Sunday, June 27, 2010

A year in review

A year ago I wrote in this blog: "We (the community of independent midwives and homebirth parents) are all wondering what will happen to homebirth after July next year."

I encouraged my small group of readers to write submissions to inquiries, to attend rallies, to contact the radio stations .... 

I argued that the legislation which mandated something that was not possible to access (professional indemnity insurance) in order for a midwife to practise "denies a woman’s natural law right to give birth under natural physiological conditions, in the place of her choosing."

Now, with only a few days remaining before the new legislation comes into force, I am content that the time-honoured profession of the midwife attending a woman in her own home will continue. 

I am not suggesting that the government has managed maternity reform well.  They have not.  Concessions have been made in response to the unprecedented outcry by the small but resillient group of homebirth parents and the midwives who attend them, as well as other fair-minded supporters. Midwives attending homebirth have been given a temporary (2-year) exemption from the insurance requirement. This awkward exemption may in fact protect lives, by averting the alternative, of driving homebirth underground or into the hands of unregulated birth attendants.

I am not suggesting that the government will manage maternity reform better, now that Australia has our first female PM.  Julia Gillard was Opposition Health spokesperson a few years ago, and made all sorts of positive gestures to birth activists and midwives in the lead up to the election.  Julia Gillard appeared to be listening to reason; appeared to be impressed by evidence supporting the safety and importance of enabling women to make their own decisions about childbirth, in a partnership with a known and trusted midwife who provides primary care throughout the pregnancy-birth-newborn care periods.  Once Ms Gillard became deputy to the PM, the spirit of working together with women for better birthing was quickly forgotten.

Many midwives are not satisfied with the way things are. The cost of indemnity insurance that will meet the requirements of the national registration law is between about $2000 and $7,500. (see the MiPP blog for detail) A midwife whose private practice brings in less than $10,000 annually is required to have insurance, the same as the midwife who is earning $80,000 annually. The cost of insurance will either be passed on to the client, or some midwives will cease private practice because they can't afford to continue.

There have been some positives as well as many negatives in this past year of preparation for our brave new world.

On the positive side of the ledger,
  • I have seen some independent midwives take action to lobby government agencies.  One particular midwife comes to mind; I won't name her.  She has made an exceptional contribution from which all private midwives stand to benefit.  She has brought together professional and political interests at great personal cost.  Many readers will know to whom I refer, and I thank her.
  • I have seen midwives who had no experience in homebirth declare their intention to move into private caseload practice, and learn homebirthing
  • I have seen people in the community - childbearing women as well as men and older folks - willing to reflect and discuss the importance of what happens when a baby is being born.

I will not list off negatives, but I have observed members of the midwifery profession acting as people under threat, and being ready to verbally attack others whose opinions differ from their own. I am looking forward to a period of healing within the midwifery profession.

Note: Part 2 of this review is at the Private Midwifery Services blog

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