Adam Cresswell, Health editor | March 02, 2009 Article from: The Australian
HUNDREDS of women each year who choose to give birth in their homes are likely to face greater medical danger for themselves and their babies with the introduction of regulations that could force the practice underground.
From the middle of next year, midwives will be required to hold professional indemnity insurance as a condition of practice, under the Rudd Government's plan to streamline registration requirements for all health professionals.
No commercial insurer has been prepared to offer an insurance policy to an independent midwife since the medical indemnity and wider insurance crises of 2001. When the new regime comes into effect, it will no longer be legal for these uninsured independent midwives to attend home births ...
... More than 50% of the submissions to the federal Government's recent maternity services review came from women calling for greater support for homebirthing services, which claim up to a 10-fold greater share of births in some overseas countries ...
Since 2001, an estimated 150 midwives have provided homebirth services to women, at a typical cost of between $3000 and $5000 ...
Sarah McLean, a volunteer with the Homebirth Access Sydney consumer group, is pregnant with her third baby and is planning to deliver at home. She said the prospect of losing the option of homebirth was "quite devastating".
"It's ridiculous to effectively make homebirth illegal, when other countries like Britain have publicly funded homebirth programs," Ms McLean said.
Caroline Homer, professor of midwifery at the University of Technology Sydney, said the "worst-case scenario is that women would be unattended" when giving birth.
"Another scenario is that the midwives will continue to practise under other names, but there won't be any standards of care, and no peer review or evaluation ... " Professor Homer said.
"Removing independent midwives and saying we won't do homebirths won't solve the problem; women will continue to have babies at home."
Obstetrician Andrew Bisits, director of obstetrics at Newcastle's John Hunter Hospital, said there was no reason that the federal Government should not support midwives' indemnity costs as it already did for obstetricians and other doctors. ....
Evidence for the safety of homebirths is disputed. US research published in the British Medical Journal in 2005 found low-risk women giving birth at home with midwife supervision had lower rates of medical interventions, such as the use of forceps, and no greater risk of their baby dying either during birth or soon afterwards.
It interests me that the Government is concerned about freebirthing, where women birth their babies at home, unassisted by a midwife. Some women birth with a doula for birth support. So while the government is concerned about this, it is also acting to prevent midwives from attending homebirths. Homebirth will not disappear simply because the government refuses to provide indemnity. Women will continue to demand homebirth services on their terms, and some midwives will continue to provide this service.