Reviewing July 2010

In a world that is constantly changing, one thing stays the same: babies are conceived and grown, in the bodies of their mothers, and the time comes for every one when she or he must be born.   The physiological, natural process is the standard way, just as breathing is usually done without drugs or machines.

In the past few weeks Australia has seen its first female Prime Minister, Julia Gillard, take over the reins of government, and a federal election has been scheduled in August.

The polls tell us that women are preferring Ms Gillard. Is she worthy of our trust?

Julia Gillard was the Opposition health spokesperson in the leadup to the last federal election. She was instrumental in assuring women that maternity reform was a high priority for the Labor Party.

The Australian people elected the Rudd Labor government, and Julia Gillard became the Deputy PM. The Health portfolio was passed to Nicola Roxon; the Maternity Services Review and various offshoot inquiries were held; and the government meekly followed the directions laid down by the medical lobby.

That's all on the record.

Birth IS important to women, and to their midwives.
Birth IS NOT an illness - to be managed, treated, and cured.

Decisions made by any woman going through any natural physiological process, such as pregnancy and birth ARE of profound significance to that person and her family. The mother not only (literally) takes the baby home; she takes her body and mind home. Many new mothers do not make the adjustments well; many suffer depression and post traumatic stress for years after what should have been a satisfying time of personal growth and development.


A group of mothers and midwives in Brisbane, under the Maternity Coalition banner, rallied yesterday as the PM and the Health Minister announced funding for mental health initiatives.

“We welcome Julia Gillard’s announcement about increased funding for mental health. Suicide is the leading non-direct cause of death for new mothers. We know that good quality maternity care, including from a known midwife, is likely to be protective against post-natal depression”, said Melissa Fox, West End mother of two and Vice President of consumer group Maternity Coalition’s Queensland Branch.

We know that rates of depression can be reduced when women receive primary care, with appropriate social support, from a known and trusted midwife. As it happens, primary maternity care from a midwife is THE very issue that the Australian health care system refuses to support.

Why?

Simply because the medical profession considers it in the public interest that all maternity care be carried out under medical supervision and strict medical protocols.

Ms Fox noted “The Government has committed $120m to Medicare for midwives. We call on the Government to remove the legislative barrier to enable the reforms to work. No action on the part of the Government would result in no improved access for women to midwifery models care ”.


In a similar press release, birth activist Justine Caines claims that:

"Women’s Rights Removed under Female PM - Sometimes it does Matter that the PM is a Woman.
The new Gillard Government has removed the basic rights of women in childbirth, with legislation that requires medical permission for all elements of [maternity] care.

"These moves mean that a doctor not a woman will decide. Most women seeking private midwifery care have gone out of their way to seek this option" Ms Caines added

"The Gillard government has just annihilated those choices, giving doctor the say over women's bodies and births."

“Minister Roxon’s total mismanagement of the Medicare for Midwives initiative will have far reaching consequences across the health sector. Childbirth accounts for the greatest number of hospital bed stays and yet we have a Health Minister putting doctors hip pockets over whole of maternity reform.”

Links:
Maternity Coalition Queensland blog
Maternity Coalition website
Homebirth Australia

post script:
The world of private midwifery practice for women planning homebirth is not very different today than it was prior to the last election. The substantive difference is that midwives now must:

• have indemnity insurance to cover all pre- and postnatal work, with homebirth being exempt
• obtain consent from women that they wish to proceed in the care of an uninsured midwife if they give birth at home.

The current status of access to homebirth midwives will have changed in some communities, particularly in rural areas.  A number of midwives who had previously attended a small number of homebirths each year have withdrawn from homebirth practice.   Many midwives are confused about the indemnity insurance rules and products.  The information and links at the MiPP blog is up to date.  A disproportionate number of midwives in private practice are currently under investigation by the regulatory authority, and one Victorian MiPP has had her licence to practice suspended.
Some MiPPs are preparing to be eligible for Medicare, hospital visiting access, and other extensions to practice (prescribing and ordering tests), which is scheduled to be in effect in November this year.  There are many unanswered questions in this arena - pregnant women whose babies are due in November and subsequently should not hold your breath for Medicare rebates for your midwife's fees, or for your chosen midwife to attend you privately in a public maternity hospital.