Monday 6 September. What a day!
This Senate Inquiry is quite astonishing! Senator Rosemary Crowley as
Chair, and Senators Brenda Gibbs and Tsebin Tchen are actually listening to
people like you and me, and reading our submissions and asking probing
questions.
I would like to quickly summarise the Inquiry in Melbourne, as I know many
of you cyber partners are keen to hear about it, and to be well prepared for
the hearing in your town.
Firstly, the hearings are open to the public. Anyone who is able to attend
will be using their time well, whether or not you have been asked to apear
before the committee. If you don't know when the hearing will be in your
town, I'm sure there will be messages on this list. There is a mobile phone
number for the committee: 0416 277 031
Transcripts of the evidence taken at hearings are available on the internet
at http://www.aph.gov.au/hansard
The report will be available in mid December at
http://www.aph.gov.au/senate/committee/clac_ctte/index.htm
I won't try to re-state what was said, as all the submissions are going to
be available to the public, and are worth reading.
Dr Jane Fisher was first to appear. Jane's Doctoral work on psychosocial
aspects of maternity care, ( incl well women and intervention) is
exceptional (imho).
Julie Collette and I represented the ACMI Vic Branch. Our 2 recommendations
are that a major reform of maternity funding be undertaken, and that
statistical information on childbirth practices &c be available to the
public. The committee was particularly interested in the changes in
maternity care in New Zealand. A recent report, Maternity Care Provider and
Outcomes, NZCOM 1998, in which the perinatal mortality rate for births under
a midwife lead maternity carer was 3.6/1000, compared with 11.5/1000 for
GP/midwife shared, and 14.9/1000 for O&G/Midwife shared, was given a lot of
attention. The chair also highlighted an anecdote which we quoted, of a
midwife who was threatened with loss of employment when she drew attention
to high rates of induction in her hospital.
The Royal District Nursing Service focused on postnatal issues, and
particularly early discharge programs.
The Victorian Health Services Commissioner, Beth Wilson, spoke of the
complaints which are received at her office. These were both complaints
about what the consumer considered unnecessary intervention, as well as
delay when intervention was considered necessary.
The Maternity Coalition was represented by Rhea Dempsey, Laura Delaney,
Annie Sprague, and Kerreen Reiger. Arguments for midwife led maternity
care, funding that allows the woman control in choosing care provider, and
hospital visiting access for midwives were supported. The committee seemed
particularly impressed with Laura's account of her experiences.
The Royal Women's Hospital had a panel of doctors, midwives, and
administration to answer the committee's questions. Questions about the
woman's 'right' to caesarean on demand, 'best practice', informed consent,
and the use of public health funding for elective surgery were very direct.
The point had been made earlier (by Jane Fisher I think) that a woman who
wants 'intervention' is far more likely to get what she wants than a woman
who makes it clear that she does not want 'intervention'. This was further
explored. A report from the UK was cited, stating that of the female GPs
surveyed, 80% said they would have elective caesarean birth. The comment by
the doctor (a neonatologist) who quoted this study that these women were
well informed about birth should have been challenged. I would say they had
seen enough of medically managed birth to be scared stiff! Senator Crowley
asked a very direct question about why the hospital will not allow a midwife
to have visiting access to provide midwifery care for private clients. The
response was that the hospital does not have a policy on this, and on the
grounds of the response I think it is timely for any midwife in private
practice to re-submit a request to be granted visiting access, and send a
copy to the Senate Inquiry into Childbirth Practices.
I was not able to stay for the final presentation, which was by the
obstetricians - RANZCOG and NASOG. I have a copy of the written submission,
which states that "The College supports the principles of choice, access and
equity in all childbirth practices."
I would advise anyone who has the opportunity to appear before the committee
to go well prepared, to have figures in front of you, and to table any
additional information that supports your submission. If anyone has extra
material that they would like to submit there is still time. Any
confidential submissions can be handed directly to the secretary, and will
not appear on the Hansard, but will be taken into account by the committee.
I was privileged to attend a birth at home early thismorning, prior to
attending the hearing. The changes we seek are really worth pursuing.
Let's all work together, and use every opportunity to ensure that women of
future generations are able to give birth with a known midwife, in the place
of the woman's choice, with respect and joyful intimacy.
Joy Johnston
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