An experienced midwife will run the PLaN (preconception, lifestyle and nutrition) clinics.

A trial clinic opened at the Royal Hospital for Women in Randwick … the scheme has now been expanded to … Sydney Hospital.

Women … can have consultations by phone …

“They may need to have some blood tests, then sort out … weight loss,” … “… can we make sure they’re taking vitamins, taking folic acid before they get pregnant?

… If their BMI was above 30 … they may be referred to a dietitian.

Women would also be advised to quit smoking and drinking … and take folic acid to reduce the chance of having a baby with spina bifida …

… one-quarter of new mothers surveyed … considered a baby born at 34 to 36 weeks of gestation to be full term, while slightly more than half of women considered 37 to 38 weeks full term.

Though technically speaking, preterm births are babies born prior to 37 weeks, 39 to 40 weeks is optimal …

Many women interviewed were also unaware that babies born even a little bit premature are at a higher risk of serious health problems compared to babies born at term …

… “The data is becoming more and more clear that the outcomes of births at those earlier gestational ages are not as good as babies that are born at 39 or 40 weeks.”

… any delivery short of 39 weeks puts a baby at higher risk of respiratory distress, sepsis… and needing to be placed in the neonatal intensive care unit …

… the percentage of babies born preterm rose by more than 20 percent from 1990 to 2006 …

… the World Health Organization … defines preterm births as babies born before 37 weeks. But that definition … is outdated … studies have shown that babies born … at 37 or 38 weeks have a greater chance of chronic respiratory disease and learning disorders than children born at 39 weeks or later.

Babies born between 34 and 37 weeks are six times more likely to die during their first week or life and three times more likely to die during their first year than babies born at 39 or 40 weeks …

In New Zealand, Canada, the UK and the Netherlands, giving birth at home is a reasonable choice, supported by both governments and insurers.

In Australia, however, the choice is threatened by proposals from Health Minister Nicola Roxon to leave midwives without insurance or funding to assist home births.

The curbing of that choice started last year when Ms Roxon initiated the Maternity Services Review and announced Medicare funding for midwives in the 2009 budget. In conjunction, she proposed the National Registration and Accreditation Scheme (NRAS) legislation, which would require health professionals to hold indemnity insurance so as to safeguard consumer safety.

… the great omission in her proposal was homebirth midwives, who were not offered funding or indemnity insurance … In effect, this would condemn homebirth midwives to operate illegally if they wanted to continue delivering babies.

… Gary Hastie, who has delivered all four of his children at home while supporting other home birthers, believes homebirthing “is the most natural process for the woman”.

However, he has observed an increasing fear of home births, distrust of a woman’s ability to have a natural birth and a demonisation of … woman’s choice. “It’s a woman’ right to choose where and how and with who she gives birth,” he said.

Nicola Roxon says she supports women having a choice, but is concerned with the consumer and ensuring a system of registration. It is “about lifting standards and ensuring that people are both registered, accredited and insured,” she said.

… Dr Ted Weaver, says it is not only the size of Australia that is a problem, but also cultural differences. “The infrastructure in other countries is completely different from the infrastructure in Australia–these countries have a tradition of home birth.”

Dr Weaver said the biggest danger lies when women get transferred to a hospital after complications arise …

Doubts are expressed too about how qualified Australian midwives are. Dr Weaver says: “Their [overseas] midwives are better trained and act along more stringent guidelines, and the selection for home birth is much more rigorous than in Australia.”

… While most high-risk women will be referred to a hospital by a midwife, … a very small portion of these women who consciously choose home birth … if they are considered “high risk”. “High risk” includes women who are having twins …

The doctor was convicted of practicing midwifery without a licence and conducting a delivery though she was not qualified to do so …

The … hospital where the doctor worked was fined … for appointing her and making her work as a midwife though it was known that she did not have a licence. The hospital … failed to provide first-class healthcare for newborn babies and this caused the girl’s complications to grow worse, resulting in the disabilities.

The hospital’s maternity unit is only suitable for low-risk births …

Any [women] with a BMI … over 34 will be turned away … “Our foremost concern is for the safety of mothers who deliver here … Mothers with a high BMI are at increased risk in labour …

The goal would require a huge rise from present norms under which only 14 per cent of mothers fully breastfeed their babies to six months. Nearly half of mothers have abandoned reliance on breastfeeding only after three months.

Federal and state health ministers yesterday endorsed the strategy which calls for more community acceptance of breastfeeding in public, more support and training for mothers before and after delivery and increased access to parental leave.

… “considering over a quarter of Australians think that breastfeeding in public is unacceptable, we know there is a long way to go,” …

She welcomed the recommendation for more support for mothers to begin breastfeeding by placing newborn babies in skin-to-skin contact with mother immediately after birth. Too often babies were taken away for jabs and checks after delivery, at odds with newborn babies’ ”extraordinary capacity to find the breast, attach and feed”.

Support for workplaces to adapt to the needs of breastfeeding mothers was also essential …

The Health Minister, Nicola Roxon, said … ”… all of the evidence shows breastfeeding children for a longer period of time than is common in Australia has enormous health benefits both for the child and for the mother.”

… the average out-of-pocket cost for delivering in a public hospital is $747, compared with $3087 in the private system.

A few women who delivered as public patients in public hospitals … did not pay a cent and many paid less than $300.

The average stay in a private hospital is 1.6 nights longer for vaginal births and 1.1 nights longer for caesareans.

… public hospital mothers are much more likely to complain that they were discharged from hospital too early – 28 per cent for public, compared with 12 per cent for private.

… concerns over understaffing are almost as common in private hospitals as in the public sector.

… private hospitals scored an average satisfaction rating of 91 per cent … compared with 87 per cent for public hospitals.

… private hospital patients were much less likely to have to share a room with another mum, and more likely to be able to have their partner stay.

While many women choose to go to a private hospital to have the baby delivered by an obstetrician rather than a midwife, one in 11 found their obstetrician did not end up delivering the baby …

… the changes restrict women’s choice in maternity care because private insurers and the government have ruled out providing midwives with insurance for non-hospital births.

In response to these moves, a campaign in support of maternity care choice has sprung up, including a 3000-strong convergence on federal parliament on September 7.

… A government review is expected to introduce Medicare rebates for some midwifery services. However, … amendments … will require midwives to make “collaborative arrangements” with medical practitioners to qualify for rebates …

… “In Holland, the option of … homebirth is the choice of around one third of expecting mothers”, she said. “A recent major study showed no differences in adverse outcomes between home and hospital births …”

… women who had undersized babies … were also more likely to have been in shorter relationships …

Bertha Kilgannan was born in Jersey on November 18, 1909 and moved to Tiverton in Devon as a child where she went to school.

Her grandmother and mother were district nurses and the young Bertha followed into the profession …

… She married, to become Bertha Hookway and had a son and daughter.

… Bertha said of her career as a midwife when she would go door-to-door on her bicycle: “I loved it. I loved my babies and the mothers.

“It was hard work, but it was an interesting job – you were interested in the mothers and their babies.”

… On turning 100 … ednesday she said: “I have had a good life. It’s been a long life …