Australia Hates Liberty… and Mothers and Babies
November 7, 2009 · By Jonathan McLeod
My very first post on ThePolitic.com was on the subject of some horrendous legislation in Australia that would effectively outlaw midwife assisted homebirth. For those who aren’t familiar with the practice, midwife assisted homebirth is exactly what it says. It takes hospitals out of the equation when it comes to planning birth. It’s not the norm in North America, but it is a safer method of approaching birth.
The issue in Australia occurred not through specific design, but a confluence of new regulations that, working together, would get rid of midwifery. It appears that the government has decided to address this quirk of intersecting laws; now, they are explicitly working to thwart midwife assisted birth:
On 5 November the Government announced that the “Medicare for midwives” Bills would be amended to require midwives to have “collaborative arrangements” with “medical practitioners” before being eligible for professional indemnity insurance or Medicare rebates.
There are three main ways in which this a horrendous idea. It will be more costly; it will be more dangerous; and it strikes against liberty.
Obstetrician assisted hospital births are incredibly expensive. Nicola Roxon, Australia’s Minister of Health and Ageing, brought forth a report on the cost of birth – the incredible increases in the cost of hospital births over the last few years. Part of the purpose of the new legislation is to rein in those costs. Unfortunately, the legislation will fail.
The legislation will foce midwives to form a “collaborative partnership” with OBs in order to get the necessary insurance to assist in birth. Unfortunately, the very term they are using is a lie. There is no partnership. The midwife becomes a subordinate to the doctor, as the doctor would be allowed to withdraw from the “partnership” at any point, thus terminating the midwife’s insurance. So, a midwife’s entire practice would be beholden to an obstetrician. Considering that obstetrician assisted birth was the problem in the first place, this promises little benefit.
By creating this dependent relationship, the government will be creating a system that will encourage midwives to alter their practices to adhere to the desires of obstetricians. Statistically, obstetrician assisted hospital births not only have a greater cost (a hospital room, naturally, will cost more than your living room), but have a greater danger. These births have a higher rate of interventions, a higher rate of harm done to mother and child, and a higher rate of mortality, again, for both mother and child.
Birth is an incredibly personal and potentially powerful experience. The physical and emotional needs of each mother and baby (and extended family) vary. However, legislators seem unwilling to realize this, and they seem to have no confidence that adults could make such decisions for themselves. The proposed legislation will lead to a system where mothers may have a variety of choices, but each choice will be a slightly different shade of beige.
It’s rather insulting of a government to think that people can’t be trusted to make deicisions, but it is even more insulting for the government to think the people won’t be smart enough to notice when their decisions are being stolen from them.
So, once again, here’s to the Australian government: Killing liberty, killing mothers, killing babies, killing their budget.
Bravo.
What do you expect when you elect a left wing lunatic government. The Aussies have only themselves to blame. After all Labour in Oz is no different from Labour in the UK.
PissEddoff,
I appreciate your sentiment but I am not sure you can directly blame Australians. Insurance companies, public servant unions and rich cronies have a lot more influence on what governments do than does the electorate.
Jon,
It really is a pity that mid-wives are not going to be permitted to get professional indemnity insurance. That is the most severe crime committed by this bill.
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In a world where a woman’s freedom to kill her pre-born child is hailed as a glorious human right, it is peculiar to watch her freedom to bring her child into this world curtailed. Opposition to mid-wifery — whether it manifests itself through increased costs, insidiously restrictive entry into the market such as this bill or just clinical fanaticism — belongs in the heap of truly demonically callous politics.
“Statistically, obstetrician assisted hospital births not only have a greater cost (a hospital room, naturally, will cost more than your living room), but have a greater danger. ”
Do you have a reference for the greater danger associated with hospital births? I’d be particularly interested to see if this is true when comparing like-for-like situations. For example, one could make the case that the emergency room is a particularly dangerous place to go after being hit by a car, as the outcome of those who do not bother to get medical assistance has a a far lower associated mortality rate than those who are rushed to hospital. This, however, might be classed as… misleading.
c, there are two recent and separate studies which have shown that homebirth has statistically superior outcomes to hospital birth.
One was conducted between 2003 and 2006 by McMaster University. The births studied were all low-risk births, but those who had planned homebirths had better outcomes (lower rate of complications) including a significantly lower rate of interventions, than those who birthed in hospital.
The other recent study was conducted in BC and studied births between Jan 1, 2000 and Dec 31, 2004. 12 972 births were studied, and comprised three groups: planned homebirth with a midwife, planned hospital birth with a midwife, and planned hospital birth with a physician. The results were still far more favourable for midwife-attended homebirths than for midwife-attended hospital births, demonstrating that environment is important in the outcome of the birth, and not just who is attending as a practitioner.
These two studies, the results of which were both only released within the past few months, demonstrate a clear advantage to planned homebirth. Certainly there are occasions which can make a hospital birth advisable, but such cases are surprisingly rare. Legislation such as that proposed by the Australian government gives us the impression that homebirth is necessarily dangerous and irresponsible, but that is simply not the case. Unbiased statistics land squarely in the favour of homebirth.
Moreover, the importance and sanctity of choice and personal sovereignty and the denial of such by administrative bodies is, quite simply, unjust.
pissedoff – actually you would think that having a woman, and that woman is a mother, as our minister for health would have had better outcomes for australian women. the denial of choice is unjust… and this is harly giving women choice when it will still essentially dictate women be treated obstetrically.
i think i might move to new zealand or holland where homebirths are considered normal for birth.
Charles — Your aside paragraph regarding birth and abortion is an excellent and astute observation. Kudos.
I’m currently reading two books — “Atlas Shrugged” by Ayn Rand and “Capitalism and Freedom, 40th Anniversary Edition” by Milton Friedman. In the latter, Friedman’s major first point is that economic freedom is necessary for political freedom and cultural freedom.
Sickness Care is one area where Commonwealth governments are particularly egregious in their limitation of freedom of association and economy, with Canada arguably being the worst. In this case, Australia is ultimately limiting freedom for women by moving to monopolize childbirth.
People often opine “follow the money.” Here it is all too true.