Visit to Alex Hawke

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

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

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

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

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'

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

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