Jane Palmer

Have you experienced a third or forth degree tear?

2011-12-01T18:01:00.001+11:00

If so, I would love to hear your story. Your experience following a third or fourth degree perineal tear following the birth of your baby or babies, will help with research so we can assess how the health care system can best care for all women who experience this complication following childbirth.

For further information please contact Holly Priddis (Midwife, PhD Candidate and Researcher) via email h.priddis@uws.edu.au or phone/text 0438 731 816.

Birth Stories Competition

2011-12-01T10:01:00.004+11:00

We are excited to announce Pregnancy Birth and Beyond's 'Birth Stories Competition'. Everyone loves reading birth stories, stories about fast labours, slow labours, wonderful stories, sad stories, births at home, hospital or birth centre. We'd like you to send us your story. If you have photos of your labour, birth, baby or the new family that help illustrate your story we'd love to receive those as well. The best three birth stories will receive the prize. Selected birth stories will be published on this website.

We have three copies of this gorgeous keepsake for Australian children, the Limited Edition, Heritage Presentation of Animal Tales Series by Susan Hall and illustrations by Ben Guy to give away. The boxed set contains 4 individual hard cover books, 52 pages each. The National Library of Australia Publishing (NLA Publishing) is offering this highly successful Animal Tales series as a limited edition heritage presentation. A gorgeous keepsake for Australian babies and children!

To enter visit the "Birth Stories Competition" page of www.pregnancy.com.au

Supporting women in Public Hospitals after a homebirth transfer

2011-09-03T08:00:00.001+10:00

This last fortnight has been quite stressful. It started with a report that a midwife had been reported for supporting a women in hospital who she gave a hot pack. The charge was she'd been practising midwifery without insurance. Then came a communication from MIGA (the insurance company) essentially saying that if a midwife stayed with a women after she transferred to hospital they would be in breach of their registration. This was shortly followed by a communication from the Australian College of Midwives basically saying the same thing. Yesterday sanity prevailed - Australian Health Practitioner Regulation Agency released a document clarifying this issue. You can find the official documentation on this page of AHPRAs website. Yes we can stay with a women who is admitted as a public patient as a support person. However the question of what constitutes midwifery care remains.

First baby to be born at Orange Aboriginal Birth Centre

2011-08-31T04:35:00.002+10:00

I had the pleasure of visiting Murundhu dharaa birthing centre at Orange last month. It is a wonderful facility. Here is a news report of their first birth at the centre.

Networked blogs

2011-07-29T07:43:00.001+10:00

Follow this blog

Check out Pregnancy Birth and Beyond on Facebook

2011-05-21T10:24:00.006+10:00

Pregnancy Birth and Beyond has just put up a Facebook page - I'd love for you to visit it and let me know what you think.

Proud owner of a registered trademark

2011-05-21T09:13:00.000+10:00

Yesterday was quite exciting - I received a certificate that Pregnancy Birth and Beyond's wonderful logo is now a registered trademark It took us 8 months to reach this point. It is a major step forward for my midwifery business.

International Midwives Day

2011-05-05T13:47:00.000+10:00

Today is International Midwives Day and I had nothing special planned. The day has been punctuated with messages wishing me happy International Midwives Day. It has been wonderful and makes enjoy even more being a midwife. Our local homebirth group "Homebirth Access Sydney" has just sent me a bunch of flowers - I feel overwhelmed and very lucky to receive such support and well wishes from the homebirth community.

I'd like to wish all the midwives across the world a very big "Happy International Midwives Day".

Love Jane xxx

Free tickets to Babies: The Movie

2011-05-01T08:37:00.005+10:00

Last chance to be in the draw to win double pass tickets to Babies: The Movie. Details below. Entries have to be in by 9am on tomorrow 2nd of May. Visit bit.ly/jMd94s for details.

Water Birth Photo Gallery

2011-03-31T08:53:00.000+11:00

New to Pregnancy, Birth and Beyond's website is the Waterbirth Photo Gallery. Waterbirth facilitates gentle, safe and empowering birth. This waterbirth photo gallery celebrates the wonderful option of waterbirth. Photos can say far more than words. If you have any waterbirth photos you are willing to share please email m e.

Water Birth Photo Gallery (Pregnancy, Birth and Beyond)

Midwifery in action.wmv

2011-02-01T08:17:00.004+11:00

Midwifery in Action is a short video that provides a glimpse into what midwives do and the special relationship that can develop between midwives, women and their family. Anna, Marc and Baby Ben share their journey through pregnancy, birth and the postnatal period with midwifery care. You'll see the continuum of care through prenatal visits, a home waterbirth and postnatal care.

Australian Resuscitation Council Release Revised Guidelines

2011-01-13T15:53:00.001+11:00

The Australian Resuscitation Council (ARC) has now published its revised resuscitation guidelines for Basic, Advanced, Paediatric and Neonatal Life Support. These changes reflect the most recent scientific evidence which was evaluated and recently published by the International Liaison Committee on Resuscitation (ILCOR) and its member organisations, including the Australian Resuscitation Council.

The guidelines continue to emphasise the importance of commencing resuscitation and providing good quality CPR. Resuscitation should be commenced where the person is unresponsive and not breathing normally as feeling for a pulse is unreliable in determining if a person needs resuscitation. It is now recommended that at the commencement of resuscitation 30 chest compressions are provided before giving the initial rescue breaths. The compression / ventilation remains at 30 compressions to 2 ventilations. The ARC also recommends that if a person is unwilling or unable to provided full CPR (ie chest compressions plus rescue breathing) then they should provide continuous chest compressions at a rate of just over 1 compression per second.

The revised guidelines for Basic, Advanced, Paediatric and Neonatal Life Support are available at www.resus.org.au and for the first time have been jointly developed and published with the New Zealand Resuscitation Council (NZRC).

Belated Christmas Gift

2011-01-09T07:11:00.000+11:00

I received this bottle of wine as a belated Christmas gift. No it isn't a hoax - it is a genuine bottle of wine. Someone told the wine maker about the effects of Oxytocin on the body and they thought what a perfect name for a wine. The label reads "You know that feeling when you're on top of the world, you've got a smile on your face and a warm inner glow? It's probably Oxytocin - a wonderful hormone our brain naturally releases putting us into a state of bliss.

Sometimes Oxytocin is called the 'love drug', because it's integral in the boding between mother and child, lovers and friends ..."

Jacob's home water-birth.

2010-09-16T21:24:00.001+10:00

In this YouTube birth video - the Aquaborn Birth Pool is used. I've just come from a birth where the woman used this same birth pool and I love it. It has more room than the La Bassine Birth Pool which enables the partner to easily get in the pool. You can find the Aquaborn Birth Pools in Pregnancy, Birth and Beyond's online store.

Vote for your favourite birth pool

2010-08-20T19:37:00.001+10:00

Gillard sells out Australian birth

2010-08-17T19:33:00.001+10:00

Celebrating World Breastfeeding Week

2010-08-02T10:26:00.000+10:00

It is world breastfeeding week and I just wanted to share these great billboard posters


Central Railway Station, Sydney

Town Hall Railway Station, Sydney

Martin Place Railway Station, Sydney

A YouTube video by BirthsMart

2010-07-18T08:43:00.001+10:00

This is a brilliant YouTube video by BirthsMart. It is very sad that birth has come to this for many women. The conveyor belt form of pregnancy and birth care. Let me know what you think?

A Bullying Culture

2010-06-22T14:16:00.001+10:00

As a woman approaches her birth she should be able to look forward to the wonderful experience of becoming a mother. Being pregnant and giving birth should be a happy and exciting time. However there is the ever pervading culture of bullying that is seeping into midwifery and the hospital system. I have observed this bullying culture over the last 19 years getting worse and worse. As a midwife in private practice I constantly faced with being bullied and I have developed mechanisms that help me battle this negative behaviour that has become inherent in the hospital system . As a midwife I find this behaviour totally unacceptable. But what I find worse is the women employing my midwifery services are also faced with overt bullying and often hostility when choosing care that does not fit with hospital policy. Women need to be nurtured and supported in their choices. They should not be bullied.

What prompted me to blog on bullying was an article I read in the recent journal of the Australian College of Midwives "Women and Birth" Vol 23 Issue 2 June 2010 - on page 53 is an article called "You can drop dead": Midwives bullying women. This is an article that reports on an unexpected finding from a large research study of women who moved away from their rural or remote homes to a large city to give birth. This article explores incidents in which a small number of midwives are reported as behaving in an "uncaring, cold, callous, abusive and aggressive" manner to these women. Repeated threats to involve the department of community services (DOCS) was a common thread used by these midwives. This behaviour by midwives is unacceptable. These women are amongst the most vulnerable in our community - all their support networks are often hundreds of miles away. I feel sad and heavy hearted after reading this article. But also I feel more determined to campaign for the rights of women. I personally will do everything I can to combat bullying behaviour and I ask you to challenge anyone who attempts to bully pregnant women or new mothers.

Photo Montage of the Homebirth Australia Conference 2010

2010-05-18T14:17:00.001+10:00

Just arrived home from the Homebirth Australia Conference - thought I'd share my experiences

Photo and video editing at www.OneTrueMedia.com

Inflatable Birth Pools Compared

2010-05-12T12:11:00.001+10:00

I often get asked about the various features of different birth pools. So I decided to develop a chart comparing all the available inflatable birth pools currently available in Australia. You can read more on this page http://www.pregnancy.com.au/birth-choices/waterbirth/inflatable-birth-pools-compared.shtml or click on the image to open the pdf document.http://www.pregnancy.com.au/bm.doc/inflatable-birth-pools-compared.pdf

New Australian Homebirth Documentary in production

2010-04-18T07:04:00.000+10:00

Check out this teaser of a new Australian documentary currently in production.

Medicare Rebates for midwives

2010-04-07T05:55:00.001+10:00

On Tuesday 16th March the Australian Senate passed bills that enable eligible midwives to provide Medicare funded antenatal, birth and postnatal care and to be able to prescribe certain medicines under the Pharmaceutical Benefits Scheme (PBS). Medicare rebates are only available for birth in hospital. Rebates for prenatal and postnatal care will be available to all woman, including women birthing at home. The new Medicare Benefits Scheme for midwifery and PBS will commence the 1st November 2010. Details of what is an eligible midwife and how the new system is to work is yet to be announced. You can read more Maternity Service Reforms fact sheet released by the commonwealth government and a summary called the National Maternity Reform by the Australian College of Midwives.

National Day of Action

2010-02-19T15:54:00.002+11:00

On the the 18th of February 2010, in 14 locations across Australia, 1000s of people gathered to register their protest at the Rudd Government's policies that threaten to restrict options for women giving birth. The choice of women to have a private midwife will at best be highly restricted and at worse impossible if the current changes go ahead.

GOVERNMENT BACKFLIP ON MIDWIVES

2009-12-15T06:13:00.001+11:00

This article appeared in Australia.to yesterday afternoon. I feel like we've had a big win - so much for Mr 3am

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.

"The Rudd Government's backflip proves they clearly underestimated how important this issue was to Australian women,” Senator Fielding said.

“Women should have the right to choose whether they want to have a birth in a hospital or at home, and midwives that assist in either case should be able to access affordable indemnity cover.

“The Rudd Government created this mess because it wouldn’t listen to the community and its concerns.

“All too often this Government is intent on ramming legislation though to suit their agenda without seriously considering the consequences.

“The Rudd Government acknowledges it made an error in essentially making homebirths illegal when it announced at the 11th hour that it would give homebirth midwives a two-year reprieve from its changes.

Now the government needs to guarantee that women will be able to continue giving birth at home with the assistance of a registered midwife once the two-year reprieve has expired.

“Numerous studies have shown that for low-risk women with appropriate transfer-to-hospital options available, homebirths are at least as safe as births in hospitals or birth centres.”

Midwives damn AMA-induced amendments to maternity reform

2009-12-15T06:06:00.001+11:00

A fabulous article by Professor Lesley Barclay and Professor Sally Tracy

Senior midwifery research academics, including 19 professors and associate professors of midwifery, have signed an open letter raising serious concerns about the newly proposed amendments to Health Legislation (Midwives and Nurse Practitioners) Bill and the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill.

These amendments are ill-informed, conflict with current regulation of the practice of midwives, and were promoted by a medical union (the AMA), rather than the craft groups most concerned and knowledgeable about women’s needs and safety at birth.

We and our colleagues are surprised and disturbed that pressure from a union rather than our medical colleagues has persuaded the government to make changes that are not informed by evidence, but appear to be based on protection of income and power.

We support reform of Australian maternity services — an area of long neglected policy by previous governments and health ministers.

To read the full article to go Crikey

2009-12-08T16:01:00.015+11:00

I would love for your feedback on the logos. I am currently working on establishing a free standing birth centre in Sydney. We have decided on the name of the Janeanna Birth Centre. You can find out more about the birth centre on our Facebook fan page We have four draft logos pictured below.

Immediately below is Logo 1 - the heart pod image is Logo 4

Pregnancy and Parenting Network

2009-11-27T08:32:00.003+11:00

Our Pregnancy and Parenting Support Network had it's final get together for 2009. It has been a fantastic year with our network growing. Any where up to 30 people come along (plus lots of babies and toddlers) to share experiences, information and support. I personally am looking forward to our next get together in 2010.

My Birth My Choice Rally Sydney

2009-11-09T21:48:00.006+11:00

Enjoy my photos from the My Birth My Choice Rally in Sydney 9th November 2009

Curbed midwives push to break free

2009-11-09T06:13:00.001+11:00

Curbed midwives push to break free

Sydney Morning Herald

JULIE ROBOTHAM HEALTH EDITOR

November 9, 2009

MIDWIVES' ability to work independently - promised by the federal Health Minister, Nicola Roxon - would depend on endorsement by individual doctors under an amendment to proposed legislation that has infuriated women's groups.

Birth advocacy groups will rally today at sites across the country, including the Brisbane headquarters of the Prime Minister, Kevin Rudd, and in Sydney outside the Surry Hills office of the Minister for the Status of Women, Tanya Plibersek, to protest at the amendment, made public last week, which reveals that to work in private practice midwives will first have to ''enter a collaborative arrangement … with one or more medical practitioners''.

Critics say the Government has capitulated to doctors and the move undermines the intent of a series of bills before the Senate, which for the first time would allow midwives' clients to claim a Medicare rebate for their services.

It also threatens rural women's access to birth services, they say, and puts midwives at the mercy of sometimes hostile doctors for their professional registration, Medicare funding and indemnity insurance.

Hannah Dahlen, vice-president of the Australian College of Midwives, said the decision tied midwives' ability to practise ''to the sign-off as a doctor'' - contradicting the World Health Organisation's definition, which describes a midwife as an ''accountable professional [who can] conduct births on the midwife's own responsibility''.

Midwives accepted the need to collaborate, she said, but should be required to have working relationships with health services rather than individual doctors.

''There are particular issues in rural and remote Australia where sometimes there is no doctor, or no permanent doctor, just three-month locums,'' Associate Professor Dahlen said. ''This is not about safety, not about evidence. It's purely about politics. Collaboration's about mutual trust and respect. It's not about one profession choosing when another will or won't work.''

Professor Dahlen said the amendment could prevent new models of pregnancy and birth care envisioned in the law reform - such as midwives working in a group practice - from getting off the ground.

When she announced midwives would be given Medicare rights, Ms Roxon said the $67 million measure would ''improve the flexibility of the health workforce'' and allow patients better access to services.

The amendment is also likely to threaten women's ability to choose to give birth at home, if midwives cannot find a doctor to support them in such births.

Doctors groups - including the Australian Medical Association, which is understood to have campaigned hard for the amendment, and obstetricians' representatives - have been vocal in their opposition to home birth, saying it is unsafe.

Under current rules, midwives can manage home births but are not insured to do so and must disclose this to women. The new law would end this.

Alison Leemen, assistant co-ordinator of Homebirth Access Sydney, said the Government had ducked a potentially furious debate about doctors' veto over midwives.

''It doesn't enable the Senate to have proper scrutiny,'' Ms Leemen said.

''Regulations do not undergo nearly the same level of scrutiny as primary legislation. It's like signing a blank cheque.''

My Birth, My Choice Rally

2009-11-06T15:29:00.005+11:00

Sydney Rally on MONDAY
MY BIRTH, MY CHOICE RALLY
MONDAY 9TH NOV 2009
from 10.30 am (THIS MONDAY!)

Outside the office of Tanya Plibersek,
Federal Minister for Women
111-117 Devonshire Street, Surry Hills NSW 2010

Rallies are also being held in Brisbane and Melbourne

Hi all,

Please find at the bottom of this Newsletter a media statement for Nicola Roxon regarding a Midwives/Nurse Practitioner Amendment. The point that will redefine the fundamental nature of midwifery and certainly homebirth midwifery in Australia is that “collaborative arrangements with medical practitioners will be required to access the new arrangements”. In short this amendment will require midwives to work with GP obstetricians and private obstetricians and have a “collaborative arrangement” in place at all times.

This is NOT acceptable. How will it be possible for a midwife who attends homebirths and for women wishing to birth at home to gain the support of a GP ob or private obstetrician when their own college statement does not support homebirth?

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) statement reads -
“The College does not support Home Birth or ‘Free-standing’ Birth Centres (without adjacent obstetric and neonatal facilities) as appropriate Health Care Settings. The College acknowledges that a very small minority of women will choose to birth in these centres, even if appropriately informed of the consequences”

In solidarity with our northern and southern sisters (who will be rallying outside Kevin Rudd’s Brisbane office and Julia Gaillard’s Melbourne office) please come and rally outside the Minister for the status of women, Tanya Plibersek’s office in Sydney.

We need this to be as big as possible. We invite other groups to join the rally to make this the beginning of a very clear election campaign.

Politicians need to understand that we have a very big problem and we are not going to go away. We have tried writing submissions, protesting in Canberra, contacting the health minister Nicola Roxon by phone and email, but she is not listening.

Our message:
My Birth, My Choice

We are:
Women, children, men, families, friends who support choice in birth, including homebirth with a private midwife.

Bring:
Bring banners, drums and percussion instruments. Let’s make sure we are seen and heard!!
Bring a 'calling card' to drop off, letting our Minister for the status of women know that women want choice in childbirth and this includes the choice to hire a private midwife to birth at home (or in hospital). The calling card should be an A4 piece of paper (can be larger or smaller) with your name and address, concerns, experience, suggestions and a request for a response from Tanya Plibersek about this important issue.

Rally organisers:
The rally is being organised by Homebirth Australia and is supported by Maternity Coalition.
More info -

HBA: Jo Hunter jophil@aapt.net.au 0412 315 228
MC: Lisa Metcalf l.metcalfe@tpg.com.au 0437 577 576

Roxen Media Statement

NICOLA ROXON MP, MINISTER FOR HEALTH AND AGEING
MEDIA STATEMENT – 5 NOVEMBER 2009
Midwives/ Nurse Practitioner Amendment

The Minister for Health and Ageing, Nicola Roxon has today circulated an amendment the Government intends to introduce into the Health Legislation (Midwives and Nurse Practitioners) Bill and the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill.

This amendment makes clear in the legislation something that was articulated both on introduction of the Bill to parliament and in the explanatory material tabled at that time.
Following requests for clarification, this amendment will simply clarify in legislation that collaborative arrangements with medical practitioners will be required to access the new arrangements.

The details of these requirements will be specified in subordinate legislation following the ongoing consultation with the professional groups.

These bills are a key plank of the Government’s 2009/10 Budget commitments which recognises for the first time the role of appropriately qualified and experienced midwives and nurse practitioners in our health system.

The Minister for Health and Ageing said today “I thank the doctors, nurses and midwives for their constructive engagement to date to ensure these new opportunities for nurses and midwives are implemented in an integrated fashion for the benefit of patients.”

For more information contact the Minister’s office on 02 6277 7220

Homebirth Awareness Week: Celebrate or Commiserate?

2009-10-26T12:14:00.002+11:00

NEWS RELEASE by Homebirth Australia
Monday October 26 2009
by Justine Caines
Homebirth Awareness Week: Celebrate or Commiserate?
Minister’s Weakness and Bureaucrats ignorance continues
This week marks Homebirth Awareness week. Homebirth Australia fears that this time next year Australian women will not have the option of homebirth.

“It is hard to understand the hysteria around homebirth in Australia. Our maternity hospitals are full to the brim, many of them churning women out conveyor belt style and yet this is considered safe, hardly! said Justine Caines Secretary of Homebirth Australia and mother of seven home born children.”

Mainstream Australian maternity care is not about women, women are rarely consulted in the development of services, they are the main player and yet they have been silenced by practitioners who insist they ‘know better’ said Ms Caines.

Homebirth on the other hand is different. Women make decisions about their care, they invite a midwife into their home, rather than be forced to meet the needs of practitioners and organisational convenience which happens when giving birth in a hospital” said Ms Caines

“The outcomes from homebirth are also considerably better*. Women experience more personalised care and fewer interventions, they also enter motherhood happier and more content.” said Ms Caines

Something that is considered a normal reasonable choice in the U.K, The Netherlands, New Zealand, and Canada is under threat of extinction in Australia. Bureaucrats advising the Minister do not even understand homebirth and they refuse to seek information from key stakeholders

“Asking an Obstetrician about homebirth is like seeking advice from a midwife on caesarean surgery.” said Ms Caines

“Health Minister Nicola Roxon plans to fund midwifery care under Medicare, something sorely needed. She has however excluded homebirth. She did this against all evidence and the express wishes of the women of Australia across two enquiries, one that broke a Senate record on the number of submissions received.” said Ms Caines

The question remains; Will politicians continue to be more responsive to those with deep vested interest in maternity services? It is time to step upand listen to women, the very people for whom these so called reforms are proposed.” asked Ms Caines

* Victorian example of homebirth outcomes vs Hospital

2010_Pregnancy_and_Parenting_network

2009-10-01T20:01:00.003+10:00

Jane Palmer wrote:

Pregnancy and Parenting Network

27 Hart Street

Dundas Valley NSW 2117

Phone (02) 9873 1750

Email: jane@pregnancy.com.au

Website: www.pregnancy.com.au

Pregnancy, Birth and Beyond & New Beginnings Midwifery Practice

Invites you to our pregnancy and parenting network on the following dates for 2009 & 2010

Thursday

29th October 2009

Natural choices for pregnancy and birth

Thursday

26th November 2009

Ideas for Toddlers & Christmas Celebrations

Thursday

21st January 2010

Pregnancy Testing

Thursday

18th February 2010

Unexpected outcomes

Thursday

18th March 2010

Vaccination

Thursday

22nd April 2010

Birth Stories

Thursday

20th May 2010

Pregnancy Experiences

Thursday

17th June 2010

Waterbirth

Thursday

22nd July 2010

Returning to Paid Employment and childcare

Thursday

19th August 2010

Pregnancy and Parenting for older mothers

Thursday

16th September2010

Introducing solids, nutrition, food additives and food intolerances

Thursday

14th October 2010

Open Forum

Thursday

11th November 2010

Birth Techniques

Thursday

9th December 2010

Childhood Development, play, preschool and school options & Christmas Celebrations

No booking is necessary. Please note that the group get togethers are roughly 4 weeks apart. The open forum provides the group an opportunity to discuss any topic and a guest speaker may be invited. The group is held at Jane’s place (27 Hart Street, Dundas Valley) from 10am until 12pm. These get togethers are casual and provide you with opportunity to talk about all sorts of issues in a safe, supportive and relaxing environment. Please bring a plate of food to share (anything you can manage).

As always, mums, dads, friends and kids are all welcome! See you there!

Love Jane and Robyn

Home or Hospital?

2009-09-14T17:00:00.004+10:00

Channel 7 Sunday Night's program has just done a feature on Homebirth. To see the video footage visit http://au.tv.yahoo.com/sunday-night

Anna's birth of Ben is just beautiful. The lack of midwifery voice and the latest research is disappointing.

This is however is one of the better portrayals of homebirth in mainstream media.

Video footage of the "Mother of All Rallies"

2009-09-11T12:23:00.001+10:00

Make an on-line slide show at www.OneTrueMedia.com

Homebirth Rally 7th Sept 09

2009-09-07T22:39:00.006+10:00

Here are a few photos we took of the Homebirth Rally in Canberra today the 7th of September 2009. There were thousands of people who braved the cold and the rain to campaign for the rights of homebirthing women.

Annoucement by Homebirth Australia

2009-09-05T06:12:00.003+10:00

Dear homebirth supporter

This afternoon we were sent through a joint communique from Australian Health Ministers.

Below is an excerpt from the communique

Homebirth

Health Ministers agreed to a transitional clause in the current draft National Registration and Accreditation Scheme legislation which provides a two year exemption until June 2012 from holding indemnity insurance for privately practising midwives who are unable to obtain professional indemnity insurance for attending a homebirth.

Additional requirements to access the exemption will include;

A requirement to provide full disclosure and informed consent that
they do not have professional indemnity insurance.
Reporting each homebirth
Participating in a quality and safety framework which will be
developed after consultation led by Victoria through the finalisation of the registration and accreditation process.

These provisions will only apply to midwives working in jurisdictions which do not prohibit such practice as at the date of the implementation of the scheme.

ABC News link
Homebirth midwives get indemnity exemption

This only makes our rally even more necessary. An exemption for 2 years just isn't good enough. Do we REALLY want to go through all this again in 2 years time? It's simply a bandaid solution and will be the demise of private practice homebirth midwifery. This bandaid will take us past Nicola Roxon's term of office, therefore in 2 years time it could be someone else's problem to deal with and it could be someone who we will yet again have to heavily lobby and educate so that they can be up to scratch with the issues at hand.

So what does this give us?
A framework that must be abided by in order to be eligible for exemption from insurance, which is led by Victoria. We have been told by Nicola Roxon's office that this is due to Victoria leading the National Registration and Accreditation Scheme. However, we have concerns that Victoria may also lead the development of a framework within which private practice midwives will have to work, in order to be eligible for an exemption. Some members of Maternity Coalition and Australian Private Midwives Association recently attended a meeting with the Victorian Health Minister Daniel Andrews and they reported back that "The Minister summarized the implications that the current Bills before parliament will have for women and midwives. He stated that midwives cannot continue uninsured as they are and that if they wanted to work it would need to be as part of a team at a public hospital providing homebirth".

He was asked whether he recognized the right of women to choose place of birth and what they would do in the instance of July 2010 if the issue is not resolved, "Well they will be faced with the difficult choice of choosing from what is available".

We have grave concerns that this will be the beginning of the end for private practice homebirth midwifery.

On radio this afternoon Nicola Roxon alluded to the fact that during the 2 year exemption, data would be collected and hospital based programs could be developed or a suitable indemnity product found. This gives us absolutely no confidence or guarantee and we are exceedingly worried that this will be the death knell of homebirth.

We have no insurance, yet again dismissing consumers of homebirth as so small in number that it doesn't really matter.

We have no funding, yet again financially disadvantaging women who choose to birth at home with a midwife.

Our message at the rally remains very clear.

ALL WOMEN - EQUAL RIGHTS

See you in Canberra

Warm regards

Homebirth Australia

Home birth with midwife as safe as hospital birth

2009-09-01T08:22:00.002+10:00

Patricia A. Janssen PhD, Lee Saxell MA and colleagues
August 31, 2009

The debate about the safety of home births continues in the literature, professional policy and practice. This study looks at one health region in British Columbia and compared outcomes of planned home births attended by registered midwives to planned hospital births attended by midwives or doctors.

Here we have another example of research in the support of homebirth. This latest study found that women birthing at home had less interventions such as epidurals, forceps, vacuum extractions and caesarean births and they also had less adverse outcomes such as haemorrhage and infection. The researchers found that baby's born at home were less likely to suffer birth trauma, need to be resuscitated and less liley to have meconium aspiration. More proof of what we already known - HOMEBIRTH is a safe option for women.

Full article

COMMENTARY: The safety of home birth: Is the evidence good enough?

National call to action – Contact your Labor MPs in the next 2 weeks!

2009-08-24T05:36:00.005+10:00

I know we're all getting tired of fighting, however we need to keep the energy going to stop this legislation coming into effect. Please read the important update below:

The continuing lobbying efforts by homebirth, midwifery, maternity groups and many of the general public, has moved us considerably further along the fight to save women’s right to choice in birth care. However, we need to do more, and very fast! Parliament will continue debating the Medicare-related legislation on the 7th September - the same day as the planned “Mother of all Rallies in Canberra. We need to urgently ramp up our lobbying efforts of local Labor MPs in the next 2 weeks prior to the 7th September.

Here are the latest developments from the last week:

Despite almost 2000 submissions to the Senate Inquiry supporting the right to keep homebirth legal after July 2010, the ALP-majority Senate Community Affairs Legislation Committee handed down on 17 August, a disappointing recommendation to pass the legislation. The 2 minority Coalition senators recommended further studies and stopped short at suggesting amendments, while the Greens senator offered one solution of giving independent midwives a temporary exemption from the legislation until an indemnity insurance product could be found.
In a meeting with homebirth and midwifery groups on 20th August, Nicola Roxon offered 2 possible solutions: 1) State-based hospital auspiced homebirth or 2) A Commonwealth-funded indemnity insurance product contingent on adopting a framework like the SA Homebirth policy. Feedback from the States show that the first option is not supported by them. The second option of a Commonwealth funded indemnity product is much more preferable, however the SA model will restrict the access to many women (including VBACs), unless there was a ‘duty of care’ clause which allowed women to make an informed choice about the risks and still access the support of a homebirth midwife if they don’t meet the guidelines.
Furthermore, this framework requires all homebirth midwives to work in collaboration with an obstetrician and/or GP, potentially resulting in midwives losing the ability to make independent professional decisions about their client’s care without obtaining the ‘approval’ of the obstetrician/GP.
Debate on the legislation started on 20th August in Parliament, with positive statements from the Coalition and a few Labor MPs in support of amending the legislation to find a workable solution. The meetings and lobbying efforts are working, but much more needs to be done before Parliament resumes debating this issue on the 7th September.

What needs to happen before 7th September?

We need as many people as possible to contact their LABOR MPs to raise the profile of this issue and get into Nicola Roxon’s ear. There are 83 Labor MPs in Australia, and their primary responsibility is to represent you, the constituents in their electorate. We need these backbenchers and ministers to stop Nicola in the corridors of Parliament House to express their concern and put pressure on finding an acceptable solution.
Our experience has shown that a simple phone call to the MP’s office (the more people calling, the better) requesting a meeting to discuss the issue, is enough to drive home a very strong message. Even better would be to follow- up with a letter and a meeting with the MP. We need as many people as possible in Labor electorates to pick up your phones in the next 2 weeks and make that call.
Save Birth Choices will provide you with all the information you will need: MP guide, sample ‘scripts’ and letter templates. Given the short time frame, you may not get an appointment, but don’t underestimate the power of an individual phone call. It is definitely noticed! If you are lucky enough to get an appointment with your Labor MP, we will provide very detailed coaching and information on how to conduct the meeting.
Check to see if you live in an ALP electorate by entering your postcode in the search field on this page http://www.alp.org.au/people/index.php. If you do, we need your help. Please contact Send mail to savebirthchoices@gmail.com urgently, with the name of your electorate and MP and we will guide you through what you need to do.

Time is of the essence- we need your help NOW!

From the Team at Save Birth Choices
www.savebirthchoices.com.au

Andrew Laming - Home Births

2009-08-22T11:01:00.003+10:00

Alex Hawke - Federal Member for Mitchell

2009-08-20T21:02:00.005+10:00

CHOICE FOR EXPECTANT

Last month I had the pleasure of meeting one of my newest constituents, two week old Benjamin Russell, and his mother Anna, who decided to home birth Benjamin, her third baby, after two previous private hospital births.

Had her baby been due this time next year, Mrs Russell would not have that choice, because, as things currently stand, as of July next year home birth with a midwife will be outlawed.

From July 2010 it will be illegal for women to birth at home with a registered midwife in attendance. New national registration laws for health professionals, due to be implemented in July 2010, will require professional indemnity insurance as a condition of registration.

Without it, independent midwives attending homebirths after July 2010 will face large financial penalties.

In June, following a visit to my electorate office by Mrs Russell, midwife Jane Palmer and other concerned constituents, I addressed Parliament regarding my concern about women not being able to birth at home with an independent midwife.

Private maternity could be made more supportive and much cheaper if private midwifery were enabled and recognised. It is important that mothers are able to choose an appropriate model of care in consultation with healthcare professionals based on their individual needs.

It is important that the Rudd Government now acts swiftly to clarify the situation and provide certainty for mothers and health professionals on this very important issue. There is limited time for the Government to act with the National Registration and Accreditation Scheme due to be implemented next year.

The Coalition certainly support the choice of childbirth options for women, and I would like to hear what you think about it, please email me at alex.hawke.mp@aph.gov.au

Senate ignores women’s pleas on homebirth – recommendation to pass legislation

2009-08-18T05:52:00.003+10:00

Media Release: Senate ignores women’s pleas on homebirth – recommendation to pass legislation
Tuesday August 18, 2009.

Today’s Senate report into the Health Legislation Amendment (Midwife and Nurse Practitioner) Bill 2009 and two other related bills failed to support the calls of Australian women to ensure that they can access a registered midwife for birth care at home.

The report recognised the concerns of stakeholders that the intersection of two pieces of legislation - including legislation drafted by COAG on national registration - may have the “unintended consequence” of forcing homebirth underground. However it failed to recommend any solution for the crisis even though they received almost 2000 submissions on the issue and the report clearly identifies that there is a significant issue for women wanting to birth at home.

“We are not seeing the leadership needed to sort this issue out” President of the Australian Private Midwives Association Liz Wilkes said. “This is a good old case of state/Commonwealth buck passing going on. The states are saying the Commonwealth needs to find indemnity and the Senate are now saying that the problem is the state based legislation. In the meantime the clock is ticking for the women of Australia who in just over 10 months will be unable to access a registered midwife to care for them in birth at home.”

The advice from the Senate committee was that the Bill did not restrict women’s right to choose a homebirth nor make it unlawful.

“The use of language to skirt around this issue is amazing. Women in Australia are not in a third world country. They currently have registered midwives available to attend them in birth at home. However this government is choosing to ensure through a complex maze of legislation, that women will have to choose an unregistered care provider from July next year.

“The Federal Department of Health and Aging’s solution to this problem, which they outlined in evidence to the Senate, was for women to be attended at home by someone as long as they do not call themselves a midwife, or be registered as a midwife with the national regulatory body,” Ms Wilkes added. “We find this ridiculous.”

Midwives will face disciplinary action for attending homebirths under state based legislation which makes insurance mandatory for all health practitioners. If midwives de-register and continue to practice, using a midwifery title, they may face a $30,000 fine.

“Of course what we will see is a rise in non-midwives providing homebirth care which will compromise safety for mothers and their precious babies. The Australian Private Midwives’ Association does not believe the only choice available for women is to birth at home with an unregistered care provider.” Ms Wilkes stated. “The real concern is that the Senate heard no evidence to substantiate the government’s position, yet they will wave the legislation through. We definitely have to assume this is more to do with politics and less to do with women and safety.”

Media – Liz Wilkes President Australian Private Midwives Association 0423 580585

Campaign Up-date

2009-08-14T16:04:00.001+10:00

The last two weeks have been quite positive. It started with the Greens releasing the statement "Greens will move to protect women's right to choose safe homebirth" on the 31st of July. This was followed very quickly by the Australian Newspaper saying "Federal Health Minister Nicola Roxon revealed yesterday she was looking at whether the government could accommodate home births in the $25 million indemnity scheme" (this was released just one day after the Green's announcement). On the 4th of August - a rally outside of Nicola Roxan's office was attended in support by Senator Steve Fielding (one of the key senators that the legislation will have to get past in the senate). On the 6th of August the Senate Inquiry into the homebirth issue was held and made for some fascinating viewing. The senators didn't hold back on repeatedly asking the department of health and medical organisations why has homebirth been excluded and why isn't their consultation with the key stakeholders i.e. consumer and independent midwifery groups (the report for this is due to be released on Monday 17th of August). On the 13th of August - the coalition discussed homebirth at length in the Party Room and Peter Dutton (opposition Health Minister) has come out publicly in support of homebirth.

"Save Birth Choices" Rally T-Shirts

2009-08-14T14:32:00.003+10:00

Commemorative "Save Birth Choices" Rally T-shirts to help you to stand out in the crowd.

To order your rally T-Shirt visit Save Birth Choices Website!

Matches on Flickr

2009-08-13T12:30:00.002+10:00

As the matches burn closer to my fingertips I think of all of the mothers and babies who will no longer be able to choose a homebirth legally in Australia after 2010.

Time is running out, let your local MP know that you support homebirth and a womans right to choose where she births.

Don't let mothers and babies get burnt by the government and prosecuted for choosing to birth at home. If you are able please attend the Rally in Canberra as outlined below:

Check out this on Flickr - Matches on Flickr - Photo Sharing!

Coalition is on board

2009-08-13T11:09:00.002+10:00

I have been contacted by Alex Hawke's office (Federal Member for Mitchell) to say that homebirth was discussed at length in the Coalition Party room meeting on the 13th of August. Below is a relevant transcript for your information.

Transcript of 2UE news grab at Parliament House with the Hon Peter Dutton MP
PETER DUTTON: Mr Rudd has tried to outlaw the practice of home birth, restricting a woman’s choice. The Coalition strongly believes that women should be able to make their own decisions and the Government effectively is putting a $30,000 fine on midwives who practice in home birth and that is not acceptable and the Australian people do not agree with Mr Rudd on this. That is why we are calling on Mr Rudd to change his position, at least restore the status-quo but to suggest that somehow they can drive these changes underground is just not going to work.

The threat to Homebirth Care with a Registered Midwife Explained

2009-08-09T07:26:00.002+10:00

Government discriminating against home births, says Homebirth Australia

2009-08-06T20:33:00.002+10:00

By Bonny Symons-Brown AAP

August 06, 2009 02:33pm

PROPOSED laws which would stop mothers from accessing registered midwives for homebirths would jeopardise the health of thousands of women and babies, a peak maternity group says.

Homebirth Australia (HA) is angry about a suite of bills introduced to Parliament by the Federal Government in June which propose, among other things, to establish a national midwifery register.

Under the draft laws, midwives must be insured to join the register but private insurers no longer provide cover for homebirthing and the Federal Government has also refused to subsidise professional indemnity for homebirth claims.

HA secretary Justine Caines said the draft laws effectively stop registered midwives legally attending home births.

"The national registration requirement is absolutely appropriate," she told a Senate inquiry into the legislation.

"What is not appropriate has been the (Health Minister Nicola Roxon's) response to say ...'I will enable the funding of one-to-one midwifery care through Medicare for midwives who care for women birthing in the hospital system, but I won't do it for homebirth'."

Despite this, Ms Caines gave the Government the benefit of the doubt, saying any discrimination against homebirthing was an unintended consequence of the registration process.

"I'm not saying that (Ms Roxon) deliberately set out to do this, not at all," she said.

"What she has done is made a giant step forward and been too scared to take the next step because of medical objection, because of the power of the medical lobby."

The Australian Medical Association has previously spoken out against homebirthing, warning it is significantly more dangerous than giving birth in a hospital. But Ms Caines said Labor's legislation would endanger pregnant women who were unable to access registered midwives for their homebirths.

"I don't care if it's 1000 women or 2000 women a year, (Ms Roxon) is putting women in great danger," she said.

"She is also saying 'Your rights don't matter'."

There were both physical and emotional advantages to giving birth at home, Ms Caines said.

"What has come through no doubt in the passion from the women is the ... amazing emotional wellbeing for that woman, for her whole family, but also it does actually impact on clinical wellbeing."

Australian Greens senator Rachel Siewert said draft laws effectively rendered homebirths illegal.

"Where there is a low-risk pregnancy it is safe to have a home birth and women and families need to be able to have that choice," she said.

The Greens will seek to amend the bills to ensure homebirthing with registered midwives remains an option for women in Australia.

From http://www.news.com.au/story/0,27574,25891706-29277,00.html

Homebirth Rally

2009-08-05T05:17:00.002+10:00

Home births back on agenda for Labor | The Australian

2009-08-01T11:35:00.002+10:00

Home births back on agenda for Labor | The Australian

CANBERRA is reconsidering its controversial exclusion of home births from a new midwifery indemnity scheme, before a Senate challenge to the draft legislation.

Federal Health Minister Nicola Roxon revealed yesterday she was looking at whether the government could accommodate home births in the $25 million indemnity scheme.

"I recognise that a very small proportion of women would like to have home births and (I) am currently investigating if there is some way that we can provide this as an option without making the proposed midwife indemnity insurance unaffordable," she said.

The scheme was welcomed by midwives, when announced in the May budget, as a precursor to next year's expansion of their powers to prescribe subsidised medicines, order publicly funded tests and claim Medicare rebates.

Private midwives had gone without insurance cover since the indemnity crisis at the start of the decade, putting their ability to practise at risk under a new national registration scheme for health professionals that also takes effect next year.

But support for the budget decision fractured when the draft bills revealed home births would not be covered under the new indemnity arrangements.

Not only would home birth midwives continue to lack cover, they would also for the first time be stripped of their professional registration from next July for failure to secure adequate insurance. Unregistered midwives who continue to practice beyond that date could face a $30,000 fine.

Greens senator Rachel Siewert announced yesterday the party would demand changes to the midwife indemnity bill and/or draft national registration legislation, saying the government had made a mess of its attempts to improve maternity services.

"If their planned approach is about providing better choice and safer deliveries, it's going exactly the other way," she said.

"Parents who have already had home births have said to me, 'we will never go back to a clinical situation so we will free birth'. That will put them into a much more dangerous position than before."

Opposition health spokesman Peter Dutton said the Coalition would "be open to negotiating with the Greens".

"I have real concerns that the government is essentially putting in place penalties for midwives who assist in a home birth and essentially they're going to drive the practice of home births underground."

Greens will move to protect women’s right to choose safe homebirth

2009-07-31T08:42:00.004+10:00

Senator Rachel Siewert

Australian Greens Senator for WA

MEDIA RELEASE

Friday 31st July 2009

Greens will move to protect women’s right to choose safe homebirth

The Greens will move in the Senate to protect the rights of women to choose safe homebirths if the Government does not change its proposed legislation, Australian Greens health spokesperson Senator Rachel Siewert said today.

The Greens will move amendments to legislation on midwife services when it comes into the Senate in the coming weeks to ensure that mothers continue to have the option of a homebirth with the assistance of a registered midwife, without incurring huge financial penalties.

"The Greens' amendments will allow private midwives to continue to provide safe, low risk homebirth services in full collaboration with obstetricians and other health services. The Government legislation as it stands will effectively make it illegal for a qualified midwife to attend a homebirth in Australia and imposes heavy financial penalties for the midwife," Senator Siewert said.

"This will be dangerous for mothers and babies. It flies in the face of international trends in maternity care and appears completely inconsistent with the Government’s stated policy of providing pregnant women with greater choice and less interventionist maternity care.”

"As it stands, the legislation will ostracise a vital part of our health provision in the community. Independent midwives are providing an outstanding service for mothers who choose to give birth to their baby at home. What this legislation will do is drive them underground - we’ll see a return to the dark days of unsupervised childbirth, malpractice and the appalling tragedies that will undoubtedly follow.”

The Greens broadly welcomed the Government's proposals to modernise maternity services.

"Including midwives in the Medical Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS) is a significant step forward and we welcome the proposed Commonwealth-supported professional indemnity insurance (PII) scheme, but it must include all midwives and safe birthing options," Senator Siewert concluded.

Don't Blame it on Homebirths

2009-07-23T08:49:00.002+10:00

Dr Andrew Lavender, SA President of the AMA recently tried to claim on ABC radio the higher neonatal mortality on homebirths. As usual these claims against homebirth have no basis on fact.

Higher mortality rates are attributable to other factors. To find out more check out the following:

Don't Blame it on Homebirths
Perinatal mortality in the Netherlands Backgrounds of a worsening international ranking (this is a pdf document)

Good News

2009-07-23T07:39:00.001+10:00

A newsletter from the Greens and the Greens Senator Rachel Siewert said this:

"There are about 12 health bills coming to the Senate shortly, including one introducing means testing for the private health insurance rebate and increasing the Medicare surcharge levy. I've been part of the Senate inquiry into this bill as well as the one looking at capping some procedures covered under the Medicare safety net. I am very concerned about the changes the Government proposes to homebirths - which will effectively ban them. We have been consulting widely with families and midwives and will be preparing amendments to fix this legislation. "

A little ray of sunshine - let's hope this makes a difference.

To all those in Australia concerned with maternity services

2009-07-22T06:20:00.003+10:00

Quote by Marsden Wagner, M.D., M.S., for 15 years a Director of Women’s and Children’s Health, World Health Organisation

Childbirth is not a medical procedure, it is a normal part of the life cycle and belongs to women and their families, not to doctors nor hospitals nor the government. There is overwhelming scientific evidence that planned out-of-hospital birth attended by a midwife is an absolutely safe choice for all low-risk pregnant women---women without any serious medical problems. To in any way limit or forbid the choice of out-of-hospital birth or the training and ability to practice of midwives willing to attend out-of-hospital births is to deny Australians the freedom to control their own lives and is to fail to honor the central importance of family values in Australia.

In the 1980’s the German organization of obstetricians and gynecologists tried to get a national law forbidding planned out-of-hospital birth. The German women rose up and fought against it, there was an international outcry and the effort of the doctors failed and since then there has been a vast effort to promote out-of-hospital birth centers, increasing from one to the present over 100 such centers, all using midwives.

In the 1990’s the Hungarian organization of obstetricians and gynecologists tried to get their government to forbid planned out-of-hospital birth. The Hungarian women rose up and there was an international outcry and the effort of the doctors failed.

In the last decade, the government of Brazil tried to lower their very high caesarean section rate through working with the doctors and hospitals. When this did not succeed, the government of Brazil started up a national network of out-of-hospital birth centers staffed by midwives which are very popular and have quite reasonable caesarean section rates.

Efforts by doctors in Australia to prevent or limit in any way the option of planned home birth attended by midwives by completely falsely claiming, without any scientific evidence, that planned out-of-hospital is unsafe, will ultimately fail as the people of Australia cannot be fooled all the time and value their freedom too highly and Australia does not want an international outcry against them and to be seen as unable to prevent unjustified medical dominance of normal family life.

Insurance Plea for Homebirth Midwives

2009-06-30T14:46:00.002+10:00

Sydney Morning Herald
Kate Benson Medical Reporter

June 30, 2009

A CORONER handing down findings into the death of a baby born at home has called on the Federal Government to rethink its refusal to indemnify private midwives outside hospitals, saying home births will be driven underground with "disastrous ramifications".

In releasing his report on Jasper Kosch-Coyne, a newborn baby who died while being driven from his parents' farm to Nimbin hospital two years ago, the Byron Bay coroner, Nick Reimer, said home-birthing was a mother's inherent right and a practice "that will not go away".

Last month the federal Health Minister, Nicola Roxon, announced that private midwives would be given access to Medicare provider numbers and prescribing rights from next year, but indemnity insurance would not be extended to midwives attending home births.

"History has shown there will always be a small group of expectant mothers who will want to give birth in their home," Mr Reimer said. "Birthing at home should be an available option."

In an unusual move, he sent the Kosch-Coyne inquest findings to the federal and state health ministers, urging them to exercise "great care" in drafting legislation that would make home-birthing illegal.

The inquest found that baby Jasper died about midnight on July 18, 2007, after the midwife, Jillian Delaile, failed to seek help when it was clear he could be swallowing meconium in the womb. Ms Delaile had attended the birth on her own, had not organised transport in case of an emergency and did not transfer Jasper's mother, Angel Kosch, to hospital before delivery even though she had requested it because her labour had become difficult and protracted. The inquest was told the baby's heart rate was not monitored adequately and Ms Delaile failed to call an ambulance when the baby was born breathing inadequately with the umbilical cord wrapped tightly around his neck.

She left Ms Kosch at home to deliver her placenta with no medical assistance while she travelled in a car to Nimbin hospital, performing cardio-pulmonary resuscitation on the baby in the front seat.

Ms Delaile had asked a family member to administer an intramuscular injection to Ms Kosch if she began hemorrhaging. Ms Delaile was cleared of responsibility for the tragedy because there had been a "series of shortcomings" and it was not possible to conclude any of them had contributed to Jasper's death, Mr Reimer said.

But a spokeswoman for the Australian College of Midwives, Hannah Dahlen, said such tragedies would become more commonplace if home-birthing was made illegal.

"Women have said they will have no option but to freebirth, midwives have said they will work so far underground no one will ever find them, people will fail to register home births and there will be a reluctance to transfer [a woman to hospital] when there is an emergency," Ms Dahlen said.

"No country has ever been able to eradicate home-birthing. The system will simply become unchecked and dangerous."

The secretary of Homebirth Australia, Justine Caines, said more mothers and babies would die if home-birthing became illegal. "Women will continue to homebirth, but will do so without the assistance of a qualified professional … removing women's rights to the point where we are back providing care in dark alleys or in back rooms, is ridiculous in 2009."

Deaths will increase with new announcements

2009-06-24T16:13:00.002+10:00

Homebirth Australia today slammed the exclusion of homebirth from insurance schemes for midwives announced by the Health Minister Nicola Roxon in parliament today.

"Effectively two pieces of legislation will outlaw midwives providing homebirth care from July 2010" said Justine Caines, mother of seven and secretary of Homebirth Australia.

"Women will continue to homebirth, but will now do so without the assistance of a qualified professional." said Ms Caines. "The result will be an increase in deaths for mothers and babies, this is certain. It is absolutely impossible to understand the government's position on this, other than to say that they have bowed to political pressure from medical lobby groups."

The National Maternity Service Review received submissions from hundreds of women wanting access to homebirth services. The vast majority of homebirth services are provided by private practice midwives. Removing this option is likely to end access for most women to homebirth.

Ms Caines called on all ALP members to declare their view on a woman's right to self determination of her health care needs. "If the ALP is so hell bent on preventing women from accessing homebirth as an option I ask all ALP members to publically state their position on this. It appears that having a Health Minister who is a woman, a recent mother, and a lawyer understanding consumers' rights, is not proving to be an advantage for women. Removing women's rights to the point where we are back providing care in dark alleys or in back rooms is ridiculous in 2009."

Australian College of Midwives Media Release

2009-06-24T05:14:00.003+10:00

Media Release, June 2009
Mothers and babies at risk: Access to qualified midwives for homebirth under threat. Private midwives will no longer be able to attend homebirths under new national laws proposed for registering health professionals to have effect from 1 July 2010.

The national registration scheme for health professionals, which has been being developed by COAG and health ministers since 2007, released the draft laws last week. One of the requirements of the new scheme will be that all health professionals have professional indemnity insurance, as a measure to ensure consumers have access to compensation if they successfully prove negligence.

But private midwives have been unable to buy professional indemnity insurance since 2001. Most midwives are indemnified by their employers, typically a public or private hospital. But midwives in private practice are the ones who have historically provided women with access to the choice of giving birth at home. Access to indemnity for private midwives ceased in 2001 following the collapse of HIH and September 11, which caused insurers to reassess their liabilities.

“The national registration laws will require a midwife to be indemnified for all areas of her practice. This will effectively make it impossible for a midwife to legally care for women planning homebirth, because there is no professional indemnity available for homebirth care” said Dr Barbara Vernon, Executive Officer of the Australian College of Midwives. “This is devastating news for private midwives, as this policy threatens to throw them onto the unemployment queues” Vernon said.

“It’s also a very dangerous move by registration officials” Vernon said. “It is essential that women who choose to give birth at home have access to experienced midwives. The widely reported tragic death in March of a baby born at home without a midwife or doctor in attendance is testimony that unattended homebirth is dangerous.”

“Midwives have knowledge and skills that ensure women who labour at home can do so safely. They closely supervise the labour to ensure that everything is proceeding normally, and can arrange for timely transfer if they are not. They also have skills and equipment to perform life saving emergency care in the unlikely event of a mother or baby need urgent transfer.”

“The Australian College of Midwives is gravely concerned that if midwives are prevented from providing professional care to women planning homebirth, that some women will proceed to birth at home anyway, unattended. Any attendant they might have would not be a regulated health professional like midwives are, accountable to competency standards, codes of ethics and conduct, and required to maintain professional knowledge and skills. This is a retrograde step”.

Health Minister, Nicola Roxon is set to introduce legislation to federal Parliament soon that will assist private midwives to access professional indemnity insurance. This assistance will be for midwives who become eligible to provide Medicare funded care to women in the community for pregnancy and postnatally and for labour and birth in a hospital.

“We welcome the Minister’s recognition of the valuable contribution midwives make to maternity care evidenced by the Budget decision to give Medicare and PBS rebates to women or care by eligible midwives” Vernon said. “The support for eligible midwives to access insurance for such care is also vital given the market failure in this area of insurance”.

“Now that the national registration laws will effectively render it illegal for midwives to attend women planning homebirth, it is vital that the government’s support for midwives to access indemnity insurance is extended to include women who choose to labour and birth at home” Vernon said.

“This is the only option if the government is serious about maintaining safety and quality for all women needing maternity care in Australia”.

Law to stop midwives working outside hospitals | The Daily Telegraph

2009-06-19T10:20:00.004+10:00

By Kate Sikora

June 19, 2009 12:00am

HOMEBIRTHS will become illegal under tough new laws that prevent women using midwives to have children outside hospitals.

The move is set to drive homebirths underground, with expectant mothers and their babies at risk.

There are fears women determined to have a homebirth will "go it alone" like birthing advocate Janet Fraser, whose baby died during a natural water birth in April.

Under the draft Health Practitioner Regulation National Law, released last week, a midwife cannot be registered unless she has insurance.

But with insurance companies and the Government so far refusing to include homebirths in the indemnity scheme, midwives will face being de-registered if they attend a homebirth.

Women's groups accuse the Rudd Government of stripping women of rights by forcing them into hospitals.

Australian College of Midwives boss Dr Barbara Vernon said the Government's intention was obvious.

"I had been optimistic until now when you can see it in black and white," she said. "Even though only less than half a per cent of women have homebirths, they should have the same rights as a woman who chooses to have a caesarean. Homebirths won't stop."

About 150 midwives do homebirths in Australia. Called independent or private midwives, most do not work in a hospital and are uninsured.

But from July 2010, they will no longer be able to call themselves midwives even though they are trained. Only those insured and registered can use the term midwife, otherwise they face a $30,000 fine.

There are about 700 homebirths a year but some say this may be as high as 2100 as they are under-reported.

For TV presenter and marriage celebrant Elizabeth Trevan, giving birth to her 18-month old twins Nash and Harvey at home was an "overwhelming experience."

"It breaks my heart to hear that the Government will do this," she said. "This is about choice.

"The Government should be driving this and helping midwives who want to (do) homebirths. They will never be able to afford insurance."

Home Births Australia secretary Justine Caines said the new law took away the rights of women.

"It technically makes homebirthing illegal," she said.

The Royal Australasian College of Obstetricians and Gynaecologists is against homebirths.

Visit to Alex Hawke

2009-06-18T06:30:00.003+10:00

I visited Alex Hawke, the federal member for Mitchell (Castle Hill and surrounding area) with a group of women from his electorate. Alex has made a commitment to fight for the right of women to birth at home. He has raised the matter with the Shadow Health Minister and raised the matter in parliament on Monday 15th June 2009. To view Alex's speech - click here

Maternity units cut despite baby rush | The Australian

2009-06-11T09:39:00.003+10:00

Maternity units cut despite baby rush | The Australian
AUSTRALIA is delivering record numbers of babies, despite losing a sixth of its public hospital maternity wards over the past decade.

Despite rising fertility rates and population growth, the number of obstetric and maternity services offered by state-run acute-care hospitals has plummeted from 298 in 2000-01 to 248 in 2007-08.

Neonatal intensive care and specialist pediatric services have also become scarcer in the public sector at a time when most other specialist units grew in number.

The Australian Institute of Health and Welfare data shows the bush suffered the steepest decline in maternity services, with medical workforce shortages and low volumes of births speeding closures.

Australian Medical Association president Andrew Pesce, an obstetrician, acknowledged that many women were travelling away from home, sometimes several hundred kilometres, to give birth to their child.

"There's real difficulty delivering maternity services outside the metropolitan areas" and it was difficult to attract people with skills to some areas, he said.

Governments should make the best use possible of local facilities, but could not be expected to provide every maternity service in all places, for safety reasons, Dr Pesce said.

"Often they're small units doing a small number of deliveries, and they don't have the nursing, the midwifery or medical expertise available to provide a safe, co-ordinated service," he said.

Justine Caines, a member of the Maternity Coalition executive, said state health services had been too quick to use obstetrician shortages as an excuse to abandon local maternity units, arguing midwives could provide substitute services if current rules were relaxed.

She said so many expectant mothers were being referred to larger regional or city hospitals that those services, too, were struggling to cope.

Even in the biggest hospitals, some birthing units were so overwhelmed they required mothers to register within weeks of conception or, in one case, used a lottery system to decide who they could take, Ms Caines said.

"Why has this been allowed to happen when the midwifery workforce has been there forever, willing and able and yet prevented from practice by funding arrangements?" she said.

The reduction in services has coincided with a multi-year baby boom that has taken demographers by surprise.

Australia is expected to register almost 300,000 births in 2008, surpassing the previous record of 287,000 in 2007.

In recent years it has reversed a falling birth rate to reach its highest total fertility rate in more than a quarter of a century.

Queensland cut the deepest into its maternity services this decade, slashing 22 obstetric units and 16 specialist pediatric services, at a time when its population was booming.

Victoria lost 11 obstetrics and two neonatal intensive care units, while NSW closed down nine maternity units.

Only South Australia bucked the trend, retaining the same number of services for mother and child as it did at the start of the decade.

Women's & Children's Hospitals Australasia chief executive Elizabeth Chatham yesterday acknowledged planners had failed to pick the baby boom, but said hospitals had demand management strategies in place.

The federal government's $120 million budget package for maternity services, which boosted the role of midwives, would allow more creative ways of returning services closer to women's homes, she said.

"I think the policy to direct closures has relied on thinking of traditional models -- models provided by hospitals only -- when now we may be able to look at hospital services working together with community ones," Ms Chatham said.

Historic News

2009-05-13T13:37:00.009+10:00

Australian College of Midwives
Media Release
“Mothers and Midwives Budget winners”

“Today is an historic day for childbearing women and their families in Australia,” said Associate Professor Hannah Dahlen, National Media Spokespersons for the Australian College of Midwives.

“Not only has the Rudd Government made the welcome commitment to parental leave to better support families with newborn babies, but they have also provided for:

mothers to receive Medicare rebates for midwifery care,
access to PBS for midwives,
national collaborative maternity care guidelines,
increased access at state level to birth centres,
indemnity for midwives
measures to enhance the access of rural and remote women to maternity care as close as possible to their home community.
A national telephone support service for pregnant women and mothers of newborns

“These reforms will together make it much easier for women living anywhere in Australia – from the middle of our largest cities to remote communities - to access continuity of care by a known midwife” Assoc Prof Dahlen said. “They will also be vital in helping to close the gap on disadvantage for Aboriginal and Torres Strait Islander mothers and babies in partnership with Indigenous people themselves.”

Continuity of midwifery care involves a pregnant woman being cared for by a known midwife throughout her pregnancy, labour and birth. It also involves follow up care in the home for up to 6 weeks after the birth of the baby to provide professional support with the all important transition to parenting.

“This is not about substituting doctors with midwives” Assoc. Prof Dahlen said. “Obstetricians will, of course, continue to have a vital role in maternity care. Midwives providing continuity of care collaborate with obstetricians and allied health professionals throughout the episode of care, in response to the individual needs of each woman and her baby.”

Research evidence shows a range of benefits when women are cared for by known midwives from early in pregnancy till well after the birth. These include fewer admissions to hospital antenatally, less need for epidurals or for any pain relief, fewer episiotomies, more normal births, reduced need for their baby to be admitted to a special care nursery, more success with breastfeeding, and less vulnerability to postnatal depression or anxiety.

“Health Minister Nicola Roxon is to be commended for listening to Australian women during the recent national review of maternity services and for acting on the evidence that their needs could be better met with greater access to continuity of care by midwives, said Assoc Prof Dahlen

“These reforms pave the way for tens of thousands of women and their families to benefit from continuity of midwifery care while maintaining Australia’s solid record of safety for mothers and babies,” said Assoc. Professor Dahlen. “The confidence the government has expressed in midwives through these major reforms will be embraced by the profession around Australia.”

“Today the government has honoured women and motherhood in this country and recognised that ‘the hand that rocks the cradle’ does indeed ‘rule the world,’ and that we as a society need to support women and invest in the future– our children,” said Associate Professor Dahlen.

The Budget and Midwifery

2009-05-13T09:20:00.003+10:00

Here is an excerpt from the budget in relation to midwifery. No coverage for homebirths as expected.

Improving Maternity Services Package

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	8.8	24.7	29.7	49.5
Medicare Australia	-	2.4	0.7	0.8	0.9
Total	-	11.2	25.4	30.5	50.4
Related capital ($m)
Medicare Australia	-	3.1	-	-	-

The Government will provide $120.5 million over four years for the introduction of Medicare‑supported midwifery services to provide greater choice for women during pregnancy, birthing and postnatal maternity care. This measure includes $3.1 million in capital funding in 2009‑10 for Medicare Australia.

The new arrangements will allow midwives to work as private practitioners, provide services subsidised by the Medical Benefits Schedule and prescribe medications subsidised under the Pharmaceutical Benefits Schedule. The Government will also provide subsidised medical indemnity for eligible midwives working in collaborative arrangements in hospitals and healthcare settings. To ensure that Australia maintains its strong record of safety and quality in maternity care, a safety and quality framework, including professional guidance and an advanced midwifery credentialing framework, will be developed. A new 24‑hour, seven‑days‑a‑week helpline will also be established to provide antenatal, birthing and postnatal maternity advice and information to women, partners and families during the ante‑natal period and up to 12 months following the birth of a child.

The measure will also assist women in rural and remote areas by expanding the Medical Specialist Outreach Assistance Program to provide integrated outreach maternity service teams for women in under serviced areas. The expanded teams will include midwives, obstetricians, general practitioners and other health professionals, such as paediatricians and Aboriginal health workers. Additionally, funding will be provided for the professional development of midwives and for general practitioners to undertake additional training to become GP obstetricians or GP anaesthetists. The package will be implemented progressively from 1 July 2009.

New Activist Group in North Western Sydney

2009-05-12T17:57:00.003+10:00

It is with great pleasure that we would like to announce the launch of a new website, SAVE BIRTH CHOICES (www.savebirthchoices.com.au).

Save Birth Choices has been the initiative of a group of women; mothers and midwives in North/West Sydney, passionate about birth and keeping all birth choices available to Australian mothers. We have seen the wonderful efforts of organisations and individuals in response to the Maternity Services Review and felt it necessary to create a central spot that is aimed at educating the greater public and communicating the collaborative efforts of organisations around Australia.

This website was launched two weeks ago with very little publicity other than a facebook causes group which now has well over 1,000 members joined in the past week. We are excited and encouraged by the response to our admin email address and requests for information about the Maternity Coalition’s postcard campaign in particular.

What we are aiming to achieve with this website is support from the greater public for all birth choices rather than targeting only women and families directly affected. We would also like to communicate community events and be a point of referral for all campaigns for birth reform that are being run around the country but not making it to the attention of the greater public. We are not a birthing organisation. We have simply created a website to appeal to the greater public as a tool to help birthing organisations like yours and as such, we would like to invite you to utilise this tool.

What we are looking to advertise is

Birth education classes
Campaigns and events and
Relevant news

We would also like to add you as a supporter to our site and would greatly appreciate a reciprocal link.

If you have any questions about Save Birth Choices please feel free to send an email to admin@savehomebirth.com.au. This email address can also be used to forward information you would like posted on this site.

With warm wishes,
Anna Russell
On behalf of Save Birth Choices
www.savebirthchoices.com.au

Homebirths 'as safe as Hospital'

2009-04-15T20:44:00.002+10:00

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births. To read the full article go to http://news.bbc.co.uk/2/hi/health/7998417.stm

The Campaign Begins

2009-04-04T09:18:00.013+11:00

Today I am beginning to coordinate a campaign in my local area to lobby to save the future of midwifery in private practice and homebirths. The Report of the Maternity Services Review failed to provide a provision for midwives attending homebirths nor to find a solution for professional indemnity insurance. As a requirement of national registration planned to be implemented mid 2010 - midwives will be asked to provide proof of professional indemnity insurance as to enable registration - as no insurance is available if midwives choose to attend a homebirth they will be practising illegally. Women have a right to a midwife attending them at home. More on my plans later. Enjoy this video produced by Homebirth Australia.

Photo and video editing at www.OneTrueMedia.com

Maternity Services Review

2008-11-07T17:28:00.004+11:00

The date for submissions to the Maternity Services Review Discussion Paper has now past. I received the email below today to say my submission has been accepted. I now am waiting excitedly with the hope that real changes are going to occur such as midwives receiving Medicare rebates, professional indemnity insurance and that we'll have the ability order diagnostic tests and have prescribing rights.

Dear Jane

Thank you for your submission in response to the Maternity Services Review Discussion Paper, “Improving Maternity Services in Australia: A Discussion Paper from the Australian Government”.

Your submission, along with all other submissions and information, research and expertise assembled from other sources will be used by the Department of Health and Ageing in the development of a report to the Minister for Health and Ageing, the Hon Nicola Roxon, MP.

Thank you again for your contribution to this important process.

Yours sincerely

Rosemary Bryant
Chief Nurse and Midwifery Officer

Midwife-led versus other models of care for childbearing women

2008-10-16T12:27:00.008+11:00

A friend has just emailed a link to this review from the Cochrane Collaboration (published October 2008) - I thought you might be interested:

Midwife-led versus other models of care for childbearing women
Hatem M, Sandall J, Devane D, Soltani H, Gates S.

Midwife-led care confers benefits for pregnant women and their babies and is recommended.

In many parts of the world, midwives are the primary providers of care for childbearing women. Elsewhere it may be medical doctors or family physicians who have the main responsibility for care, or the responsibility may be shared. The underpinning philosophy of midwife-led care is normality and being cared for by a known and trusted midwife during labour. There is an emphasis on the natural ability of women to experience birth with minimum intervention. Some models of midwife-led care provide a service through a team of midwives sharing a caseload, often called 'team' midwifery. Another model is 'caseload midwifery', where the aim is to offer greater continuity of caregiver throughout the episode of care. Caseload midwifery aims to ensure that the woman receives all her care from one midwife or her/his practice partner. By contrast, medical-led models of care are where an obstetrician or family physician is primarily responsible for care. In shared-care models, responsibility is shared between different healthcare professionals.

The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials, involving 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects. The main benefits were a reduced risk of losing a baby before 24 weeks. Also during labour, there was a reduced use of regional analgesia, with fewer episiotomies or instrumental births. Midwife-led care also increased the woman's chance of being cared for in labour by a midwife she had got to know. It also increased the chance of a spontaneous vaginal birth and initiation of breastfeeding. In addition, midwife-led care led to more women feeling they were in control during labour. There was no difference in risk of a mother losing her baby after 24 weeks. The review concluded that all women should be offered midwife-led models of care.

To read more visit: http://cochrane.org/reviews/en/ab004667.html

Proverb Translated from the Tao Te Ching

2008-10-10T20:43:00.005+11:00

You are a midwife, assisting at someone else's birth. Do good without show or fuss.

Facilitate what is happening rather than what you think ought to be happening.

If you must take the lead, lead so that the mother is helped, yet still free and in charge.

When the baby is born, the mother will rightly say: "We did it ourselves!"

from The Tao Te Ching

Greater Roll for Midwives

2008-09-10T16:59:00.005+10:00

Midwifery is on the national agenda today. There has been wide coverage on television and newspapers. Finally we are seeing a shift by the government towards midwifery care. This is long overdue. My fingers are crossed the government is serious about implementing the planned changes.

Here is the report in today's Sydney Morning Herald (on the front page).

Mark Metherell - September 10, 2008

Midwives would be given doctor-style responsibilities such as being able to order diagnostic tests and prescribe drugs under proposals being considered by the Federal Government.

With a shortage of nurses and doctors straining maternity services at a time of near-record birth rates, the Minister for Health, Nicola Roxon, will release a discussion paper today proposing a boost in the role of Australia's 12,000 midwives.

The paper cites fragmented services, professional restrictions, funding problems and a lack of affordable indemnity insurance as barriers to greater use of midwives. Australia's use of independent midwives compares poorly to other developed countries, including New Zealand and Britain.

To provide a comprehensive service similar to that of general practitioner obstetricians, the discussion paper says, midwives require rights in hospitals to enable them to visit and refer their patients to specialists, to order diagnostic tests, prescribe drugs and have access to Medicare payments for the work they do.

The proposals are likely to encounter resistance from the Australian Medical Association, which has previously raised concerns about patient safety - claims that have been rejected by the Australian College of Midwives.

The discussion paper is part of a comprehensive review of maternity services being led by the Chief Nurse and Midwifery Officer, Rosemary Bryant, to be completed by the end of the year.

The review will cover issues including support for a greater role for midwives; opportunities for women to have more birth-care options, including home births; the shortage of maternity staff and services, particularly in rural and remote areas; and rising levels of post-natal depression.

The paper says that as there is no Medicare benefit payable to midwives for management of labour and delivery, there is only limited support for midwifery services through private health insurance.

In most cases, mothers choosing to have their babies outside hospital pay the full cost of midwife services, which is typically more than $1000.

A key issue was expanding the scope within both the public and private sectors for women "to achieve greater choice and increased continuity of care.

The report states that Australian women often had a range of different health-care providers during pregnancy.

This was despite international studies which had consistently demonstrated that continuity of carers improved satisfaction for both patient and carer, and improved health outcomes.

Shellharbour Hospital gets new home birth service

2008-06-21T08:27:00.004+10:00

Some exciting news has just published by ABC News. This adds to the growing trend of publicly funded homebirth programs in New South Wales.

New South Wales Health Minister Reba Meagher has announced a new home birthing service and family care centre for Shellharbour Hospital.

The family care centre will offer prenatal services and post-discharge midwifery support, such as help with breast feeding and sleep management.

The home birthing service will see publicly funded midwives offer continuity of care through a pregnant mother's labour, birth and postnatal care.

Ms Meagher says the new centre will add to the range of choices available to women in the Shellharbour region.

"This will mean those women who want to give birth at home will be able to do that with the support of a specially trained midwife. Increasingly women are choosing to have children at home," she said.

The home birth announcement has been welcomed by the New South Wales Midwives Association.

To read the complete article go to www.abc.net.au/news/stories/2008/06/13/2273925.htm

National Health and Hospital Reforms Commission

2008-06-11T11:30:00.004+10:00

On 25 February 2008, the Prime Minister and the Minister for Health and Ageing announced the establishment of the National Health and Hospitals Reform Commission. The commission will provide a blue print for tackling future challenges in the Australian health system. Out of the blue I received an invitation to attend a focus group, which was one of many groups facilitated by the commissioners across Australia. They brought together a diverse group of front line health care providers such as midwives, physiotherapists, ambulance officers, dieticians, nurses, doctors, prison health care workers (and quite a few other professions). It was a very interesting few hours. We sat randomly at round tables and worked as a group to discuss what we wanted to see changed in the health care system. We each had the opportunity to present two changes. Then together as a group developed three changes for the future. Each table presented their ideas (there were five tables in all). Out of all the ideas collected we had to all agree on five changes. Then a table was assigned one of these changes and we had develop ideas on how to achieve these changes. It was a fascinating process and easy to contribute to. As health professionals I found we all have similar ideas of what was needed for the future. I had the opportunity to speak for improvements in maternity care and have some of my ideas included into the submissions to the commissioners. I spoke for the right of women to have publicly funded homebirths, for the care of well pregnant women to be available in the community (rather than by the hospitals), to change from an illness focus to a wellness focus in maternity care and for the need of midwives to have professional indemnity insurance. While I was only one voice - I did feel that I was listened to. I do commend the government for this initiative. However I hope the Australia Government doesn't just produced a blue print for the future, I hope they choose to act on it rather than filing it in the bottom draw. To find out more visit the National Health and Hospital Reforms Commission Website.

Belmont Birthing Service

2008-05-27T12:00:00.004+10:00

While being an independent midwife has it's struggles and I often feel like the birthing services are getting worse instead of better, - there are many people working behind the scenes to improve the care women and their families receive. Belmont Birthing Services is a fantastic example of what can be achieved with the right support. The following information is written (and reproduced with permission) by Carolyn Hastie

Hi all, thought I'd write and give you all an update on what's happening at Belmont Birthing Service (BBS) on the shores of the beautiful Lake Macquaire near Newcastle, NSW.

To remind you about BBS, we are a stand alone, women centered, midwifery managed maternity service, situated with in Belmont Hospital. We are a public health service, part of the maternity services offered through John Hunter Hospital. There are 8 of us, seven midwives and one manager. We care for women throughout pregnancy, birth and the postnatal period for two to three weeks. Our service commenced on the 4th July 2005, so we are almost three years old.

We have now cared for 651 women through the birth of their babies and beyond.
72% are having their babies on site at Belmont.

The normal birth rate, even for those women who are transferred to the tertiary referral hospital, either in labour or before is > 95%

Reasons for transfer are predominately post dates for induction of labour and slow progress in labour - either requiring pain relief or augmentation. Interestingly, there were far more transfers in the first two years of our service than there are now. That is due to several factors including the fact that in the first year, women who were Group B Strep positive were transferred for antibiotic cover. Since then, all the midwives have been credentialled as immunisers, so can give IV antibiotics without medical presence. Chlorhexidine douches are very popular and effective for GBS prophylaxis and most women choose to use that as they are not keen on antibiotics.

Other stats you may find interesting include:

most of the women choose to birth their babies through the water - the baths at BBS are wonderful.
most of the women choose undisturbed labour, including third stage and so the physiological third stage rate is very high blood loss rates are very normal, postpartum haemorrhage is exceedingly rare there have been only two women with elevated blood pressure (no actual Preclampsia) prenatally and one postnatally.
there have been five premature births and those babies were one at 32 weeks, the rest at 34-36 weeks.
Four women have had breech babies and given birth at the tertiary referral hospital.

We are very blessed to have great midwifery and medical management and our health executive are fantastic, very supportive of our service and other innovative ways of caring for the health needs of their population.

Other great items include:

Hunter New England Health has an area wide homebirth policy based on the wonderful NSWHealth Homebirth policy and we are now able to provide homebirth for those women who choose that option. Our first homebirth occurred on Christmas Day 2007. We have a virtual ward and virtual nursery for these births and babies.
Intradermal water injections are used as needed and have been very beneficial to the women who have used them.
The midwives have admitting rights and now women are admitted with the midwife's name as care provider.
Across the health service, routine birthing medications, such as syntocinon, N2O, Konakion and Hep B, Priorix are now midwife initiated medications, so no doctor's signature is necessary for their administration.

It's all very exciting and wonderful to see the way that everyone in the health service is supportive of enabling women and midwives to work together to keep birth normal and rewarding for everyone.

love, Carolyn Hastie
Midwifery Manager
Belmont Birthing Service
0428112786

To download a flyer on Belmont Birthing Service (PDF Document)

Save Independent Midwifery

2008-05-24T06:57:00.003+10:00

Since 2003 Independent Midwives in Australia have been unable to obtain professional indemnity insurance. Insurance companies felt that the number of independent midwives is extremely small and that one claim would wipe out any premiums they'd obtain - making independent midwives an uneconomical group to support. As far as we can ascertain there have been no major claims against independent midwives (or none that the insurance companies have let us know about). This had a big impact on my independent midwifery practice. I'd enjoyed a wonderful working relationship with Prince Alfred Hospital at Camperdown - I had visiting rights as an independent midwife which enabled me to support women as their primary caregiver in the birth centre and also enabled me to continue care for women who required a transfer after a planned homebirth. In NSW the Nurses and Midwives Registration board does state that we are supposed to carry Professional Indemnity insurance but does not enforce it.

It seems that Independent Midwifery in the UK is not so fortunate. The government is proposing that all health professionals carry professional indemnity insurance - which effectively will make it illegal for independent midwives to continue practicing. I cannot believe that such problems face my sisters in the UK. If you wish to read more go to http://www.saveindependentmidwifery.org/

Dangers of Prenatal Testing

2008-04-28T11:32:00.004+10:00

Channel 9's Sunday program has a very interesting video footage on the "Dangers of Prenatal Testing"

An ultrasound screening test at 12 weeks is now considered a routine part of pregnancy, but an eminent British Radiologist claims the test, designed to pick up chromosomal abnormalities like Down syndrome, is highly inaccurate.

In a controversial interview with the Sunday program, Dr Hylton Meire claims that the screening test known as a Nuchal Translucency, has a false positive rate of 95%, and that healthy babies are put at risk of miscarriage from more invasive tests to confirm or deny the original suspicion. He argues up to three healthy babies die for every one Downs syndrome baby that goes to term. Read On...

Scared for Life

2008-01-28T14:35:00.003+11:00

The Sydney Morning Herald recently put Caesarean Birth's as a major headline for more than a week. As the caesarean rate fast approaches 1:3 births - it was a timely response from a major newspaper. If you happened to miss the headlines you can read about them on Sydney Morning Herald's Website. They have also uploaded a very powerful video interview with two women who's caesarean births went very wrong.

Awesome VBAC story

2008-01-28T08:42:00.001+11:00

I was reading my emails this morning and was sent a link to the site One True Media - which I wasn't aware off. It is similar to YouTube so I thought I'd check it out. The link was to a short video of Theresa's journey to a successful vaginal birth after three caesareans - it is one of the most powerful birth stories I've come across - so I thought I'd share it with you.

Make video montages at www.OneTrueMedia.com

The worst intervention in the birth room ...

2008-01-23T14:29:00.002+11:00

My recent experience working as a midwife in the hospital system has fastened my belief that the worse intervention in the birth room is the clock. When working with women in the community - there is no clock, there is no pressure and there is no unnecessary intervention. The events of labour unfold as nature intended. This is in stark contrast with birth in hospital. Every aspect of labour is MANAGED according to the clock. For example a women's membranes break the clock starts ticking. Often times she may be offered an induction of labour straight away or alternatively allowed 12 to 24 hours to establish labour or then have the induction of labour (and all it's associated problems).

A women's progress in labour is managed by the clock - the expected dilatation is 1cm per hour or her labour is considered abnormal and her labour sped up with Syntocinon. There is no quality evidence that supports a woman must dilate at a certain rate and in fact speeding up a labour unnecessary is quite harmful. Syntocinon causes the uterus to contract more painfully than a natural labour - increasing the use of pain medications (and their inherent effects). Syntocinon often causes too frequent contractions - depriving the baby of oxygen causing unnecessary fetal distress. One of the most catastrophic problems syntocinon causes in an increase in postpartum haemorrhage and the associated morbidity and occasionally mortality that a haemorrhage can cause.

While Syntocinon, in a few causes, will assist a woman to achieve a vaginal birth where her labour is truly prolonged. In most cases it is used unnecessary, causing a cascade of intervention.

Get rid of the clock in the birth room and allow women to labour under their own steam.

First Post for 2008

2008-01-21T17:10:00.001+11:00

I can't believe I've left it this long to add to my blog. I must say that it was exhausting organizing the screening of The Business of Being Born - there was more work than I'd anticipated. The feedback from the screening was very positive - I'd love to make the documentary more widely available. It looks like the DVD will be released in March 2008 - which is great news. I'll keep you posted.

Christmas was fantastic, I enjoyed time with my family doing Christmas activities (like taking my younger children into the city - they are seen in this photo riding Santa's train).

I continue to work at the local hospital in the birth unit. It is challenging as intervention rate is unnecessarily high. The system has lost sight of what normal birth is and complication rate is high. It is rewarding though as I feel like I make a difference and I have access to lots of education programs.

Parramatta screening of "The Business of Being Born"

2007-12-10T10:35:00.001+11:00

I am hosting a sneak preview screening of "The Business of Being Born" by Ricky Lake and Abby Epstein with Dr Alphia Possamai-Inesedy. It is a not to be missed opportunity.

Venue: University of Western Sydney, Parramatta. The evening commences at 7.00pm.

Doors open 30 minutes beforehand, please arrive at least 20 minutes early to avoid a last minute rush and interruption to the beginning of the movie.

Prior to the screening Jane Palmer and Alphia Possamai-Inesedy will present a short introduction. The movie (running time 85 minutes) will be followed by Question and Answer time.

A light supper is available after the movie.

Babies in arms are welcome. Children may find some parts of the film upsetting.

Tickets are available from me (Jane) by email jane@pregnancy.com.au or phoning 02 9873 1750. Tickets will be available at the door. Tickets $12 each.

Homebirth Conference

2007-11-15T12:15:00.002+11:00

This was the must have photo of the homebirth conference - to have your photo taken with the legendary Sheila Kitzinger was an opportunity too good to miss. Sheila is such a gracious woman and an inspiration. The very fist book I ever read on pregnancy and birth was written by Sheila. Also pictured in this photo is my friend and fellow independent midwife Robyn Dempsey (in the middle).

I had expected to write about the homebirth conference much sooner than this - but time has just gotten away (now that I'm working with women again and doing some casual shifts at the local hospital).

I must say I really enjoyed the conference. I just immersed myself in the atmosphere and listened to the speakers. It was fantastic networking and catching up with people I hadn't seen for ages. I have come away from the conference inspired. I have put together a slide show of the conference I've taken on my trusty digital camera - I hope you enjoy them.

Snapshots of the Homebirth Conference 2007

For me the highlight of the conference was the Gala Event and watching the documentary "The Business of Being Born". The only down side to the evening was some of the comments from the audience directed at Ricky Lake - they were inappropriate and I felt embarrassed (as did many people seated around me). It saddens me that homebirthers cannot join together in a united voice instead this dissenting one.

The Business of Being Born

2007-11-11T17:17:00.001+11:00

One week a go I met the wonderful Ricki Lake. Ricki was in Australia to present a preview of her new documentary "The Business of Being Born". I got to see it (along with over 450 other people) at the the Homebirth conference in Sydney before it's official release in the United States this coming January.

What an incredible documentary - showing both the reality of birth and the possibility of what it could be like. I found the documentary both wonderfully encouraging and very sad all at the same time. This is a must see documentary. It has been dubbed 'The Inconvenient Truth' of birth.

You can view a trailer of the documentary here at the The Business of Being Born website. I believe this documentary has the ability to get message out about the sad state of health care for birthing women. With the power of a celebrity behind it, The Business of Being Born is bound to get noticed.

If you are interested in seeing this wonderful documentary - stay posted as I am trying to organise a screening in Parramatta Sydney.

Promoting Midwifery

2007-11-11T07:03:00.001+11:00

Nic Edmondstone has produced this fantastic 30 second advertisement promoting midwifery called "Australian Women Deserve their own Midwife". The advertisement was entered into a completion and made finals. The advert has recently been uploaded to YouTube and is well worth watching.

Homebirth Australia Conference and Gala Film Night

2007-10-29T11:05:00.001+11:00

Just reading my emails when I found a press release for the Homebirth Australia Conference and Gala Film Night this coming weekend (3rd and 4th of November). It is going to be an exciting weekend and I am so looking forward to going. The Sun Herald in Sydney included a double page feature on the conference and Shelia Kitzinger (a well known childbirth activist and author). It is well worth a read - check out the "Cot Crusader Lashes Australia".

Here is Homebirth Australia's Press Release.

Homebirth Australia is launching it's HBA conference 2007, along with a gala showing of the new Ricki Lake and Abby Epstein film The Business Of Being Born, at their conference in November 3 & 4 2007 at Paddington Town Hall.

Australia's maternity system is a broken mess. Unlike the U.S we have a universal health care system, but within maternity that system is being rorted and private obstetric care is milking a huge amount of money from the public purse. Obstetricians have raised their fees (and the public purse has footed the bill) by 269% since 2004. Our c/s rate is higher than the US. Our national rate is 31%. We have had a considerable increase in post natal depression. Nationally less than 5% of Australian women can choose a midwife and have their care (like the homebirth model). Less than 5% of Australian women can choose warm water as pain relief. Many women in rural areas are giving birth on the side of the road. There is a cultural perception that mothering is not overly enjoyable and post natal support is essentially non existent. Maternity Coalition has been Australia's national consumer organisation since 1989. Justine Caines who is organising this conference was the National President for nearly 5 years. She has now formed a political party for Australian women - What Women Want (Australia) to raise childbirth choices as a major issue, for a new minor political party she is receiving great media coverage and interest. Ricki Lake and Abby Epstein will be coming to Australia just before a federal election, in support of these issues, with their film, The Business Of Being Born. The timing is perfect for this documentary in Australia and for Ricki Lake, like Justine Caines, has set out to make this 'political', along with a host of celebrities: Elle McPherson

"I enjoyed giving birth to my second son in a birth pool. My birthing room was warm and candlelit and I was lovingly supported by my birthing team. This made me feel emotionally safe as I birthed my baby gently. I would love Australian women to be able to enjoy water birth just as I did. I am surprised to hear that less than 5% of Australian women can choose warm water immersion for pain relief and for birth! I strongly recommend that the medical system in Australia give women the choice to be able to use a warm water pool during labour, for deep relaxation and for giving birth. I support Homebirth Australia's work to enable all Australian women to choose where and with whom they share the intimate experience of birth." Hugo Weaving and Katrina Greenwood "Giving birth at home was both relaxed and empowering. The close bond our son shares with his sister after witnessing and participating in her birth will last a lifetime." Bill Granger and Natalie Elliot "After one attempted home birth and two successful ones in our family, having children welcomed into your world in your own peaceful environment with no intervention in the natural process, nothing beats a home birth and the nurturing ongoing support of a dedicated midwife and that lasting relationship with them that comes from sharing such an intimate and momentous moment. And of course the food is better too!' Come and Support Us too!

If you are interested in the conference - you can check out the details on Homebirth Australia's website. Hope to see you there.

First Shift

2007-10-29T10:33:00.001+11:00

Yesterday I complete my first shift on the maternity ward. I certainly found it quite stressful. While the other midwives were supportive - I really was thrown in at the deep end to manage a variety of situations without being shown first. Lucky I can think on my feet and don't usually shy away from such challenges. It has proven to me one major thing - I've come a long way since I've worked as a midwife in a hospital situation. I'm in a totally different mind set. It is going to be difficult to continue with my holistic approach to midwifery care - while the hospital system is very task orientated, but I'm determined to do it. I must say though I had some delightful encounters with postnatal women and really felt I made a difference.

Launch of the "Pregnancy and Birth Group"

2007-10-25T14:46:00.001+10:00

Today I was the first get together of the "Pregnancy and Birth Group". It was a lovely group - small and friendly. We were privileged to have two fathers join the group (usually it's only women that are able to come) - two babies were less than 2 weeks old. We heard stories of hospital and homebirths, both the positive and negative was talked about. Stories enable us to compare experiences, review our own experiences and plan for future births. Stories also enable us to work through our own experiences, particularly if they were an unexpected outcome. I believe that sharing stories and experiences is so important for expectant and new parents. The support between everyone was just fantastic. It has spurred me on to advertise the group in the local community. The next topic planned is "Gentle Parenting" and it will be facilitated by Denise Love. Time 10am to 12noon. If interested please phone me on 9873 1750. The details for the rest of 2007:

Thursday	29^th November	*Gentle Parenting* Guest Speaker – Denise Love
Thursday	13^th December	*Open forum*

Birth Stories

2007-10-22T11:21:00.000+10:00

This Thursday, the 25th of October, I am holding a sharing session at my home in Dundas Valley (Sydney). The topic for this month is "Birth Stories". Come and talk with other people about birth and listen to their stories. This is an informal and supportive get together. Mothers, Fathers and Children are welcome. Bring a Plate of food to share. The time is 10 till 12 noon. If interested please phone me on 9873 1750. There is no cost. Other sharing sessions for 2007 include "gentle parenting" and "open forum". To download a handout with details of the sharing sessions for 2007 - click here.

Joyous Birth

2007-10-14T12:31:00.001+10:00

This photo captures the essence of this "Joyous Birth" - the emotion and the triumph. I was honoured to be present as a midwife and it was a wonderful first birth after coming back from having time off from Midwifery. The journey to birth often has its challenges and this birth was no different. Claire had moments of doubt of being able to "do this" and a fantastic long stage of peace and rest before the challenges of pushing out her newborn baby. For Claire the most important part was the circle of womanly support she had gathered to take with her on this miraculous journey.

If only midwives could see birth as it truly is - most never have the privilege of being present at such a birth. All midwives have their initial practical experience in the hospital system - which, on the most part, is quite medicalised. Time limits are placed on labour, birth is managed in a prescribed format and intervention rates are high. For example in 2005 the average caesarean rate for New South Wales was 28% (the range for different hospitals ranges from 15.8% for Bankstown-Lidcome to a high of 46.8% for Kareena Private in South Eastern Sydney).

Giving birth at home is a safe option - but is often see unfoundedly as being risky and only for hippies. However research across the word smashes these myths on homebirth - homebirth is safe with a skilled midwife and access to medical care should this become necessary. Of women seeking my care 80% gave birth in their chosen birth place. Of the other 20% - 6% gave birth vaginally and the remaining 14% had a caesarean birth. My clientele is not always low risk - as I believe all women benefit from having midwifery care. The type of women seeking a homebirth come from many and varied walks of life - and many are from the so called middle class.

Claire has given me permission to share this photos which gives you a glimpse into her wonderful journey and welcoming her new baby.

Homebirth Midwife works in a Tertiary Hosptial

2007-10-10T10:56:00.001+10:00

For the past nine years I've focused my midwifery on providing independent midwifery services for women and the families who primarily want to give birth at home. I love my work and believe passionately about the importance of the choice of birth place. For family reasons I am now only attending a limited number of births as an independent midwife and felt the need to network with the hospital system. The way I've chosen to do this is by working casually within a major teaching hospital.

I've just spent one shift in a birth unit and have found the medicalisation of birth has increased even more than when I was previously employed by a hospital. This saddens me no end. Research clearly shows that high intervention birth does not improve out comes in fact it increases the complications for mothers and babies. Within my own practice women birth under their own steam, in their own time with the people they choose to be with them. I would love this model to be available to women publicly - by that I mean free through Medicare.

I was talking to a hospital based midwife about the reasons for the extremely high intervention rates - her answer actually floored me. She said "its the women". Her logic was that they are apathetic and don't take response for the own health care. I didn't quite know how to respond to these comments (that is without responding rudely). But these comments have got me thinking - what is the best way I can influence women's experience giving birth and I think it is education. Not of the women, but of the midwives. This may be my path to take on this new journey.

After having a break for midwifery for the last 18 months - I've come back with renewed energy and passion. I am going to fight for better birth out comes and positive experiences for women and their families.

First Day

2007-10-05T16:48:00.001+10:00

Wow!!! what a week. Tuesday was a very emotional day. Traveling to Melbourne for Nanna's funeral was sad, happy and very tiring. Sad because I was saying good bye to a wonderful woman who had a powerful influence on my life. Happy because Nanna had a wonderful, happy and long life. Tiring simply because of the emotions of the day (and that it was a long day). It is also an ending. Nanna was the central person that kept our families (Aunts, Uncles and Cousins) together. This photo is of all the cousins and will quite possibly be the last photo of this type.

Wednesday and Thursday have been quite relaxing and I have enjoyed life getting back to some semblance of normality. I have attended prenatal visits with my clients and have made live my new website www.scraptastic.net.au This is my latest commercial endeavour which I'm sure I'll write more about soon.

Today has been a big day. It was my first day working on the ward as a Midwife within the hospital system. It has been challenging as it is a long time since I've worked in this way. I've been an independent midwife for over 8 years now. The hospital has a lot to offer in the way of education as a midwife and lots of support for staff. It also has lots of negatives - but nothing I can't work my way around. I hope to have a major influence both on the midwives I work with and the women and families I care for.

Celebration of Life

2007-10-01T09:30:00.001+10:00

It's been a difficult week - I got news on Monday that my Nanna (Violet Hurrey) was in a bad way. Her heart had been causing her problems for quite some time - but now it wasn't pumping blood very well to her legs and she was in a lot of pain. Nanna's time on earth was limited - my Mum was told it would be no more than a couple of weeks. At 93 I think it is cruel that the body should do this to her. I really wanted to be there for her - but was unable to get down to Melbourne. Thankfully my uncle was with her constantly - so at least I knew she was being loved and supported. Mum rang me Wednesday evening to say that they didn't think that Nanna would make it through the night. Mum was in Sydney and was unable to get a flight out that night - I felt really sad for her. Nanna was still with us on Thursday morning - so Mum managed to get a flight. Nanna's fight for life ended just after noon - while Mum was still on her way. Both my Auntie and Uncle were with Nanna and said that she died peacefully. I am sad for mum but Nanna stayed in her room so Mum could say good bye (Mum didn't arrive until around 4 pm).

I feel I should be happy that Nanna didn't suffer for long and that she had a wonderful and fulfilled life. But I will miss her terribly - Nanna was very important person in my life. She was always there for me, always made me feel very special. Nanna had a very kind heart and had a special gift with children. Today I am preparing to fly to Melbourne so that I can be at Nanna's funeral tomorrow to celebrate her very special life.

I've put together some recent photos I had of Nanna - to see the album visit my Flickr page

New Beginnings

2007-09-26T16:30:00.001+10:00

It's been a really big week. I've made a major step in accepting a job working as a midwife in the hospital system. I've worked as an independent midwife for over eight years now working with women giving birth at home, birth centre or occasionally hospitals. Working in this way you get the true sense of what it means to be a midwife. It's a partnership with woman and their families. The down side of working as an independent midwife is working in isolation and also trying to gain access to continuing education that's essential as a midwife is difficult to obtain.

At the hospital - so far I've only attended a two day orientation I start working at the end of next week. I'll keep you informed of how it goes.

Time to Blogg

2007-09-22T10:15:00.001+10:00

When I started this blog back in June - I had every intention of blogging regularly. Well as you can see that hasn't happened. My plan is to make my entries regular from now on. Life's great at the moment. I have decided that I need to go back to paid work. So I've started my midwifery practice again. You can find out more about this on my website www.pregnancy.com.au I am so excited - with the first birth as an independent midwife I'll be attending due in around 2 weeks or so. I've also decided to go back to working in a hospital on a casual basis. This way I'll touch base with different health professionals, have access to the education available in such a facility, have a positive impact on women access public maternity care and also hopefully enact some change with my fellow midwives. I'm really excited at the possibility of being involved in change within the health system.

I'm also working on another business idea selling Craft Robo machines - but more on this later. As I'd said life's good and excited about the future.

Welcome to my Blogg

2007-06-30T14:05:00.002+10:00

Have enjoyed reading lots peoples different blogs, so thought it was time that I started my own blog. I've had a interesting year. Back in February I sold my business Aussie Scrapbooking Studio - that I spent three years building. It was both as sad and happy occasion. Sad as Aussie Scrapbooking Studio was my baby, but happy as it is now time to move on. I've had a lovely time spending time fixing up my house (that was quite neglected) and spending time with my children.

I am now considering my future. I am a midwife by profession and I am keen to start practicing midwifery again. I am currently working on my website www.pregnancy.com.au and planning the different services I am going to offer. I have practiced in the past as an independent midwife attending births at home, hospital and birth centres. More on this later. Well that's it from me at the moment my children are getting a little physical with each other in their play - better go and do some negotiating.

Thursday	29th October 2009	Natural choices for pregnancy and birth
Thursday	26th November 2009	Ideas for Toddlers & Christmas Celebrations
Thursday	21st January 2010	Pregnancy Testing
Thursday	18th February 2010	Unexpected outcomes
Thursday	18th March 2010	Vaccination
Thursday	22nd April 2010	Birth Stories
Thursday	20th May 2010	Pregnancy Experiences
Thursday	17th June 2010	Waterbirth
Thursday	22nd July 2010	Returning to Paid Employment and childcare
Thursday	19th August 2010	Pregnancy and Parenting for older mothers
Thursday	16th September2010	Introducing solids, nutrition, food additives and food intolerances
Thursday	14th October 2010	Open Forum
Thursday	11th November 2010	Birth Techniques
Thursday	9th December 2010	Childhood Development, play, preschool and school options & Christmas Celebrations