Homebirths to become illegal or go 'underground'

Rachel Day

Tuesday, March 3, 2009

The option to have a home birth could soon become a thing of the past following new federal government regulations, The Australian reports.

New regulations

In an attempt to streamline the registration requirements of Australian health professionals the Rudd Government has deemed that from mid-2010, all midwives will need to hold professional indemnity insurance. This insurance is unlikely to be made available to independent midwives, through which the majority of women access homebirth services, effectively making this safe birthing choice for low-risk women illegal.

Once the regime begins, independent midwives will not legally be able to attend a birth at a home, except for the very few midwives employed by publicly funded services permitted in the eyes of the law. There is only one such service in NSW.

Australian homebirths

The number of Australian women opting for homebirths is small with around 0.3 percent in 2006 (just over 700 births) choosing to have their baby in this way, according to The Australian.

But those opposed to the new regulations point out that it is taking the choice away from the women, pushing the practice underground and leaving a potential risk for women to give birth unattended. If these services were Commonwealth funded then perhaps the number of women choosing to birth in their own homes would increase in line with countries such as the UK where homebirths represent more than 10 times the proportion of homebirths in Australia, according to The Australian.

Insurance issues

Private midwifery is the only health profession that is not covered by indemnity insurance and women who choose homebirth are the only consumers of health who are not covered. In other First World countries such as New Zealand and the UK, homebirth is funded as a public health strategy. This does not appear to be a reality that will be seen in Australia anytime soon.

The choice for the federal government not to support private midwives' indemnity costs has been deemed unfair by homebirth supporters, obstetricians and other doctors, particularly as the government spends a significant amount of money supporting obstetricians and doctors.

Safety

The commonly held perception that home birthing is a less safe option than hospital births has been challenged by numerous studies over the years. One such report, published in the British Medical Journal in 2005, studied 5418 women who were planning a homebirth and concluded giving birth at home, with the care of a midwife, had lower rates of medical intervention such as episiotomy, the use of forceps and Caesarean, and no greater risk of an infant dying than birthing in a hospital.

To read the full report, visit the federal government's Department of Health and Ageing website.

For more consumer group information check out the Maternity Coalition website.

Your say: Is this move by the federal government jeopardising women's rights? Should women be able to birth in the place that they feel is safest for them? We want to hear your views.

User reviews

The Government or anyone else has no right to make the decision for me as to where i have my baby or who's there. I have had a 'forced' c section when i was very young because the drs didn't want to wait a few more weeks to see if my baby turned. The 2nd baby i was determined to have a natural birth (in hosp) they tried again to scare me into another c section. This time i plan to have my baby at home. Unfortunately i have to have no midwife there or be forced into another c section or a hospital setting which i find very upsetting and often being forced or pressured to succumb to the doctors wishes instead what's best for me or my baby. I would prefer to have a midwife there but where i live it's impossible so i feel there is no other nicer choice. If you want a hospital setting have one but don't condemn me for wanting the safety, comfort and convenience of my own home. GET YOUR ACT TOGETHER AND LET MIDWIVES DO THEIR JOBS!

I would just like to say that home birthing was done way before a lot of medical stuff that they do now was even invented. I think that if they take away the choice of home births that it will take women back to the dark ages before they could even vote. It should be up the the mother to decide if they want to have a home birth. What do they think that people in remote areas are going to do, if they can't get to a hospital on time, or if the mother goes through labour quickly and doesn't get to the hospital in time. I am one of the people that has been advised by a midwife that for this pregnancy to get trained up in home birthing for just in case as i go through labour quickly (as I did for both my other children) and might not make it to the hospital in time to be able to give birth there. If that was to happen I know that I am sure that I do not want to get slapped with a lawsuit as soon as I get to the hospital and I'm sure that a lot of other people wouldn't either.

i dont think the govt is taking away the so called "rights" from women... you dont "Have" to have a Caesarean... u cant be forced by the doctors... its still ur choice... besides its always safe to have the option "If" any serious life or death complications occur ! you dont "Have" to get episiotomy, you dont "Have" to get the freagin drugs.... as long as we give our instructions to the doctors....nothing can change that but uncontrollable circumstances. as simple as that why do people have to make things so complicated?

I am 24 and my husband and i had our first birth at the birth cente, which is a house in the city. It was a beautiful birth, with no medical intervention and i had my daughter in the bath - natural pain relief. My husband and i are expecting our second child and I am excited to give birth again, either at the birth centre or in my own home. It is a peaceful, trusting and calming environment and experience with midwives who we have developed a strong relationship over the course of pregnancy. It is completely safe - for those who doubts - do your research, statistics clearly show this. I hope and pray that the government will give insurance to these amazing and professional midwives who help and ensure that you have the best possible birth in the environment of your choice.

You state "We have that right to choose" then go on to criticise mothers who use that right for elective c section. You ask "what is so wrong with natural births" and go on to suggest that elective c-sections are some kind of pain avoidance, as though they are an easy way out, suggesting that somehow it diminishes the excitement of "the excitement of seeing the faces of our little ones". C Sections are major abdominal surgery, they are by no means an easy way out, it can take up to 6 weeks to fully recover. A woman who elects to have a C-section doesn't do so lightly, she makes an informed choice, a choice that is absolutely rightly hers to make without the judgement of anyone else. You don't hear mothers who elect for C-Section criticise mothers who elect for vaginal births, they don't use the reasons for their choice to somehow assume that to choose to do something a different way is wrong, ill conceived, ill informed or weak. I say hooray for you and your choice, leave me to mine.

as has been said, the studies (and history) show that homebirth is safe. so we need to question - who benefits with this latest attempt to squash women in their prime? our bodies know how to digest a sandwich, cycle through the menstrual cycle, sneeze, conceive, grow and BIRTH our babies. Women's confidence in their ability to birth naturally is systematically eroded - by the system - from when a woman first gets her pregnancy 'confirmed' - and the tests begin, one after the other, every month, every week... no wonder that by the time the pregnancy nears its end (if she's lucky enough to avoid an induction of labour) the woman is putty in the hands of those who will 'deilver' her of this child. i have been a midwife in the hospitals, and at homebirths. the vast majority of my homebirth families are very knowledgable and have a great sense of responsibility about their planned homebirths - whereas many (not all) in the hospitals abdicate their responsibility to others.

I am 26, a former nurse & final year chiropractic student, with a great passion in natural birthing. I have no children as yet, but what i feel at this stage is that childbirth is our one chance to make our own decision & choice regarding our health & our unborn child's hea'th. Childbirth, pregnancy and labour is not pathology or disease, it is the most incredible natural physiological miracle and transition. Why is the government butting in??? If a baby is born at home by accident or in the car on the way to the hospital what is the problem, because this happens alot. Also if i can make one thing clear... OBGYNs do not deliver babies, the mother's body does!!! Women should be able to make this very indiviual and personal choice themselves with no external interuption, laws or health acts. When women birth at home in their own element with no hospital stress and strangers around they are most comfortable, and relaxed, and in most cases don't come into any labour complications.

Nicola Roxon stated that she believes women should have the right to choose a safe environment to birth their babies. If so, then to follow ALL the recommendations in the Maternity Services Review Report would be going against her own beliefs and thus stripping women of their right to choose. Why is it that indemnity insurance of other health professionals (general practitioners and obstetricians) are subsidised by the Government (to the tune of $500million!) and their services recognised under the Medicare scheme and yet independent midwives who attend homebirths are not recognised nor subsidised? As it stands, women have a choice to birth at home, but they have to pay for it (as much as $4000 or more). An elective caesarian puts more stress on the already overburdened health system, costs much more than $4000, but is subsidised, and poses more risks for the mother and the baby....However...it is the WOMANS CHOICE and that is what this is about. PLEASE DON'T TAKE AWAY OUR RIGHTS!

It will just mean that women will birth without any qualified medical practitioner on hand. So in the rare instance that something occurs that does need medical attention, women and their doula's will be on their own figuring out what to do and calling an emergency medical team. Believe me, those 700 women a year who birth at home are committed to it because they can read the research that points to it being the safest option. They will take their chances and birth at home, midwife or not. Congratulations, Rudd government, for taking birthing at home from first world to third world in a stroke of a pen.

I'm really disappointed 2 read about the changes in homebirth insurance. At a time when the hospital system is over run and the fortune it costs 4 a hospital stay, surely it is more economical 2 have women deemed low risk to at the very least try to have a home birth!!! I have had 2 of my 3 pregnancies in the UK & on my first pregnancy was given the option 2 try a home birth. I was delighted with the option. Unfortunately in my circumstances my baby was breech & despite attempts 2 turn her, I became high risk requiring a caesarean. What I think is great about the option for a home birth, is that I had every confidence that my midwife knew her parameters & would call for an ambulance should I have needed to go to hospital. Childbirth is not a disease, we have managed to make it this far as a society without hospitals, why take a step backwards & frighten women into thinking childbirth will go wrong. It all comes down to hospital statistics - not about the individual & their own choice.

Also in this section