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Australian Homebirth is in Danger

Jane palmer midwife attending a homebirth

As a privately practicing midwife I feel life is on a merry-go-round. My levels of anxiety have increased as another deadline is approaching that threatens women's right to birth at home with a private midwife. I've been attending homebirths as a private midwife for the last 16 years and I am passionate about supporting women in their choice of birth place. Women have a right to birth at home in a safe environment with a qualified and experienced midwife. But yet again women's right to birth at home with a midwife is being threatened. Unless the Australian Government comes up with a solution, any women planning to give birth at home after the 31st December 2016 will not have access to a privately practicing midwife.

The ability to obtain professional indemnity (PI) insurance is the issue and to understand what is going on today we need to take a step back in time. When I first started practicing as a midwife I was able to obtain PI insurance for my practice and I attended women giving birth at home and at Royal Prince Alfred Hospital (RPAH) as a visiting midwife. I could attend women birthing in the birth centre at RPAH and those women who required a transferred into hospital from a homebirth. It was wonderful being able to provide this continuity of care and to have access to appropriate back up as needed. Then HIH insurance collapse occurred in 2001, insurance companies went into a tail spin and the end result was that private practice midwives lost their professional indemnity insurance we were deemed too risky.

Many homebirth midwives stopped practicing as they did not want the financial risk associated with practicing without insurance. Personally I chose to take on that risk and continue to practice as I strongly believe women have the right to be attended by a midwife at home. I continued to practice this way for many years, while it wasn't ideal for me personally it was something I was committed to. Then on 1st July 2010 the National Registration Scheme through the Australian Health Practitioner Regulation Agency (AHPRA) came into place requiring all health professionals, including midwives, to have PI insurance to cover all aspects of their practice. In the lead up to the National Registration Scheme a lot of campaigning by women, community groups and midwives occurred. The reasons for the passionate campaigning was that a registered midwife without PI insurance could not be in private practice nor could they attend any births. I wrote about this at the time - see 'The Campaign So Far'.

 Australian homebirth is in danger

 The end result of all the campaigning in 2010 was the the Australian Government funded a PI insurance scheme supporting private midwives that covered antenatal care, birth in hospital as a private patient and postnatal care. No PI insurance was offered for homebirth. To get around the registration requirements of PI insurance by AHPRA an exemption was put in place that allows midwives to attend homebirths without PI insurance. Since 2010 we have been promised that a solution to the issue of PI insurance and homebirth will be found. The exemption for PI insurance was initially for two years and this exemption has been extended a number of times. The next deadline for the PI insurance deadline is 31st December 2016. We were told that there would be no further extensions to the exemption.

What does this mean for women? Essentially it means no midwife attended homebirths after 31st December 2016 in Australia unless a solution can be found. If you were planning a homebirth you need to be pregnant now or this option may not be open to you. It is time to campaign again. Women have been asking me what they can do. Campaigning works best when we work together. If community groups such as the homebirth groups, midwifery groups and maternity coalition could work together and coordinate a campaign this would be the most effective way to go. Individual ideas include:

  • Visit your local member of government
  • Write or sign a petition
  • Write a letter to the editor
  • Phone a talk back radio station
  • Attend or organise a rally
  • Form your own local support group

These are just some ideas. But we need to take action now!

 Australian homebirth is in danger

Jane Palmer is a private practice midwife and international board certified lactation consultant. Through her company Pregnancy, Birth and Beyond Jane provides midwifery, childbirth education and lactation services. For over 22 years, Jane has supported women and their families from preconception to the year following birth. Registering as a midwife in 1997 Jane went on to be one of the first Medicare-eligible midwives in Australia, Jane currently provides midwifery care in collaboration with the group practice Midwives @ Sydney and Beyond, caring for women planning to give birth at home or in hospital. In March 2012 Jane opened the PBB Health Centre in North Parramatta when midwives, general practitioners and allied health professionals provide services to the local community.

Comments

9 comment(s) on this page. Add your own comment below.

Rachel
Apr 1, 2016 5:20pm [ 1 ]

Homebirth should be an option for women as it is as safe or safer than a hospital birth for healthy women. If attended Homebirth s are not an option for women, free birthing will increase and outcomes become affected. Why is home birth such an issue in this country when it is absolutely normal to birth at home in nz and the uk? Both extremely similar countries to ours? We need to keep moving maternity care forward in Australia not backwards by restricting viable, safe options!

Ashlea
Apr 1, 2016 7:56pm [ 2 ]

Women should have the choice and freedom to choose where and with whom they birth their babies. It's our bodies and our babies! Limiting their choice will only lead to risk taking behaviour and puts the lives of women and their babies at risk. A solution to the insurance issue for independent midwives needs to be sought asap to address this important issue.

Heather-lee
Apr 3, 2016 8:30pm [ 3 ]

Australia needs to wake up and take a lesson from more progressive countries in Europe & UK. Aand the government needs to quit being ruled by the self-protecting policy advice of the 'medical' profession and allow people to make their own choices. Legislation should promote human rights, not limit them.

Penny Hardy
Apr 4, 2016 12:18pm [ 4 ]

The statistics speak for themselves, that homebirth is a safe option for low risk women. Take a leaf out of Europe's book and reduce the congestion on hospitals and the financial burden of Medicare. This is a safe, economically sound alternative to birthing in hospital

Chani Ridley
Apr 4, 2016 8:42pm [ 5 ]

This makes me feel really angry! I plan to have a home birth when I'm pregnant. I personally can't imagine giving birth in a hospital! I wish Australia would get with the times as far as having a choice of where to birth and have that choice supported. Home birth for healthy pregnancies are proven to have a good outcome so why would we push all woman to go to hospital because suddenly home birth midwives will no longer have PI insurance. I agree, that many women might choose to have an unassisted birth.

Nicholas Vaughan
Apr 7, 2016 9:05am [ 6 ]

Women have a right to have their baby in a place where they feel safe and supported and for many people that is in the comfort of their home

Joy Emms
Apr 7, 2016 10:30am [ 7 ]

I've had 8 babies in x3 different countries!x5 were home births in NZ and Oz, they were by far the safest and happiest! My first hospital birth had mistakes made which I am know could have had serious side effects, it was extremely traumatic. My second last birth was a hospital birth but at a natural birthing centre, if I had not had a midwife fighting for me, it could have gone very wrong, yes Oz, not a third world country! By far the medically safest births were my home births. The midwives were super focussed, kind, respectful and highly professional. I have heard so many local hospital birth stories that were not so! :-( swappibg shifts at crucial times, women being ignored when they know something is wrong, women being forced to do something unecessary against their wish via verbal bullying, tension, stress....none of this good for Mum and Bubba! Women should have the option of chosing a safe midwife to birth at home, it is a most basic human right!

shantay
Apr 7, 2016 11:04am [ 8 ]

Lets keep this going. Birth choices should not be restricted.

jade kaser
Apr 10, 2016 12:52am [ 9 ]

This will make many women free birth without medical assistant. Risky???

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