Birthing choices under threat

Gathering outside Page MP Janelle Saffin’s office on Monday, homebirth advocates protested against newly proposed legislation which may mean an end to privately practicing midwives across Australia.

On November 5, the federal government announced that the ‘Medicare for Midwives’ Bills would be amended to require midwives to make collaborative arrangements with medical practitioners before being eligible for professional indemnity insurance or Medicare rebates.

Kath O’Driscoll, spokesperson for the Northern Rivers Maternity Action Group (NAG), said that the proposed amendment will severely limit an independent midwife’s practice.

“It will mean the death of home birthing if these amendments go through,” she said. “Midwives will be dependent on the approval of doctors for access to Medicare rebates... doctors will also have the right to veto a woman’s choice of care.”

Ms O’Driscoll said that the proposed amendment would result in more revenue for GPs.

“The Australian Medical Association (AMA) want to control birth,” she said. “They will have access to a range of women on the periphery of the system that they normally don’t have access to.”

Lynne Austin, midwife at the Lindendale Natural Birth Education & Research Centre, said that women had been lobbying for Medicare rebates for midwives for many years.

“Because Medicare is a federally-funded reimbursement, there’s been a push to get all midwives registered nationally and accredited with a national standard,” she said.

Ms Austin said that before they could be registered, midwives would need to have professional indemnity insurance.

“Doctors have professional indemnity insurance but up till now midwives have not been able to get it from anywhere – no insurance companies will offer it.”

Minister for Health and Ageing Nicola Roxon has announced a two-year leeway before the national registration scheme for midwives will be introduced. By July 2010, the government will develop a national model of care for midwives in order to convince insurance companies to offer professional indemnity cover to them.

“I’m happy that there are moves to get insurance for midwives so that women can have the option of having babies outside of hospital if they choose,” Ms Austin said. “Over the years, birth has become more medicalised. As a society we are educated that when we go to hospital, the doctors know what’s best and they do what they say. We need to re-educate the community that pregnancy and birth are a normal part of life, not a sickness,” she said.

NAG spokesperson Ms O’Driscoll said that independent midwives’ specialist skills allowed them to recognise many important signs in pregnacy and birth, which enabled them to support healthy women without needing medical interventions.

“Midwives have the experience that many doctors have lost because they are afraid of litigation from assisting in births such as breech births or birthing twins without medical intervention,” she said.

Binnie O’Dwyer, a home birthing advocate who attended the protest, said that she was angry that the proposed amendment would force midwives to work within the hospital system or be out of work.

“Midwives take the pressure off the public health system. I’ve spoken to women who had to wait for a birthing suite to be available. There’s a baby boom at the moment,” she said. “I’ve had two home-births which went beautifully. We became close to our midwives and had continuity of care, trust and confidence the whole time – I can still ring them now.”

Ms O’Dwyer is concerned that if she was forced to have her children in the hospital system or under the supervision of a privately practicing GP, she would not recieve an adequate level of care.

“My sister had a baby in hospital and as soon as she walked through the door, they took control of her – there was no magic there. The obstetrician came in only 10 minutes before the birth and when she left hospital, she wasn’t informed of where she could get support,” she said. “Maybe we’re slipping back into a witch-burning mentality.”

Staff from Janelle Saffin’s office said they received 12 submissions from protesters and that Ms Saffin would be happy to represent their concerns in Canberra as she has an interest in women’s choices in safe birthing options.

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