Home births under threat

Thousands rallied to support independent midwives – and women’s right to choose home births.

NSWNA members joined thousands of people at a rally last month to protest against the Government’s exclusion of independent midwives from maternity services reforms.

National reforms that come into effect next year will require all midwives to be registered, and in order to be registered they must have professional indemnity insurance. The majority of midwives will be given a PBS number, allowing them to lead maternity care and offer continuity of care throughout a woman’s pregnancy. A PBS number will entitle midwives to a range of support mechanisms, including access to affordable public indemnity insurance.

But independent midwives will not receive a PBS number, making it near im-possible for them to get this insurance. Without insurance, midwives will be un-able to practise so the exclusion has the potential to make attending a home birth illegal.

In response to pressure from the Australian College of Midwives and NSWNA, the Government has given a two-year exemption for independent midwives on the insurance requirement for registration.

According to NSWNA Assistant General Secretary Judith Kiejda, this response is inadequate. ‘It is unacceptable that midwives will be forced to practise without insurance. The Government needs to ensure they can achieve insurance.’

NSWNA member Lisa Wilmott, a midwife currently on maternity leave from St George Hospital in Kogarah, attended the rally with her son Dominic because she is passionate about home births. ‘I had a home birth with my son and I really value home births,’ said Lisa. ‘Being a midwife, I know the safety of home births for low-risk women and that it is safer for me to be at home – safer for me and my baby. If you look at the stats of other countries that have home births as the norm, you’ll see that’s true.’

Lisa’s home birth was a ‘very positive’ experience and she is keen for other women to be able to choose a home birth if they want it. ‘I had a really wonderful labour with two known midwives,’ she said. ‘It’s really important to have midwives you trust. I think it’s important that women have a choice in how they birth their babies and that choice includes independent midwives.’

The rally was attended by women from all walks of life. ‘The feeling was really positive,’ said Lisa. ‘I was surprised how may people there were as it was a miserable rainy day, but they still turned up, some with their kids, so they must be fairly passionate about the subject.’

Lisa said the mood of people attending the rally was one of hope that the Government will listen to what women have to say. ‘They need to realise that it’s not up to them but an individual’s choice.’

If a solution is not found, the danger is that home births will be forced underground. ‘Not having independent midwives will force a small percentage of the population to maybe birth at home on their own, without professional support,’ said Lisa. ‘It’s making home birth illegal and that’s not right.’

International studies show home birth is safe 

Studies of more than half a million women in The Netherlands and just over 13,000 women in Canada reveal that home births are as safe, if not safer, than hospital births, among low-risk women.

Between them, the studies found:

  • No significant differences between planned home and planned hospital births;
  • Home births do not increase the risks of perinatal deaths or disorders in newborns among low-risk women, provided that a trained midwife is integrated into the health care system with access to emergency services and good transportation to a hospital;
  • Women with a planned home birth are less likely to experience referral to secondary care and obstetric intervention than those with a planned hospital birth;
  • The home environment may be more conducive to birth without referral or interventions.