All maternity professionals are expected to act in a way that protects the wellbeing and safety of mother and baby. That's a reasonable expectation of any society. Midwives have guidelines and codes of practice and decision-making frameworks that are all structured around principles of safety and quality.
The tragic death of a woman, Caroline Lovell, after giving birth at home in a Melbourne suburb, has thrust homebirth midwifery into the media spotlight. I have written about the breaking news at the MIPP blog. One comment summed up the situation,
"A tragic event is made sadder by the tendency of traditional media to suggest a causal link between the setting for this birth and the poor mother's passing before the facts have come to light."I do not have information about the facts of this case, and I therefore cannot form an opinion. I have heard the TV reports, read the newspaper reports and online commentators, and had conversations with other midwives and members of the community who have heard rumors. A TV reporter who spoke to me before recording an interview told me that a leading legal person in Victoria had commented that she considered homebirth midwives to be "cultish". I reject this notion. There is nothing at all cultish in professional midwifery as described in international and Australian definitions and standards: the standards against which all midwives are judged.
I am hoping that whatever tests are done, the autopsy, coroner's inquiry and report, and the investigations by the Nursing and Midwifery Board of Australia will satisfy my need, as a member of this community, to be confident that in this case, there was no professional negligence or unprofessional conduct. I would have this expectation regardless of where the death occurred.
Many women have contacted their midwives with messages of love and support. Women have also told their midwives that they are being questioned by concerned family members about their plan for homebirth.
The decision to give birth at home is made by the mother, with professional advice from her midwife. If the labour is not progressing well, it's crucial that decisions about transferring care to hospital are made in a timely fashion. This is the midwife's responsibility - not the woman's choice. A labouring woman cannot be expected to monitor her own progress. A mother and baby have limited reserves. When the demands of the birthing process become more than the mother or baby can be reasonably expected to cope with under natural situations, the best option is to transfer care to a hospital which provides emergency obstetric care. There can be no guarantees of particular outcomes.
Dear reader, I have only touched on these deep and potentially unsettling issues. The intense media interest in this case passed quickly. However, midwives who are ready to learn from each situation will not forget.
The reports by Coroners are placed on the public record. For example, a baby death in hospital from perinatal asphyxia.
Thankyou for your comments
