actual delivery
Home births were 27 times more likely to result in death of the baby from intrapartum asphyxia.

Bear in mind that the hospital births probably include preterm deliveries to a much greater extent than hospital births.

I think, in summary, that although the overall death rates are similar, the babies who die during home birthing may have been saved if timely intervention at hospital was available. The babies who die in hospital may still die from these complications, but it is much less likely. They are more likely to die from more serious problems (such as developmental abnormalities, preterm delivery and so on).

It is obvious that some people will achieve a better outcome with a homebirth and some people will achieve a better outcome with a hospitalbirth.
In the same way that some people respond better to Fentanyl and some people respond better to Morphine.

My question about safety was not about a specific person. It was about safety on a population-wide level. The safety of all births, not just one.

So, which location is, on average, safer? And by how much?

The safest location depends on the individual medical history of the woman, and where she feels safest. this is a decision to be made by the individuals involved. Not something government should seek to legislate for all women.

Nobody is trying to force all women to home birth. I personally choose not to. But I will fight to the death for the right to decide that for myself.

several times, I have asked the homebirth supporters in this thread: which location is safer, home or hospital; and by how much; and how do you know that.

I have not received an answer.

I am forced to conclude that the homebirth supporters in this thread do not know which location is safer. *note, I do not know which location is safer either.

—

so, another question to the homebirth supporters. Why should the readers of this thread support your advocacy for easier access to homebirth, when you don’t even know how safe/unsafe it is?

Sepi has made some great points about home birth being a valid option for normal, healthy pregnancies. Bosworth will probably only ever see what he looks for, but his opinion on safety is irrelevant anyway. What is relevant is whether informed women are entitled to right of refusal and consent for medical treatment. The fact that they are carrying an unborn child does not disallow pregnancy termination or choosing to give birth with the added risk of medical intervention even with no medical reason, so why should it disallow birth under the care of a registered midwife?

Making it impossible for women to call on a registered midwife means we will have some women (at a guess, 1% of all births in Australia) who birth at home with no registered midwife in attendance. Registered midwives are accountable to a professional body that has clear guidelines on when it is time to go to hospital, requirements to keep training up to date, insurance etc. Surely, if a woman is going to birth at home anyway, it is better that she has a registered midwife with her?

How about you provide some evidence to convince me that homebirth is unsafe?
While you’re at it, you can convince the College of midwives, the governments of Europe, and hospitals and goverments in 5 states of Austraalia, who all practice and support homebirth.

You could even convince our Federal Govt, who are not actually banning homebirth, or making it safer, they are just making it administratively impossible, due to insurance clauses.

The issue is not about the safety of homebirth, but rather the practicalities of ensuring indemnity insurance for private midwives.

If you want to convince other people that your positive opinion on homebirth is accurate, you need to do better than saying: “Just go read wikipedia”.

Especially when wikipedia says:

“The safety of home birth has been a subject of some controversy, especially among professional physicians groups. A number of studies have shown that the safety of an attended home birth for low-risk women is equal to the risks of giving birth in the hospital or a birthing center, though the quality and reliability of the available data has been called into question.[1][2] The American Medical Association and the American College of Obstetricians and Gynecologists oppose home birth on the basis that a seemingly uncomplicated birth can still potentially become a medical emergency without warning, and they assert that home birth makes the birth experience a greater priority than safety. [3][4]”

—

so, are you able to back up your opinion with evidence?

The link above contains the scientific studies.
I’ve made up my mind, you’ll have to do your own research.

sepi said: “Homebirth advocates believe that homebirth is in fact less harmfull than hospital birth.”

sepi said: “There are studies that show low risk births at home, attended by midwives, are just as safe as hospital births.”

so, which one is it?

are homebirths less harmful(more safe) than hospital births?
or are homebirths equally safe as hospital births?

how do you know that your view is accurate?
upon what evidence do you base your view?

Bosworth – it seems you have answered your own question in that you clearly believe that homebirth is ‘more harmful’.

Homebirth advocates believe that homebirth is in fact less harmfull than hospital birth.

I believe that women should be able to choose a homebirth if they so wish, just as they should be able to choose a hospital birth.

There are studies that show low risk births at home, attended by midwives, are just as safe as hospital births. But it is a pretty hard thing to study exactly.

And once it is illegal, there will be no way to study it at all.

http://en.wikipedia.org/wiki/Home_birth

emd said :

I notice there’s a lot of people complaining that women who homebirth aren’t thinking about the rights of the unborn baby.

Do these same people also want to criminalise abortion? Because if women are allowed to choose to terminate a pregnancy, why shouldn’t they equally be able to choose who their healthcare provider is for birth?

Do these same people want to ban elective caesarean with no medical reason? Because if a woman is allowed to undergo major surgery, giving her baby five times higher chance of breathing difficulty at birth and giving herself six times higher chance of death, why shouldn’t she equally be allowed to choose NOT to have intervention?

Or are women only allowed the final say over what happens to their body if they choose to remain childless?

Women who choose not to have children are tolerated by modern Australian society. But if you decide that you want to have children, you’re expected to lie down and take it like a good girl. Women do not lose their ability to make decisions when they get pregnant. For most women, their focus is very much on what is best for their babies. The women who make an informed choice to pay for private midwifery (for hospital or home birth) are doing so because they believe it will give them the best chance of a good outcome for both mother and baby.

With all this argument about the rights of the baby vs the rights of the mother – as if they don’t affect each other – it was only a matter of time before this comment came up.

you didn’t answer my question. If you don’t want to that is fine.

How much more harmful is homebirth, when compared to hospital-birth, for low-risk pregnancies?

Hospitals in 5 states run homebirth programs. They wouldn’t do this if it was highly dangerous.

I know the first impression of homebirth is that it is for fluffy hippy types only, but that is not actually the case.

My wife was also ambushed by pro-breastfeefing zealots.

—

When comparing a low-risk hospital birth to a low-risk home birth, how much more harmful is the homebirth?

DJ said :

the breastfeeding brainwashers that ambush many new mothers telling them that their child is in danger of not developing correctly unless they breastfeed… or was that just my experience?

No, we had EXACTLY the same thing happen to us – and ‘ambush’ is the word.

The choice to abort is not criminal and never should be. Women have the right to make that choice and lets be honest that decision is most likely never made lightly or without due consideration. I see this subject as black and white not the grey that surrounds the safety of homebirths.

As stated above, my opinion is that if you are going to have a child I do not believe that it is responsible to do so at home.

“Lie down and take it like a good girl” – Oh please! Are the informed choices that are being provided coming from neutral sources? Or are the people providing the information like the breastfeeding brainwashers that ambush many new mothers telling them that their child is in danger of not developing correctly unless they breastfeed… or was that just my experience?

This whole informed choice is bollocks in many (not all) cases – how about a look at motivators and agendas?

I notice there’s a lot of people complaining that women who homebirth aren’t thinking about the rights of the unborn baby.

Do these same people also want to criminalise abortion? Because if women are allowed to choose to terminate a pregnancy, why shouldn’t they equally be able to choose who their healthcare provider is for birth?

Do these same people want to ban elective caesarean with no medical reason? Because if a woman is allowed to undergo major surgery, giving her baby five times higher chance of breathing difficulty at birth and giving herself six times higher chance of death, why shouldn’t she equally be allowed to choose NOT to have intervention?

Or are women only allowed the final say over what happens to their body if they choose to remain childless?

Women who choose not to have children are tolerated by modern Australian society. But if you decide that you want to have children, you’re expected to lie down and take it like a good girl. Women do not lose their ability to make decisions when they get pregnant. For most women, their focus is very much on what is best for their babies. The women who make an informed choice to pay for private midwifery (for hospital or home birth) are doing so because they believe it will give them the best chance of a good outcome for both mother and baby.

Currently midwives are insured – this is partly why it costs women 3000.00 to employ a homebirth midwife. People don’t take these decisions lightly.

It seems that hospitals in 5 states run homebirths.

http://www.premier.vic.gov.au/newsroom/9132.html

Health Minister Daniel Andrews said pilot programs would be established at the two Melbourne hospitals to trial public home-birth services.

“The Brumby Labor Government is taking action to give Victorian families the best possible start in life, with access to world-class health services,” Mr Andrews said.

“Our expectation is that there will be around 50 home births in each of these pilot projects during the 12 month assessment period, which will begin early next year.

“The Victorian pilot model has been established following consultation with consumer groups, maternity health professionals, leading maternity obstetricians and midwives.

“It will also draw on the experience of similar programs in Western Australia, South Australia, the Northern Territory and NSW.

Anna Key said :

And when something unfortunate does happen in the hospital, there is a legal avenue to compensation (if you are so inclined). However, what are your options with an uninsured midwife. A few tea candles and a CD of whales farting isn’t going to pay ongoing costs of care

Anna, you’ve made my day! 🙂

And when something unfortunate does happen in the hospital, there is a legal avenue to compensation (if you are so inclined). However, what are your options with an uninsured midwife. A few tea candles and a CD of whales farting isn’t going to pay ongoing costs of care

Oscillate Wildly said :

Because nothing EVER goes wrong during hospital births, hey DJ? http://www.smh.com.au/nsw/how-could-this-happen-hospital-blunder-turns-a-familys-joy-into-heartbreak-20100820-138xw.html?autostart=1

Occasionally people die on operating tables.

Using your logic, no-one should have surgery, ever.

Now go away, or I shall taunt you a 2nd time

I didn’t suggest that there was no risk or things never go wrong in hospitals. Nobody is perfect nor are hospitals. Mistakes and errors are human however if something happens during child birth that requires immediate medical attention, in hospital you are there where the help is – not in the comfort of your home where the help isn’t.

I believe that the risks are simply not justifiable considering the possible outcome.

This may be a case of society doing something for people who sadly think they know better.

Because nothing EVER goes wrong during hospital births, hey DJ? http://www.smh.com.au/nsw/how-could-this-happen-hospital-blunder-turns-a-familys-joy-into-heartbreak-20100820-138xw.html?autostart=1

Oscillate Wildly said :

sepi said :

I’d be interested what % of comment comes from those who have no kiddies of their own

Because people without children shouldn’t be allowed to have an opinion? The same could be said about you commenting on how women give birth, when as a male you have no first-hand experience of it.

Define first hand experience.

I have accompanied my wife through the entire labour and birth of both our kids and discussed all of the above with her, and her opinion is the same as mine.

You, on the other hand, have no idea. Your head lives firmly in the hypothetical, whereas mine resides in the actual

Some interesting posts from some informed and less-informed people. I am father and not a doctor and some will not appreciate my opinion. This is a storm in a tea cup – time to get over it.

No, people without children, unless they have other birthing experiences, cannot fathom the emotion and stress of an event like this.

To make the decision to home birth is a selfish reason to place an unborn life at risk not to mention the mothers welfare. Could you live with the outcome if things turned for the worst at home? Would you accept that your decision to homebirth, regardless of the presense of a midwife or other person to help, could cost a life or maybe two? Oh, that’s right an ambulance will save the day… but could you live with yourself if they were delayed by traffic or busy elsewhere? You’d blame everybody except yourself.

Oh, the hospital was awful, or not what I expected, or I felt like a number not a person I hear some of you say – imagine how much worse it would have been with a minor complication and being at home and no way to fix the problem – prayer does SFA whereaw a doctor can. Complain about the system all you like but how about just being grateful that you survived the birth and you have a healthy baby?

How about we go with hundreds of years of MEDICINE/SCIENCE in our modern society to even up the odds somewhat and USE A HOSPITAL. Yes, in the past rice fields and drafty castles were ok but this isn’t the dark ages.

You can throw statistics from overseas or anywhere else for that matter at me until the cows come home but having lost a very young child (not child birth related) I know that I don’t want anybody else to experience what I have experienced.

Sorry, that quote was from vg, not sepi.

sepi said :

I’d be interested what % of comment comes from those who have no kiddies of their own

Because people without children shouldn’t be allowed to have an opinion? The same could be said about you commenting on how women give birth, when as a male you have no first-hand experience of it.

Careful Leinna, you are adding informed, sensible opinion. It has no part in this discussion!!!

Well as a doctor who doesn’t work in obstetrics…

1) There are midwives out there who push for home birth no matter what. I have experienced this in Canberra, Melbourne and Sydney. This policy protects women. It allows a specialist obstetrician, who has at least 14 years of medical training, at least 6 years specifically on obstetrics and gynaecology, to ensure that a woman is not entering into an unsafe birth at home. If you see a public obstetrician, I’m sure that they’ll be quite happy to certify a home birth as safe or not, as they have no monetary benefit from doing so – a public hospital birth costs nothing to the patient.

2) Home birth advocates frequently quote studies from Sweden and Holland. In this nations, the average ambulance response time is under 5 minutes. I don’t think we can say the same for Australia.

3) While birth is a natural process, it is also a dangerous process. I don’t recall the exact figures from medical school, but it was something like 1/10 or higher women/babies dying during the process. The Canberra Hospital caesar rate is something like 30% of women. This is because birth is a dangerous natural process. Things can be fine, but can then go wrong very quickly.

Placenta praevia has been mentioned above. Shoulder dystocia is another problem which is becoming more of a problem in our increasingly overweight society. Most of the time this can be managed by simple maneuvers, but occasionally surgical intervention is necessary. More than one person is often necessary.

Home birth is probably safe for women giving birth the second time, after having a normal vaginal delivery for their first baby with no complications (so long as they aren’t overweight, their baby is a normal size and has the correct presentation, etc etc).

sepi said :

Vg – imagine how angry you would be if someone insisted that your wife should birth at home (and every pregnant woman).

This is how the homebirthers feel about being forced to birth in hospitals.

Noone cares how your wife has her babies. So why should you get to dictate what others should do?

Homebirth is perfectly safe (for low risk pregnancies). Half of non-caesarian births in Holland are homebirths (run by the state). Homebirth is not more expensive.

If ‘someone’ insisted I would tell them to get effed. If the government legislated I would obey the law, or I guess my wife would.

I don’t get to dictate here, I get to opine. The government gets to ‘dictate’, so wind back the hysterics petal.

Homebirth is not more expensive? When did cost come into it? Dropping a kid in a car park unaccompanied is free…..what’s your point?

I’d be interested what % of comment comes from those who have no kiddies of their own

sepi said :

Homebirthers believe drug free calm birth is better for the baby. They don’t want to persuade others to do this, but want the right to have their babies in the way they believe is best for themself and the baby.

This is the crux of the issue. Whether acting on the belief that homebirth is better is an action that the community, through the Government, should restrict. And how severely it should be resricted.

As an example, if a person wants to spend three hours a day worshipping a Black Rock, then the community should have no interest in restricting that activity, as it causes no harm.

If a person believes, and acts on the belief, that their child should consume soft drink only, then that is an action that the community should (and does) restrict, as it is very harmful to the child.

so, the question is, how harmful is homebirth to the baby, the mother, the partner, and the family?

and based on that level of harm, how severely should homebirth be restricted?

thankyou to all that protested. I think its an extremely important issue – the right to have a choice of where to give birth! whilst raising awareness of the superior care of professionally trained midwives and the superiour birth outcomes with low risk births in an environment a woman is comfortable in. For some of us, hospitals dont provide the space we desire, and I for one, and others I know when in a low risk situation do not want to be treated by doctors that work from the mentality that birth is a ‘medical event’, not a ‘natural event’. And let me assure you – its definately about the well being of the child.

And why does Holland and NZ have higher maternal mortality rates?

Honestly. If homebirth is so deadly, then why is it so common in Holland and New Zealand, and why do Victoria and WA have homebirth programs run by hospitals?

sepi said :

I personally think the govt has taken this action to be sneaky and to try to be all things to all people. they should just come out and ban homebirth, if that is what they want to achieve. Instead they have banned qualified midwives from working for themselves, without getting a sign-off from a specialist dr. Which is completely impractical, and has the effect of banning homebirths, while the govt can still pretend that was not their intention.

it is not all about insurance. Insurers hate birth full stop, as quite naturally, parents who have a tragic event tend to sue tenaciously, as feelings run so high. Insurers tried to stop insuring Obstetricians also, and the govt stepped into sort that out. So the govt could support independent midwives if they so wished.

Still don’t see what was so sneaky. The states require a midwife to have insurance coverage. The feds have offered to support independent midwives at homebirths as long as it is medically safe. Maybe the government doesn’t like babies to die unnecessarily

give me one instance where it is safer for a completely healthy woman, with no distiguisable complications prior to birth, to give birth in hospital

When the baby is born with major complications that were unforseen or undiagnosable in advance of the birth. Eg when bubs decides to inexplicably revert to foetal circulation.

When the mother has major PPH. Or amniotic fluid embolism.

Basically anything requiring immediate intervention by a doctor for either mother or baby.

And remember most hospital births are only attended by midwifes and the midwife is the one who diagnoses a problem and then calls the doctor and also it takes 30min to organize an epidural which is required for a ceasarian. How is waiting the half an hour in the hospital different to waiting in an ambulance?

Because not every problem during labour and delivery can (a) wait and (b) be solved by a c/s.

Natural birth is better for the baby’s lungs than caesarian, and also the lack of drugs in the mother is better for the baby

Oh FFS not every birth in hospital has c/s, intervention and/or drugs!!

sepi said :

1. I would just not bother with the ob gatekeeper, as I don’t think it is necessary.
OR i would have a govt OB who ticks off a sheet at a single visit.

2. Homebirths can be said to be better for baby as no drugs get into their system.

Yeah, ok Dr Sepi. The problem is that how women ‘feel’ about things is no substitute for propoer medical analysis.

Vg – imagine how angry you would be if someone insisted that your wife should birth at home (and every pregnant woman).

This is how the homebirthers feel about being forced to birth in hospitals.

Noone cares how your wife has her babies. So why should you get to dictate what others should do?

Homebirth is perfectly safe (for low risk pregnancies). Half of non-caesarian births in Holland are homebirths (run by the state). Homebirth is not more expensive.

I’m tired of reading comments from people who haven’t researched the issue.

To all those who noted that they cared about the welfare of the child over the mother – I would challenge you to do some research on the impact of a mother’s health on the child. Women who experience a positive birthing experience (through the right of informed consent and choice) regardless of if intervention was required, have lower rates of post-natal depression and higher rates of breastfeeding and attachment. Additionally, in Australia there are high levels of non-medically indicated interventions including inductions, episiotomies and C-sections – these all impact unncessarily on the baby’s hormonal imprinting – that is right, natural labour (when possible) results in a cocktail of healthy hormonal interplay which has short and long term benefits for mother and child.

Birthing in an environment which allows optimal emotional health (eg. no stress or fear, respect for privacy) allows the physiology of birth to work as nature intended. The hospital environment can inhibit this and midwives are ‘woman centred’.

It needs to be highlighted that birthing activists, while strongly believing in the right to birth at home, are fighting for women to have the qualified health practitioner of their choice – either at home, in a public hospital or in a private hospital. Midwives are recommended by the World Health Organisation as the ideal model of care for normal birth. This is not just about homebirth.. it is the progression of the medical interventionist model of care. Formerly interventionist in a ‘doing things during birth’ sense… now interventionist in how midwives practice. Will you be happy when it is legislated that all women need to have C-sections because obstetricians believe it is the safest way to birth?

vg said :

Doctors are just mechanics for bodies, so the analogy is more than apt. Feel free to tell a woman, mid delivery, that what she is doing is just ‘run of the mill’.

The birth of my children wasn’t ‘run of the mill’

To you perhaps, but in the grand scheme of things it was just another in 500,000 that same day.

My oar….

I personally have nothing against anyone doing anything. They can have a baby in tree for all I care. With one single proviso; that I – as a tax payer – dont have to pay for the choice. I already have to pay for people to have babies in ‘maternity/paternity payments’!

The role of the State is to ensure there is a way to give birth in a safe and 100% subsidised way. However, ‘he who pays the piper, picks the tune’ and if the State is paying then the State should have the say about where it happens. If the State considers that the safest place (with the least risk of extra costs) is a Birth centre then sobeit.

If someone is willing to underwrite the risk of giving birth away from medical facilities – should something go wrong – then who am I to say they shouldn’t! Being male and not medically qualified I quite rightly should have zero to say on the subject; but as a tax payer, I should be allowed to have a say in where my hard earned money is spent and that say is in the ballot box.

Oscillate Wildly said :

vg said :

You can do a grease and oil change on your car in your backyard but, unless you’re qualified yourself, you need to send it to a mechanic for anything more difficult, complicated, dangerous or pear shaped.

Come the day when a parent or midwife gets charged with manslaughter because they did not seek reasonable medical help or forsee its needs when the birth is complicated you’ll sing a different tune.

A midwife is not a doctor, and the birth of a child is not a ‘run of the mill’ thing.

500,000 babies are born every day. Sounds pretty run of the mill to me.

And what a charming comparison to make between a car and a woman’s body!!

Doctors are just mechanics for bodies, so the analogy is more than apt. Feel free to tell a woman, mid delivery, that what she is doing is just ‘run of the mill’.

The birth of my children wasn’t ‘run of the mill’

Some doctors and nurses homebirth their babies too.

CraigT – I fully support homebirth, and I vaccinate my kids and do not use homeopathics.

VG – I have had two kids without a doctor in sight (in hospital, not in the birthing centre).
The birthing centre at Canberra Hospital delivers a couple of babies a day with no doctor involved.

Homebirthers believe drug free calm birth is better for the baby. They don’t want to persuade others to do this, but want the right to have their babies in the way they believe is best for themself and the baby.

Midwives are not doctors, but they are qualified nurses, trained in childbirth. they know what they are doing, they only want to take on low-risk mothers for homebirth, and they know when to transfer to hospital if things are not progressing well.

Yes its all good and fine to have your home birth. But when something goes wrong, you’ll expect the ambulance to come and get you and race you to the nearest hospital with theatre facilities, where a surgeon who knows nothing about you will cut the baby out. That is if your “private midwife” does’nt fancy herself as being just as capable and knoledgable as a doctor, and hold on to you for too long before calling for help. At the end of the day, if you survive long enough, it will be us doctors who are called on to fix the mess. Home birhing is dangerous,driving with out a seat belt is fine, untill you have a crash.

vg said :

You can do a grease and oil change on your car in your backyard but, unless you’re qualified yourself, you need to send it to a mechanic for anything more difficult, complicated, dangerous or pear shaped.

Come the day when a parent or midwife gets charged with manslaughter because they did not seek reasonable medical help or forsee its needs when the birth is complicated you’ll sing a different tune.

A midwife is not a doctor, and the birth of a child is not a ‘run of the mill’ thing.

500,000 babies are born every day. Sounds pretty run of the mill to me.

And what a charming comparison to make between a car and a woman’s body!!

Remember this is caused by the fact that no insurance company will provide coverage. Obviously the actuaries think it too risky as well.

And I, for one, welcome our new actuarial overlords setting social policy.

You can do a grease and oil change on your car in your backyard but, unless you’re qualified yourself, you need to send it to a mechanic for anything more difficult, complicated, dangerous or pear shaped.

Come the day when a parent or midwife gets charged with manslaughter because they did not seek reasonable medical help or forsee its needs when the birth is complicated you’ll sing a different tune.

A midwife is not a doctor, and the birth of a child is not a ‘run of the mill’ thing.

DJ said :

Because I am so, can somebody please explain, in laymans terms, why has the Govt taken this course of action? It seems to be upsetting only a very few people here which is unusual for an emotive topic.

If only a small group of women take their children to stand in the cold and protest this evil when it is such a bit deal doesn’t that make it a storm in a tea cup?

For the record, my wife had an emergency c-section in 2005 and if it had been at home I would have lost my wife and baby without any doubt.

don’t confuse the size of the protest with its veracity – rachel carson was pretty much a lone voice against ddt for many years; would you be happy to be sprayed with ddt today?

and while i am very glad to hear your family came through the birth experience well, a homebirth option doesn’t exclude medical intervention and, in canberra, access to a hospital is pretty quick. not to read into your experience, but emergencies happen at home, too, but the patient can get in an ambulance in short order and into theatre pretty quickly – an experienced midwife deals with this, too…

Could the homebirthers posting here help me?
I’d like to study the correlation between
– Homebirthers
– Homeopathy users
– Anti-vaccinationers

From my limited experience, the homebirthers belong in the “irrational extremists” bucket, along with anti-vaccinationists and should take a long hard look at themselves for putting their babies in danger the way they do with their irrational beliefs.

To those thinking 25 people is insignificant, this was just one small protest. There have been several around the country in the last year or so, with approx 3000 people at Parliament House last September, many (including my family) who traveled from interstate to attend. There were 2 Senate inquiries – both receiving record numbers of submissions.

This does not only affect homebirths (although the majority of independent midwives are employed for homebirths). The Govt said they’d expand midwifery care by allowing women to have their choice of midwife throughout the pregnancy for planned hospital births, as well. The way it’s all panned out with medical veto & the collaborative agreement requirement means most women won’t be able to access the continuity of care that is internationally recognised as the gold standard.

If you had an electrical issue in your home, would you expect a plumber to have to agree with what the electrician planned to do? How would you feel if that plumber said they would not allow the electrician to do their work, instead insisting that’s a job for a plumber? How would you feel living in a place you didn’t feel safe because someone said you couldn’t have the tradesperson best qualified to do the job?

Think before you respond to those questions. Both are in the same trade, but come from different skill sets. Midwives are the experts in normal birth. Obstetricians are the experts in problematic births. Midwives already know when to refer clients on & are professionally bound to do so – no need for any collaborative arrangements.

Even the obstetricians know the collaborative model we now have is flawed & often unworkable. In New York, they’ve just passed the Midwifery Modernization Act that removes the requirement for doctors to sign off on choices because IT DIDN’T WORK.

I plan on a homebirth for my next child, all things going well. Having done extensive research, I know 1000 times more about pregnancy & birth now than I did when I had my daughter in hospital (an experience I don’t wish to repeat if possible). Talk to any woman who has experienced both models of care & I can tell you which comes out on top, both for mother & baby. I can also guarantee that a woman planning a homebirth is much better informed than one who automatically goes to the hospital for care. To imply that any woman would intentionally choose to put their baby at risk is insulting & uninformed.

I think it should be compulsory for all medicos (particularly Obs) to attend homebirths as part of their training & just observe. Most have never seen a normal physiological birth, so their decision making is going to be biased. Until then, we’re going to be stuck in this misogynistic, risk-based view of birth.

I personally think the govt has taken this action to be sneaky and to try to be all things to all people. they should just come out and ban homebirth, if that is what they want to achieve. Instead they have banned qualified midwives from working for themselves, without getting a sign-off from a specialist dr. Which is completely impractical, and has the effect of banning homebirths, while the govt can still pretend that was not their intention.

it is not all about insurance. Insurers hate birth full stop, as quite naturally, parents who have a tragic event tend to sue tenaciously, as feelings run so high. Insurers tried to stop insuring Obstetricians also, and the govt stepped into sort that out. So the govt could support independent midwives if they so wished.

Because I am so, can somebody please explain, in laymans terms, why has the Govt taken this course of action? It seems to be upsetting only a very few people here which is unusual for an emotive topic.

If only a small group of women take their children to stand in the cold and protest this evil when it is such a bit deal doesn’t that make it a storm in a tea cup?

For the record, my wife had an emergency c-section in 2005 and if it had been at home I would have lost my wife and baby without any doubt.

Placenta praevia pregnancy would be sent to hospital by the midwife, no doctor needed for that one. Homebirth is not a matter of deciding to stay home no matter what, its just staying home because there is no need to go to hospital. There are many situations that homebirth is not recommended, that’s homebirthers use hospital as a back up plan. There are many situations where a hospital birth is not ideal and that would be in a low risk pregnancy where you don’t want your labour to be constantly interrupted by strangers and have medical procedures performed on you that interfere with a naturally progressing birth. It also includes a low risk pregnancy where the mother doesn’t want to go to hospital and has no medical reason to do so. If she has a midwife then there is nothing that hospital provides that isn’t already provided at home. There are many other benefits to a homebirth as well, and not all of them are about the mother, most of them are for the baby.

Why are people commenting on this when they have obviously not even tried to understand what is actually involved in a homebirth? Who do they think are delivering babies in hospitals? doctors? don’t think so!! its midwives. Same as at home. Except at a homebirth the midwife has seen the woman through the whole pregnancy, its not a matter of whoever is on shift having to read the notes.

And to the person who criticised woman for having their children out in the cold to protest…what options do they have when their rights are being trampled on? Mothers with young children find it very difficult to be heard because its hard to get out when you have young kids. But the alternative is to do nothing and watch the rights of the mother to choose what is best for her future babies being taken away. How dare you criticise people for defending their rights to decide on the safest place to birth their own baby. As long as its not dangerous, and homebirth has been proven to be safe over and over and over again, then its not anyone elses place to decide but the person who is giving birth to that baby.

Remember this is caused by the fact that no insurance company will provide coverage. Obviously the actuaries think it too risky as well. Or are you saying an insurance company would rather have an anti-woman principle than sell a profit amking product?

Also, the requirement for a midwife to have insurance is a state/territory law not federal. The federal govt has agreed to provide insurance coverage for midwives in limited circumstances.

tam said :

Sorry let me rephrase that….. give me one instance where it is safer for a completely healthy woman, with no distiguisable complications prior to birth, to give birth in hospital?

And who provides the diagnosis that a woman is completely health? Wouldn’t that be a doctor? Or is a midwife now qualified to undertake a comprehensive health assessment?

sepi said :

Diagnosing placenta praevia is done via a scan. Blind Freddy can diagnose it after the 20 week scan. So probably a doula could diagnose it, however a qualified midwive, such as those this thread is about, could definitley diagnose it, and would send the mother for a caesarian, exactly as currently happens at the Canberra birth Centre, where the midwives book all placenta praevia cases straight in for caesarians
(placenta praevia = placenta lower than baby).

NEither doulas, nor placenta praevia have anything to do with the way the govt has surrepticiously banned qualified midwives from supervising low risk births.

OK Sepi, clearly you have some very strong views on this. However, the govt did not do this surrepticiously – suggest you learn what this means as well as learn to spell it.

However, maybe you and EMD should think of the child, not the me me me attitude of the mother. And I’m intrigued by EMD mentioning the babies/small children. I’m sure a 6 month old fully understands the complexity of the issues and decided to turn up on their own volition.

astrojax said :

Jethro said :

am guessing by now ma bodine and you have the place in a maternity ward all sorted but otherwise can heartily recommend queanbeyan – midwife-staffed, doctors called as needed but not poking their noses in every five minutes for no good reason. astromonkeyman and of course astress had a wonderful time; and then they have single rooms where you can stay with mum and bub for a few days, is the best bit!

We have heard many rave reviews of Queanbeyan and considered going there for a time. However, a move to the north west of Canberra made that seem a rather difficult option.

sepi said :

Homebirthers believe that homebirth is healthier for the baby also.

Natural birth is better for the baby’s lungs than caesarian, and also the lack of drugs in the mother is better for the baby.

This argument doesn’t seem very persuasive. You can go to hospital and choose not to use drugs. You can even refuse a cesarean if you don’t want one when the doctors recommend it.

and finally – it really irks me that birth services are so diverse, and yet we have so little choice in what we end up with. QBN is by all accounts fantastic with birthing baths, lovely midwives and private rooms (and free/public), Canberra hospital is free and has rooms for only 2 women, Calvary has antiquated rooms for 4 women, the birth centre is great, but most people don’t get past the waiting list, and private hospital with an obstetrician costs 5 thousand (if you have health cover). Meanwhile other states have sponsored homebirth. It seems like a lot of choice, but in reality, most of these options aren’t open to us, we just have to go to our closest hospital and put up with whatever they have on offer.

Agreed. It does seem odd that our hospitals seem to have such different standards. Perhaps the answer should be that our regional hospitals should start to specialise in certain areas. Canberra Hospital could become THE birthing hospital. Calvary becomes THE burns specialists (or whatever).

Isn’t this kind of where K-Rudd was going with his hospital plan… having regional clusters of hospitals that make decisions together?

Diagnosing placenta praevia is done via a scan. Blind Freddy can diagnose it after the 20 week scan. So probably a doula could diagnose it, however a qualified midwive, such as those this thread is about, could definitley diagnose it, and would send the mother for a caesarian, exactly as currently happens at the Canberra birth Centre, where the midwives book all placenta praevia cases straight in for caesarians
(placenta praevia = placenta lower than baby).

NEither doulas, nor placenta praevia have anything to do with the way the govt has surrepticiously banned qualified midwives from supervising low risk births.

Why is it ok for a birthcentre pregnancy and birth to be entirely supervised by qualified midwives, but not a homebirth? I don’t see the difference.

Midwives are nurses, who have additional qualifications and experience with childbirth. They aren’t just happy hippies.

sepi said :

1. I would just not bother with the ob gatekeeper, as I don’t think it is necessary.

So your doula is going to diagnose placenta previa then?

1. I would just not bother with the ob gatekeeper, as I don’t think it is necessary.
OR i would have a govt OB who ticks off a sheet at a single visit.

2. Homebirths can be said to be better for baby as no drugs get into their system.

Karlsmum said :

georgesgenitals said :

As for whether homebirthing should be allowed – well, that’s a doctor’s decision. And they should make that decision in the best interests of the child.

Wow, so all doctors who don’t even know the mother has the best interests of the child MORE than it’s own mother??????

Please realise how outrageous and offensive your comment is and retract it!

What a ridiculous thing to say. “All doctors”?

This isn’t just about your body – it’s about the body of another human too. I’m not suggesting that homebirths should never happen, but that doctors know better than someone who is emotionally involved. Having the best interests of the child at heart is not the same as professional medical advice.

FWIW, I think midwives do a great job, but the ultimate decision should be made on medical grounds.

sepi, What is your proposed solution to the obstetrician-gatekeeper issue?

—–

sepi said: “Homebirthers believe that homebirth is healthier for the baby also.”

That’s an interesting belief. If you believe this, how do you know that it is true?

I am sick of hearing people say how unsafe home birth is, this isn’t about safety of the baby, its about fear. People fear birth. If it was about safety of the baby women would not elect for c-sections, they would not have drugs in birth.

This is about mothers choosing what is right for them and their baby, the way they will be best able to birth their baby. They should be able to say who gets a say in what happens to their bodies and who touches them.
Women wouldn’t choose home birth if they didn’t care about their babies, this is not the easy option in today’s society.

This issue is about many things, but how many of you would stand in the rain to support something you are so passionate about? Something you want your daughter to be able to choose when she has a baby.

This isn’t about safety of the baby, its about fear. People fear birth. If it was about safety of the baby women would not elect for c-sections, they would not have drugs in birth, all these things are really unsafe for baby.
This is about mothers choosing what is right for them and their baby, the way they will be best able to birth their baby. They should be able to say who gets a say in what happens to their bodies and who touches them.
Women wouldn’t choose home birth if they didn’t care about their babies, this is not the easy option in today’s society. You really care to have a home birth.

This issue is about many things, but how many of you would stand in the rain to support something you are so passionate about? Something you want your daughter to be able to choose when she has a baby.

noone says every birth can happen at home. we’re talking low risk births, which midwives can sipervise very safely, as they do, without drs in hospitals.

a midwife is qualified to know that placenta praevia pregnancies have to have caesarians – you don’t need an ob to decide that if you and i know it already.

Cheers Sepi.

Was just curious because my hubby is a qualified cabinetmaker and electrician. He is currently employed as an electrician but still sometimes has to use his cabinetmaking skills but is still classified as an electrician. Just thought this might be the same for midwifes if their employment contract stated they were actually employed as something other than a midwife.

tam said :

And secondly to all the naysayers, please give me one instance where it is safer to birth in a hospital???? Just one?

Ok. Here’s just one … Placenta previa.

sepi said :

tam – the new law specifically makes it illegal for a qualified midwife to attand a homebirth (without Obsatetrician sign-off). I don’t know if calling herself a Doula (birth assistant) will make this legal – I doubt it…

further, i’d imagine the midwife, practising outside her (or his!) profession as something else [be it doula or landscape gardener], would not be covered by the legal indemnity and insurance, which is kind of the point of this whole exercise as far as i can see.

btw, big ups for doulas!

tam – the new law specifically makes it illegal for a qualified midwife to attand a homebirth (without Obsatetrician sign-off). I don’t know if calling herself a Doula (birth assistant) will make this legal – I doubt it…

Sorry let me rephrase that….. give me one instance where it is safer for a completely healthy woman, with no distiguisable complications prior to birth, to give birth in hospital?

The only people who seem to be going ‘on instinct’ in this discussion seem to be the men who just have a gut feeling that a dr is necessary for a birth.

Yet most straghtforward births in public hospitals occur without a dr, but with a nurse who has qualified as a midwife in attendance.

Homebirth right now is legal, with a qualified midwife in attendance. This should be sufficient. Qualified midwives do not wish to understake high risk births at home any more than doctors do – or mothers.

When the new law comes in for next year, it will be illegal for a qualified midwive to attend a homebirth without some sort of clearance from an obstetrician (unlikely). It will still be legal for the woman to give birth at home by herself…. Not very progressive legislation. Or even logical.

Most homebirthers do a lot of research and engage a qualified midwife to look after them. they don’t just go on gut feelings, unlike most of those in opposition, who blindly assume a dr is required for a birth.

Why would you take babies and children out in the wind and rain and cold weather just so you can protest? Not cool.

Firstly I just wanted to ask why can midwives get homebirthing mothers to sign an employment contract hiring them as Doulas? Technically they are not working as unliceanced midwives but doulas that happen to have midwifery experience. Could this be a way around the stupid reforms? I have asked a few people and no one has an answer.

And secondly to all the naysayers, please give me one instance where it is safer to birth in a hospital???? Just one?

I had a public hospital birth and am planning another in 6mths time so I am not bias.

And remember most hospital births are only attended by midwifes and the midwife is the one who diagnoses a problem and then calls the doctor and also it takes 30min to organize an epidural which is required for a ceasarian. How is waiting the half an hour in the hospital different to waiting in an ambulance?

And thirdly hospitals are just as dangerous to newborns. My son contracted staph from the hospital and myself, my husband and bubs all got a cold/flu a week after bub’s birth which I suspect was also picked up from hospital. Imagine what else baby could pick up?

OMG it isn’t just about homebirths! It is about women being able to employ a private midwife in a private (or public) hospital. Why can’t I have far superior midwifery care that actually cares about what I want whilst doing the best for my baby AND have a private hospital stay afterwards? I just don’t want some arrogant obstetrician forcing his views and preferences on me (as was my experience with my 2nd child) in the complete absence of medical complications. All OB’s care about is their ridiculously high frees and protecting their own backs.

georgesgenitals said :

As for whether homebirthing should be allowed – well, that’s a doctor’s decision. And they should make that decision in the best interests of the child.

Wow, so all doctors who don’t even know the mother has the best interests of the child MORE than it’s own mother??????

Please realise how outrageous and offensive your comment is and retract it!

Why do we fully understand a women’s right to choose whether to keep a pregnancy or not but cannot fathom the rights of women to have the final decisions in their births?

(Nice to know you had good birthing experiences but many women do not, I had two births in hospital that were traumatic before I finally decided to home birth my 3rd baby after considerable research into my decision being the best one for my myself and my baby! When do a babies rights outweigh it’s mother’s rights and wellbeing?

“…surely an experienced doctor has a better shot at making a correct decision than someone going ‘on instinct’.”

Chances are that an experienced midwife has seen more ‘normal births’ than a Doctor has. If a woman is in the low risk categary, than wouldn’t it make sense for her to have a carer that is more likely to deliver her baby in a normal and natural way, providing the opportunity for optimal outcomes for both her and the baby? I think that the main problem is that decisions are being made from a place of fear. The amount of trauma a great majority of women and babies experience during hospital births, and the immediate postpartum period, is tremendous. Hospitals can unfortunately strip women of choice and dignity. It might not sit too well with some of the male participants of this discussion, but it is possible that a woman does know whats best for her unborn child. A mother that is tuned into her body and her baby is the best resource you can have at a birth, I definitely do not consider it a safe option to have that taken away by stepping into a hospital. Its not just a simple matter of going to the hospital because its better to be safe than sorry. Its a matter of making an educated and instinctual decision as to which place of birth is going to provide the best outcome. Many people are blinded by the tragic outcomes of ‘high risk’ pregnancies, who will obviously have the best outcome in a hospital. Please remember that its the health of both mum and bub, equally, thats important.

georgesgenitals said :

sepi said :

….and the woman is just a host-being who counts for nothing at all.
nice.

No-one said that. I think the needs of the child need to come before the wants of the woman, in this instance.

why can’t both be considered?

do you take the protesters to be advocating solely for the mother at the expense of the child’s well-being, rather advocating for the mother’s right too..? i see the child’s welfare implicit in their demands/concerns.

It is rarely an either or situation though is it? And in that case they consult next-of-kin, not you.

sepi said :

the problem with the obstetrician gatekeeper policy is that the ob has to certify that it will be a straightforward birth in only one $85.00 visit with a woman. they are unlikely to do this (why would they or their insurer support this, when they could be sued for millions). if they require the woman to become their patient, this costs around $5000.00, on top of the $3000.00 she would be paying the homebirth midwife.

thanks for the reseponse sepi – i can see the issue with obstetricial-gatekeepers, they are incentivised to deny the request.

What is your proposed solution to this issue?

—–

sepi said: “Homebirthers believe that homebirth is healthier for the baby also.”

That’s an interesting belief. If you believe this, how do you know that it is true?

sepi said :

….and the woman is just a host-being who counts for nothing at all.
nice.

No-one said that. I think the needs of the child need to come before the wants of the woman, in this instance.

….and the woman is just a host-being who counts for nothing at all.
nice.

We had our kids through QBN hospital, and couldn’t have been happier. Staff dedicated to us (as in, while birthing they no no other clients), access to OB when needed, and private room.

And all as public patients.

As for whether homebirthing should be allowed – well, that’s a doctor’s decision. And they should make that decision in the best interests of the child.

bravo, woody.

and yes, sepi, qbyn is da bomb – it is a sorry state (territory?) of affairs that a country regional facility in nsw is better by far on so many levels than supposed state of the art enterprises in the nation’s capital.

After an ear-bashing from some female friends, I’m less certain in my views than I was yesterday. I now accept that the government’s new arrangements may not necessarily create the right balance of incentives for doctors to accurately reflect real risks in their decision-making, could unnecessarily cloud a legitimate decision to say ‘no’ (that is, a woman could not be satisfied that a decision was made for genuine medical reasons rather than simple arse-covering), and that the private / public split reduces access in a manner that might be contrary to reasonable expectations about the operation of our national health services.

Homebirthers believe that homebirth is healthier for the baby also.

Natural birth is better for the baby’s lungs than caesarian, and also the lack of drugs in the mother is better for the baby.

Homebirth programs are actually run by hospitals in Perth and Victoria, but like our birth centre, only the lucky few get to sign up for these incredibly popular programs. It is odd, as homebirths are significantly cheaper for the hospitals – as are birth centres.

Homebirth is very common (and state sanctioned) in NZ, and 1/3 of births in Holland are state sanctioned homebirths with qualified midwives attending.

It is a bit naive to believe that Dr always equals better. An uncomplicated birth is done in hospitals with no dr in attendance, and uncomplicated births can be very well managed at home with qualified midwives, who make a decision to call an ambulance in the rare occurance of a problem.

It is usually women having their second baby who want a homebirth, so not always naive young things who want to risk their baby’s health for the sake of getting to give birth in candlelight at home (it is a bit insulting to women to imagine that we all think like that….)

and finally – it really irks me that birth services are so diverse, and yet we have so little choice in what we end up with. QBN is by all accounts fantastic with birthing baths, lovely midwives and private rooms (and free/public), Canberra hospital is free and has rooms for only 2 women, Calvary has antiquated rooms for 4 women, the birth centre is great, but most people don’t get past the waiting list, and private hospital with an obstetrician costs 5 thousand (if you have health cover). Meanwhile other states have sponsored homebirth. It seems like a lot of choice, but in reality, most of these options aren’t open to us, we just have to go to our closest hospital and put up with whatever they have on offer.

I wouldn’t be so sure that a doctor always knows best in regard to a natural process that has happened for thousands of years. It’s instinct, not irrational emotions. I watched my sister….

The doctor certainly doesn’t ‘always know best’, but if you judge it on overall probabilities, surely an experienced doctor has a better shot at making a correct decision than someone going ‘on instinct’.

I confess though that my main issue with the topic is that it seems to be more by a political argument (‘a woman’s right to choose’) rather than an argument about what is best for the baby. The baby can’t choose how it will be born. It is about to undergo an event (birth) where any mishap could kill or maim it for life. If that was you, wouldn’t you rather do it in a hospital rather than take your chances at home?

the problem with the obstetrician gatekeeper policy is that the ob has to certify that it will be a straightforward birth in only one 85.00 visit with a woman. they are unlikely to do this (why would they or their insurer support this, when they could be sued for millions). if they require the woman to become their patient, this costs around 5000.00, on top of the 3000.00 she would be paying the homebirth midwife.

it is not true that drs are always onsite in hospitals. for most private births at night the dr is called for the very last part of the birth, or if there are problems, so they have to drive in from home.

Jethro said :

Birthing centres seem to be a happy medium between a medical birth in a hospital and a (in my view) somewhat dangerous birth at home.

Perhaps more funding for these would be a good idea, particularly if homebirths are going to be very difficult to achieve under the government’s regulations?

I don’t know of any pregnant women (and with Ma Bodine about ready to pop I mix with more than a few) who actually want a home birth, but know of many (including Ma Bodine) who have wanted to get into the Birthing Centre attached to the Canberra Hospital but have been knocked back due to very limited places. Basically, you need to book in the day you find out you’re pregnant and you might be lucky to get in. These centres seem to have quite good outcomes and run largely on the same philosophy of childbirth that homebirth advocates would have, with the added insurance of having hospital facilities readily available if needed.

am guessing by now ma bodine and you have the place in a maternity ward all sorted but otherwise can heartily recommend queanbeyan – midwife-staffed, doctors called as needed but not poking their noses in every five minutes for no good reason. astromonkeyman and of course astress had a wonderful time; and then they have single rooms where you can stay with mum and bub for a few days, is the best bit!

Hells_Bells74 said :

Call me naive, but I can’t recall (doesn’t mean it didn’t happen, just not made aware of it) a bub ever dying from a homebirth in recent times? I know of the odd bub dying in hospital though.

BAN HOSPITALS!!!

sepi said :

the birthing centre definitely needs to expand. they turn away far more people than they let in.

One thing I don’t understand is that most hospital births are done with midwives only and no doctor, so why is homebirth so different?

Because in hospital, the doctor is 10m away.
At home, the doctor is 10km away.

—–

EMD, what specifically is your issue with the obstetrician-gatekeeper policy?

I gave birth to two children in birth centres.

The first in NSW was supervised only by midwives. I was young and idealistic and felt I should be able to do it without “intervention”. Apparently the midwives agreed. It was an extremely traumatic event for both the child and I, with second stage lasting over 2.5 hours (usually 30 minutes to 2 hours). I think we were both close to death by the time I finally pushed her out. I’m sure this trauma, difficulty and exhaustion compromised our ability to effectively bond during the first few days and contributed to subsequent post natal depression. The poor wee baby was blue at birth from oxygen starvation and her soft delicate skull was quite squashed from spending so long in the birth canal.

The second birth was at Canberra hospital – a different care plan involved both doctor and midwife care. The baby nearly died three times and each emergency was dealt with in a timely, professional manner. The doctor stayed the whole time, several times calling his surgery to cancel appointments. No one suggested that I be moved to the labor ward. The pediatrics team were there with a mobile trolley. Intervention (suction) saved me and the bub from a repeat performance of the first labor.

All I can says is, sometimes a young idealistic woman, with all the good intentions in the world, doesn’t actually know what is best for her and her child. In retrospect, I feel the midwives didn’t provide adequate or compassionate care during the first birth. I wish a doctor had been there. I dread to think how things may have gone had I attempted either birth at home. I support more funding for birth centres with shared, respectful doctor and midwife care.

Hells_Bells74 said :

Call me naive, but I can’t recall (doesn’t mean it didn’t happen, just not made aware of it) a bub ever dying from a homebirth in recent times? I know of the odd bub dying in hospital though.

Well here are a couple, BTW the first one was a vocal home birth advocate:

http://www.dailytelegraph.com.au/news/joyous-birth-advocates-child-birth-death-tragedy/story-e6freuy9-1225694610168

http://www.smh.com.au/news/national/homebirth-baby-dies/2008/09/13/1220857899000.html

Call me naive, but I can’t recall (doesn’t mean it didn’t happen, just not made aware of it) a bub ever dying from a homebirth in recent times? I know of the odd bub dying in hospital though.

Good on those women. Restricting birth choices (where there’s no clear safety reason to do so) is far too controlling.

Under the new rules, private midwives must practice within the collaboration guidelines to be registered. If they practice unregistered, they could face criminal charges. The AMA and MIGA are telling doctors not to collaborate. And why should they collaborate? They have nothing to gain by agreeing to the birth plan, no negative consequence for not agreeing to it, but their indemnity insurer says they could be in trouble if anything goes wrong with a home birth they agreed to sign off on.

So we now have a situation where a woman can terminate a pregnancy, but if she says she wants to make a bloody mess of her own lounge room carpet it’s all “won’t someone think of the poor little children?”.

If it is acceptable for a third party to decide if a woman has the right to decide who her maternity care provider is, what comes next? What decisions about your body – particularly when it affects your fertility and sexual function – are you willing to hand over to Julia Gillard and Tony Abbott to legislate on, or to a doctor who has never seen you before to decide if your informed choice is in your best interests?

25 people!

Shit, viva la revolution!!

It is my understanding that the govt has made it illegal for qualified midwives to attend homebirths.
Which is really just a way of making homebirth illegal, while pretending they haven’t done so.

Tetranitrate said :

Pork Hunt said :

Oh goody, I look forward to this one…
In any case, women have been giving birth since the year dot give or take nine months so they probably deserve to have a say on these matters. I’m sure the world would be a happier place if blokes (inc doctors) went fishing or golfing more often and left women alone to do the things they like doing…

Oh great, so I guess it’s all well and good if go back to the infant mortality rates and the rates of deaths during childbirth we had back in the year dot.

What has infant mortality rates got to do with my comment? I merely suggested that men leave women alone to do things women like doing?

My mum was born in a sauna in Finland in 1927 as were her 3 sisters and 3 brothers (not on the same day, obviously). Present would have been my grand ma and one or two older female relatives and a midwife.

No Doctor or “infant mortality rate”, just seven healthy kids.

the birthing centre definitely needs to expand. they turn away far more people than they let in.

One thing I don’t understand is that most hospital births are done with midwives only and no doctor, so why is homebirth so different?

When is the obstetrician supposed to certify that a homebirth can be attended by the midwife – and will there be a proper procedure for this (and a medicare number?). If not, then no obstetricians will approve any homebirths, and the govt have just abolished homebirth by stealth, which is a bit childish.

Unless we have entered a 1984-style totalitarian society, governments cannot stop you giving birth at home in the presence of anybody you choose. It is absolutely your right to choose to do so. Taxpayers, acting through governments, may even grant you the privilege of paying for your choice through Medicare. However, you have no right to this payment, which is what this group is asking for.

The unfortunate reality is that any medical scheme such as Medicare will of necessity ration services. If actuaries are telling those running Medicare or the state health systems that the risks (and consequent financial exposure) associated with home birthing exceed those of giving birth in a hospital, then the only sensible decision is for them not to pay for home birthing.

That’s ok if you want a home birth or birth centre, BUT wouldn’t you want pain relief and the safety for your baby? Anyway at the moment Canberra’s maternity hospital is under staffed.

In any case, women have been giving birth since the year dot give or take nine months so they probably deserve to have a say on these matters

Except, it seems, if you’re a female doctor, in which case MY body, MY birth, ME ME ME ME ME.

Birthing centres seem to be a happy medium between a medical birth in a hospital and a (in my view) somewhat dangerous birth at home.

Perhaps more funding for these would be a good idea, particularly if homebirths are going to be very difficult to achieve under the government’s regulations?

I don’t know of any pregnant women (and with Ma Bodine about ready to pop I mix with more than a few) who actually want a home birth, but know of many (including Ma Bodine) who have wanted to get into the Birthing Centre attached to the Canberra Hospital but have been knocked back due to very limited places. Basically, you need to book in the day you find out you’re pregnant and you might be lucky to get in. These centres seem to have quite good outcomes and run largely on the same philosophy of childbirth that homebirth advocates would have, with the added insurance of having hospital facilities readily available if needed.

Pork Hunt said :

Oh goody, I look forward to this one…
In any case, women have been giving birth since the year dot give or take nine months so they probably deserve to have a say on these matters. I’m sure the world would be a happier place if blokes (inc doctors) went fishing or golfing more often and left women alone to do the things they like doing…

Oh great, so I guess it’s all well and good if go back to the infant mortality rates and the rates of deaths during childbirth we had back in the year dot.

Oh goody, I look forward to this one…
In any case, women have been giving birth since the year dot give or take nine months so they probably deserve to have a say on these matters. I’m sure the world would be a happier place if blokes (inc doctors) went fishing or golfing more often and left women alone to do the things they like doing…

“What are these women complaining about? The Government’s new Medicare for midwives legislation means that women can only access a registered homebirth midwife if a private obstetrician agrees to the birth plan.”

This looks like a pretty good policy. EMD (or someone else), can you please explain what your issue is with this policy?

justin heywood said :

…”By giving private doctors the right to veto a private midwifery home birth plan, the Government has set a dangerous precedent for women’s rights in Australia. It is now legal for a doctor to decide what a woman can do with her own vagina, even if the woman disagrees”

Who is most likely to know what is in the child’s interest? The doctor with years of training and experience, or the woman who has both limited experience and an emotional component to her decision.

If a doctor agrees that a home birth is likely to be safe, fine. But if the doctor doesn’t agree, there is likely to be good reason. I think the best interest of the baby should take precedence over the personal preferences of the mother.

this and georgesgenitals’ comments ignore the element in here that a qualified midwife is implicatdd in these decisions, someone who will be able to ensure appropriate medical intervention is administered whould it be required; so it isn’t simply a matter of a woman demanding to stay at home and impinge upon the right of the child. in fact, the outcome regarding the well-being of the child is usually very prominent in the decision making process of these parents-to-be, but that something that is easy to ignore and dismiss…

If you are worried about women’s rights, can I suggest your first point of call should be events featuring Tony Abbott?

Last time I looked Gillard was in charge, not Abbott.

*sigh* If you are concerned about women’s reproductive rights, the prospect of an Abbott led Governemnt should be a massive concern.

…”By giving private doctors the right to veto a private midwifery home birth plan, the Government has set a dangerous precedent for women’s rights in Australia. It is now legal for a doctor to decide what a woman can do with her own vagina, even if the woman disagrees”

Who is most likely to know what is in the child’s interest? The doctor with years of training and experience, or the woman who has both limited experience and an emotional component to her decision.

If a doctor agrees that a home birth is likely to be safe, fine. But if the doctor doesn’t agree, there is likely to be good reason. I think the best interest of the baby should take precedence over the personal preferences of the mother.

I’d be more interested if the argument was about the rights and wellbeing of the child involved.

If you are worried about women’s rights, can I suggest your first point of call should be events featuring Tony Abbott?