This is the letter I wrote to Minister Roxon today, with thanks to Hoyden About Town and Save Birth Choices for some of the text.
To: The Minister for Health
Hon. Nicola Roxon
Dear Minister,
I am a mother of one. My daughter’s birth was low-risk, drug-free, and intensely rewarding. I laboured without a doctor’s assistance save for the delivery, where a GP caught the baby. Like most women, I went to a hospital, and took up a state-funded room for three days although there was nothing I needed that couldn’t have been provided at home more cheaply and effectively.
For my next child, assuming the pregnancy is low risk again, I want to give birth at home, in a more spacious, well appointed and comfortable space, where I am free to move around at will and choose my own level of privacy.
My local hospital is tiny and ill-funded with no facility for high risk or preterm birth and no equipment over and above that which midwives possess. I have a good relationship with a local midwife who provides homebirth services, I’m educated on alternative labour techniques and in excellent health, and there is no point taking up a room in a hospital which is genuinely needed elsewhere.
Homebirth is my choice for my body, my baby and my birth.
As a maternity consumer, therefore, I greatly appreciate your recognition of the need for change, and applaud your initiative in taking action to review and reform maternity services in Australia.
I support the principle of effective collaboration between all maternity care providers, and the aspirational goal of the Government to provide “safe, high-quality and accessible care based on informed choice.”
And yet, the government is proposing legislation which makes it illegal for privately practising midwives to attend homebirths. This legislation goes against your own aspirational goal.
Of babies born at home in 2006, all were liveborn. In the same year, there were 2,091 stillbirths in Australia. 2,091 of those occurred in hospitals or birthing centres[1]. There is no evidence that homebirth is less safe than hospital births.
If you outlaw homebirth, there will be some women who cannot or will not access hospital services who instead choose to ‘free birth’; that is, deliver their baby with no medical professional in attendance.
Women who find their labour progressing faster than expected and who cannot get to a hospital in time will be afraid to call a midwife to their home for fear of offending against the ‘incitement’ clause in this legislation. Midwives will be afraid to come.
Women who intend to birth at home and who experience complications or fetal distress, whether attended by a midwife or not, will be afraid to transfer to hospital for fear of repercussion.
This is not providing safe care.
Private midwives study a three year specialised degree course in order to gain qualifications. In a private homebirth model, the midwife provides wellbeing care for the expectant mother throughout her pregnancy, as well as personalised antenatal care. Pregnancy testing is offered just as it is by obstetricians. Midwives carry and are trained in using an array of medical equipment which allow them to respond to emergencies as in a small maternity hospital. Private midwives provide follow-up care to post-partum mothers.
The personalised one-on-one care provided by private midwives is unmatchable by the hospital system, and it would cost taxpayers billions of dollars to attempt it.
If this legislation is passed, there are private midwives with decades of experience in home births whose skills will be lost. Meanwhile, women will be forced into an already overcrowded public system, whose hospitals do not have enough beds. Or they will find themselves paying for private care, which carries a significant gap even for those with private health insurance, in a system which currently boasts an almost 50% caesarean section rate.
Women who do require high intervention care will be competing for those resources with women who would prefer, but are prevented, from seeking a home birth. Like me.
This is not providing high-quality care.
There will be other, rural, women who are forced to drive several hours to the nearest hospital, in labour, because a local midwife can no longer assist. If they have no car, no partner or friend to do the driving, or no money for petrol, they will have no way of getting help with their delivery.
This is not providing accessible care.
Australia is a country which champions free choice, and most of its laws recognize that.
We do not legislate to stop pregnant women from playing sport, or smoking, or eating sushi, or skipping an antenatal appointment, or declining an ultrasound scan. We allow access to pregnancy termination and we do not coerce women into breastfeeding if they do not choose to give their body over for that purpose.
None of these decisions warrant child protection referrals, or court trials, or jail terms. Either we trust women to make good choices or we recognize their right to make bad ones, but we champion their freedom to choose. By criminalizing home birth the government is turning its back on that principle.
Please don’t criminalise home birth.
[1] The Australian Institute of Health and Welfare Perinatal Statistics Unit, Published December 2008.
