No sense in denying women safe births

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me at Essential Birth Consulting or call 0400 418 448. Link

As a medical student, I am encouraged to think critically about health-care legislation. I can see no reason why registered midwives should not be enabled to attend home births, as a safe and desirable part of maternity services.

... the weight of medical evidence shows that for low-risk women, a planned home birth attended by a competent midwife is essentially as safe as giving birth in hospital, and involves fewer interventions such as medicating for pain. The (noticeably fewer) studies that report a higher risk for home births often neglect to discriminate between low- and high-risk situations, such as a preterm or unplanned birth, or where the mother is not attended by a registered carer.

The unavailability of a midwife will not prevent some women giving birth at home with no professional assistance. This year's Maternity Services Review reported its concern about the ''small number of Australian women [who] are choosing home births without the support of an appropriately trained health professional". Why, then, did it recommend making it harder for women to obtain such support?

There appear to be two reasons. First, few women in Australia, 700 to 800 a year, choose a home birth. But this is no reason to restrict the practice further. A woman giving birth at home with a midwife will incur lower costs than one using a public hospital and the services of nurses and doctors. In many regional and remote areas , a midwife may be the only option ...

The second reason the report gives is that allowing home births risks ''polarising'' the health professions and obstructing a collaborative approach to maternity services. I can only ask how restricting the services of one profession can promote a collaborative approach.

Given the proven safety of planned, low-risk home birth attended by a registered caregiver, and its economical and practical benefit, it is strange and disappointing to see Australian women's choices in giving birth restricted in this manner.

Melissa Maimann, Essential Birth Consulting 0400 418 448