Women’s rights and independent midwives

Dear Minister,

I am writing to voice my objection to the proposed changes and their un/intended consequences instituting a medical model monopoly over the birthing options of Australian women.

Background

You may not be aware, but at the moment women can choose to give birth in a hospital, in a birth centre or at home. The latter being a less known option and thus used by very few women, as it is never given as one by medical practitioners. It is available never the less for those that actively search it out. In most states the woman has the option to hire, at her own expense, a fully qualified independent midwife to attend her birth and provide the support she may need.

From a woman’s perspective the current situation is not perfect as it essentially reserves the option of an independent midwife for a certain class of women who can afford the $4000-$5000 cost of this personalized service. And it is just that, high quality, one on one care – appointments at the expectant mother’s house throughout the pregnancy, monitoring progress and health not only with scales and machines, but through extended conversations and discussions, which reveal more than any quick check up can. The woman is then supported throughout her labour in the comfort of her own home by the same person she has built a trusting relationship with in the past several months. The support is continuous and there is no change of shift that can disturb this comfort and familiarity. After the birth, the midwife can assess both the mother’s and the newborn condition in her position of a qualified medical professional and ensure their health and well being is not in any danger and if needed can make the call with the woman for any needed transfer to a hospital. The care doesn’t stop here, as she continues with the home visits past the birth of the child to ensure the safe transition for both mother and child. This is a service that cannot be given by any other form of medical care. That is why when the Maternity Services Review asked for suggestions from us as to how things can be improved in the area, many responded and more than half of the submissions (53%) asking for more support and recognition of homebirth.

We were not heard.

Proposed Changes

Not only were we not heard, the resulting changes to the law will have the effect of making independent midwives and their services illegal.

Clauses from the draft legislation Health Practitioner Regulation Law 2009:

69 Eligibility for general registration
(1) An individual is eligible for general registration in a health profession if:
(a) the individual is qualified for registration in the health profession,
and
(b) the individual has successfully completed:
(i) any period of supervised practice in the health profession required by the National Board established for the health profession, or
(ii) any examination or assessment required by the Board to assess the individual’s ability to competently and safely practise the profession, and
(c) the individual is a suitable person to be registered in the profession, and
(d) there is, or will be, in force in relation to the individual appropriate professional indemnity insurance arrangements, including a policy held, or arrangements made, by the individual’s employer that will cover the individual
101 Conditions of registration
(1) If a National Board decides to register a person in the health profession for which the Board is established, the registration is subject to the following conditions:
(a) for a registered health practitioner other than a health practitioner who holds non-practicing registration:
(i) that the registered health practitioner must complete the continuing professional development program required by the National Board, and
(ii) that the registered health practitioner must not practice the health profession unless professional indemnity insurance arrangements are in force in relation to the practitioner’s practice of the profession,
(b) for a registered health practitioner who holds non-practicing registration, that the person must not practice the health Profession

The government steps in and ensures indemnity insurance for all other medical professionals, but it will not extend the same curtesy to independent midwives, which will leave them unable to fulfil the requirements for registration and thus become unable to practice, despite being fully qualified and trained to do the job.

After the initial shock, women from all over Australia followed up and made close to 2000 submissions to the senate enquiry.

We were not heard.

This issue is not about whether homebirth is safe. There are enough studies to show that whether slightly safer or slightly riskier, the choice to birth at home is not a reckless one. Certainly no more than getting in our cars every day.

The issue is freedom for women to choose how and with whom to give birth. Who can have access to our bodies in this quite vulnerable process. We already accept that no woman should be made to birth if she doesn’t want to and support the elective surgery of cesarean section as a viable option of delivery. The government funds it, even though it carries more risks to the mother and baby and despite being a lot more expensive than normal birth.

And yet, if these changes are passed, if a woman doesn’t want to give birth in a institutionalised medical environment, but still wants to be supported by a qualified professional in the face of an independent midwife, she will be denied her choice.

I am quite gutted by this prospect, even more so that this draconian, anti-women law is being pushed by a government I have voted for; a government that prides itself on defending the rights of the vulnerable, the rights of the minorities in our community. But then Minister Roxon light-heartedly dismisses our concerns as we are such a “tiny group” and its too hard to figure out how to fit us and our choice in with the proposed changes.

I am off to Canberra with women from across Australia and will be outside Parliament house fighting for our rights. I hope someone inside will actually finally hear us.

And since you, Minister, are my representative in there, I am letting you know and hope you will do that – represent me and give voice to my very real concerns and opposition to the proposed changes.

Regards,

S.B.
Hoping to never give birth in a hospital again

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Home Birth Australia