Home birth is where the heart is

Jade Trapp with her baby Django, who she delivered at home with the assistance of a midwife.
Jade Trapp with her baby Django, who she delivered at home with the assistance of a midwife.

A long-awaited report into publicly funded home birthing is now in the hands of the Local Health District. The report has been prepared by the Homebirth Advisory Group, which was established by the Northern NSW Local Health District (NNSW LHD) and its recommendations are now being considered by the NNSW LHD Executive, the Health Care Quality Committee and the board.

According to NNSW LHD board chair Hazel Bridgett, some local hospitals, including Lismore Base, already have Caseload Midwifery Models of Care in place to allow the birthing mother to have the same midwife throughout her pregnancy and at the birth in the hospital.

"However, moving from that option to a home birth is a big step and needs careful consideration by the board," Ms Bridgett said. "There are two concerns for the board: ensuring the skills and credentials of the service providers (the midwives) and the relationships and referral systems they have with local doctors are in place. The other issue, which is common in other publicly funded home birth services, is whereby the birthing mothers agree to the safety guidelines put in place that would mean in some circumstances home birth is not safe or acceptable."

Maternity Coalition Northern Rivers Branch president Sally Cusack would love to see a home birthing service offered by all hospitals in the local district.

"Home birth is not an option for everyone, but to have your baby at home is a choice that lots of people would make if it was easier to access," Ms Cusack said. "Even if in the first instance, it was run out of just one hospital so people can see it running successfully as a cost-effective option. In Australia, 12 public hospitals offer publicly funded home birth services out of maternity wards, if the women meet the low risk criteria. In NSW, hospitals such as St George Hospital and John Hunter have been really successful."

Lismore resident Jade Trapp was born at home and two years ago, she chose to give birth to her son Django at home with the assistance of a midwife. She welcomes the possibility of the introduction of a publicly funded home birth service.

"For me, I felt the best chance for a healthy outcome was to have a home birth," Ms Trapp said. "In hospital, 95% of births involve interventions. I felt really strongly about being able to birth naturally and I trusted my midwife. It was an amazing, wonderful experience, with no medical intervention, and no transfer to a secondary health facility. It's well known that a natural birth is best for mum and baby… for immune function and providing the hormone releases that allow mum and baby to bond. Our hormones change as soon as we are pulled out of a comfortable situation to one with strangers in a brightly-lit environment. Women need to have the choice to be able to birth at home."

Ms Trapp said that the model of care in New Zealand where a midwife was recognised as a primary health care provider is one Australia should consider adopting. In New Zealand, the number of women choosing to birth at home rose from 1% in the 1980s to nearly 6% in the 2000s once changes were made in how maternity services were run. These days up to 65% of women in New Zealand have babies with the assistance of a midwife.

"These are wonderful outcomes" Ms Trapp said. "It's an inspiring model for a smooth way of providing maternity care."

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