Australia Might Respect Women After All

After working hard to imperil the lives of women and babies, it seems that the government of Australia might do the reasonable thing and not force midwives and homebirths underground.  It’s kind of sad that we have to commend a nation for not outlawing (essentially) a basic human function and basic human freedom.  (For background see here and here.)

Family First Leader Senator Steve Fielding has welcomed the decision by the Health Minister to back down on its controversial plan to drive homebirths underground.

Under the Government’s original proposal, homebirths were to become illegal unless a midwife could find a doctor willing to work in collaboration with them.

But now the government says it won’t force midwives to work in formal collaborative arrangements with doctors as a condition of insurance.

Congratulations, Australia. You’re not governed by ghouls.

Australia Hates Liberty… and Mothers and Babies

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.

Follow the Yellow Brick Maternity Ward

In the land of Oz, there’s no place like home…

…unless you’re having a baby.

Potential legislation from Australia’s Labor Party (no irony intended, I’m sure), based on a report form the Federal Maternity Services Review, looks to implement the de facto criminalization of midwife-assisted homebirths (and, potentially, all homebirths).

From Home Birth Australia:

The Report proposes an end to women’s access to midwifery care for homebirth, except possibly within state-run services. If the Report’s recommendations are followed, homebirth midwifery could become illegal in 2010 with the introduction of National Registration of health caregivers.

The report reads:

[T]he Review Team has formed the view that the relationship between maternity health care professionals is not such as to support homebirth as a mainstream Commonwealth-funded option (at least in the short term). The Review also considers that moving prematurely to a mainstream private model of care incorporating homebirthing risks polarising the professions rather than allowing the expansion of collaborative approaches to improving choice and services for Australian women and their babies.

The Australian editorializes:

Although the number of women giving birth at home is tiny in Australia – just over 700 in 2006, or 0.26 per cent of all births – this represents a committed group. More than 50 per cent of submissions to the federal Government’s recent maternity services review came from women calling for greater support for homebirthing services, which claim up to a 10-fold greater share of births in some overseas countries such as Britain.

Since 2001, an estimated 150 midwives have provided homebirth services to women, at a typical cost of between $3000 and $5000, but without rebates from Medicare or private health funds, and without insurance cover that would give recourse to compensation should anything go wrong.

I can just imagine that some people around here (paging Charles Anthony) will object to the idea of the government paying for midwives.  And, sure, I can see your point and, in a perfect world, agree with it.  However, in a society that has already moved to a socialized system of medicare, legislation like this is just perverse.

Labor is setting up a system that encourages women to go to hospitals for child birth.  If women are being given “free” hospital births, but must pay for midwives at homebirths, the government is distorting incentives and working against choice, freedom and responsibility.  And the idea that politicians are the best arbiters of birthing decisions is abhorrent.

Further, studies in societies that do not adhere to such a medicalized technocracy demonstrate that giving birth in a hospital increases the rate of interventions, caesareans and complications.  The Australian government is pondering enacting legislation that risks people’s lives and health, increases costs for medicare, and violates personal liberty.  That’s quite a trifecta.

Thankfully, in Canada, we are moving away from the dangerous hyper-medicalization of birth.  It is sad that Australia’s mothers and babies see no such protections.

It’s difficult to click your heels together when your feet are in stirrups.

(H/T: inFORMing birth)