Monday, August 24, 2009

What is the big deal about changes to midwifery?

It's not about whether you agree with birthing at home - it's about whether it should be made very difficult (if not illegal) to be attended by a qualified professional in the place of your choosing. It's about whether midwives should be allowed to register and practice as midwives in a setting of their own choosing, and in line with the guidelines that already guide their practice.

It's about women's rights as well. If the push was to stop elective c-sections, or the use of epidurals, then there'd be outrage! But because it will only affect a small number, it's apparently ok to take away this right?

And the small number of births probably has a lot to do with the fact that it will cost upwards of $3k to birth at home, whereas a birth in a hospital costs nothing, because one is covered by Medicare and the other isn't. This, plus the small number of midwives in private practice, means that a lot of women just aren't able to access the option, regardless of their preference.


daharja said...

I birthed my daughter at home in Australia in 2007, and our total costs came to about $5K, up front, all paid for by US.

If we'd been in a hospital, it would have been free. So there is already a strong disincentive to give birth at home.

Still, if I were to have another baby, I wouldn't even think twice about it. Of course I'd give birth at home!

Anonymous said...

In my opinion home birthing WITH a qualified midwife or other birth-related professional should be allowed as a choice for those who wish to do so.

The one thing that should be banned, and from what I understand is the main thing that has brought this whole issue up in the media and politics, is "free-birth" where it is just a woman at home giving birth on her own with no assistance from anyone except maybe her unqualified partner or friend.

There've been a number of free-birth cases that were reported upon where the babies died because of complications and/or because there were not the qualified personell there to fix things.

Instead of banning home birth outright they should just ban home birth WITHOUT a midwife/qualified person!

daharja said...

Hi Zang2424 - You can't ban something like free birth.

Banning something doesn't make it not happen, as the US found out in the prohibition era. A pointless exercise in ridiculousness.

I think the whole point that this issue is often missing in the media is that, in the end, government has absolutely no control over where women birth. None.

It can legislate, but in the end, women will birth where and when they want to. And as women who birthed in fast food restaurants and petrol stations have found out, if a baby is coming, it is coming!

I mean, what are the Government going to do? Break down doors and arrest a woman who is free birthing in the middle of her labour? Reality is, it isn't going to happen.

The whole issue of the changes to midwifery laws is that this is about control. It's about money and power, and the obstetric lobby wanting complete control over birth. Oh, and more money. And more power.

Finally, as someone who has given birth twice, once in a hospital (birthing centre) and once at home, you don't need a "qualified person" present for a safe birth. They're there purely as backup and support, in case something does go awry, and to encourage. But they don't actually assist.

And for the women who were emotionally (and sometimes physically) raped in hospitals and would do anything to avoid that happening again, one must question what the words "safe birth" actually mean. Is a birth safe if it happens in a hospital and the woman is raped and ends up emotionally devastated by the experience? I would argue no. For them, free birth, with all its supposed risks (real or otherwise) is a much preferred option for second and subsequent births.

In reality, birth is a completely natural, instinctive process and you don't need any help at all. Your body knows exactly what to do, and does it. In the vast majority of home births, where interventions are not encouraged and part of the menu as a matter of habit, "qualified assistants" mostly take the role of helpful friends, doing what they can to make the mother more comfortable, and providing ease of mind during the labour. But they don't actually "do" much, if anything, at all.

What we're seeing at the moment in Australia is an argument over control of women and our rights, not over safety or the ability of women to birth. Plain and simple.

Ask any medico who has been present at a birth how much intervention they honestly need to do in a typical birth, and you'd find they have to do NOTHING, until it comes to cutting the cord. And anyone with a sharp pair of sterile scissors can do that!

But what would I know? I'm only a mother who has given birth twice, to two healthy babies, with no interventions or drugs. And I'm NOT QUALIFIED!!!! ;-)



Anonymous said...

Hi daharja,

The point I was more arguing than anything is that this proposed ban on midwifes working outside a hostpital (what is it, like a $30000 fine of something) which I think is ridiculous (to fine midwifes for assisting with homebirths). Ultimately I don't think they shold legislate against anything, but it seems like they're going to regardless, hence my point-

I understand that a woman's body pretty much does the whole birth thing itself, haven't physically done it myself but I've been there and seen my mother give birth to my younger sister in 2007 so I know how it goes.

I don't have a problem with women giving birth at home, in a hospital, or wherever... My point was more about if the government has to legislate something (which it seems insistant upon regarding this issue) then they should perhaps legislate against/ban/whatever free birth and make it compulsorary for a midwife/medical person to be in attendance at any birth. One it would allow midwives to practice wherever they want, and two it would make sure someone was there IF complications were to arise- as you said "backup and support" =).

As for the women who give birth before they can get to hospital/medico or midwife person well obviously they're the exception and I'm sure the government would have some loophole for these people.

Hope that clears things up! =)

Emma Someone said...

Perhaps check out some of the facts about homebirthing and freebirthing before stating that the latter should be outlawed - media beat up does not count here.

You are suggesting banning a free choice of a woman, effectively curtailing a woman's right to autonomy over her body, and also suggesting that the rights of the child, who until born does not legally exist, outweigh those of a woman. Consider this in the feminist context and also from a legal point of view.

And frankly if my choice was to freebirth or to be forced into a hospital, my babe would be born in my bathtub with a doula and some very qualified and experienced birth photographers.

As I said - if this push was to outlaw tests without scientific backing, or reduce ultrasounds to "just if indicated" rather than as a screening tool, or epidurals only to those women deemed "in need" of them, or elective c-sections, or social inductions, there would be outrage! But because this only affects a small % of women (both those birthing, and midwives), it appears to be ok...?

Anonymous said...

Emma, I don't think they should ban either of them! I don't think it is okay!

All I'm saying is if they really want to change the laws with regards to birthing (which all reports I've read seem to say that the government are insisting upon) then they should just make it so that a medical person/midwife/doula (anyone who knows how to fix complications in birth) needs to be present at all births where possible. They don't have to work in a hospital, they just have to be present- at a home, at a birth centre, in the middle of a park... Wherever the hell the woman giving birth wants to be!!

Ultimately it should be a woman's choice if she wants to have someone there or not, if she wants to be in hospital or not, if she wants to have medication or not- it should be the woman's choice-

BUT the government seems insistant on legislating something so of all the things that they could possibly legislate at with regards to birthing, surely the best case scenario (aside from no legislation) is just making it so that women must have that back up there at the birth (wherever it is) to help if the woman or the baby needs it??

If a legislation must be made-
The only legislation I am in support of with regards to this issue is "A midwife/medical professional must be present at all home/outside hospital births."

That's it. Plain and simple. With that legislation midwives don't get fined for working, women can choose where to have their babies, and both mother and child have trained medical back up near by if it is required.

I'm hoping that this whole issue blows over and that the government don't legislate on anything though! Women should be able to choose what they want to do with their bodies.