Honourable Sandra Kanck MLC
Deputy Parliamentary Leader
SA Democrats
Dear Sandra,
further to your International Midwives Day speech "Restoring Midwifery's
Voice" in which you so wonderfully highlighted in the SA Parliament the many
issues that currently face midwifery in Australia today, I would like to draw
your attention again to further attempts to silence the midwifery voice.
Due to a recent decision by Guild Insurance, the collective insurer for
Midwives in Private Practice (MIPP) here in Australia not to renew
professional indemnity insurance for MIPP, MIPP are currently having to close
their practices. In Canberra, one of the midwives effected by this decision,
her policy has now run out and she has been forced to tell 12 of her pregnant
clients that they must make alternative arrangements and cease practice.
Another's policy runs out in September and another 80 or so midwives across
Australia will face the same difficult decision as their policies run out
during the year.
This decision to withdraw insurance from MIPP is a huge lack of recognition
and respect for midwifery as an autonomous profession, which has far reaching
implications for ALL women and midwives - not just the MIPP and the homebirth
community.
The homebirth movement here in Australia is still considered a radical,
questioning and an independent movement outside of medical control and its
always been a thorn in the obstetric side and subject to a great deal of
attention, scrutiny and anticompetitive behaviour. Historically we know that
many of the improvements in maternity care have been born from the homebirth
movement. So to dismiss this issue or to shrug it off as something that only
affects homebirth midwives and their clients is a HUGE mistake.
Homebirth needs to exist for the benefit of ALL, not just the few that choose
it, because out of this movement we have another model by which to compare
the obstetric model, and measures by which to demand greater accountability
from medical men and their machines and evidence for continued improvements
for mainstream maternity care. Once you recognise this it becomes apparent
that the withdrawal of professional indemnity insurance from MIPP is just the
tip of the iceberg and actually represents the largest assault on the
autonomy of midwifery this country has seen and THIS THEN AFFECTS ALL
MIDWIVES AND ALL WOMEN - NOT JUST THE HOMEBIRTH COMMUNITY.
THIS IS A NATIONAL ISSUE. It means that women will no longer be able to
choose to engage a midwife privately to provide care for their pregnancy
and births unless they choose a practitioner who is uninsured (which is not
in anyone's interest, midwife or consumer). Moreover, the decision by
insurers denying/refusing to insure MIPP, is to effectively, slam the door
shut on midwifery as an autonomous profession in this country, relegating
midwifery to be forever controlled by the medical fraternity. This has ripple
effects into EVERY other facet of midwifery practice. It will eventually
effect EVERY MIDWIFE in her capacity to work as a midwife 'with woman' as it
effectively undermines EVERY midwife's status and claim to autonomous
practice as the health care professional that she is, irrespective of where
she provides midwifery care. Further more, while the majority of midwives may
work in hospitals and have their liability underwritten by state governments,
many midwives also choose to have PI outside of this as well - independent of
their employers interests!
The World Health Organisation (WHO) in a statement on care in normal birth
(WHO Geneva 1999) states that "the midwife appears to be the most appropriate
and cost effective type of health care provider to be assigned to the care of
normal pregnancy and normal birth, including risk assessment and the
recognition of complications."
This country has seen a plethora of government reports, State Ministerial
reviews and Senate enquires into maternity services, which have all confirmed
this statement by the WHO and which all called for further expansions of the
midwifery profession's involvement in the provision of maternity care as lead
care providers for the majority of pregnant and birthing women. The decision
by Guild to withdraw professional indemnity insurance from MIPP effectively
wipes out further development of midwifery models of care which further
restricts women in their choice of birth place and caregiver. So to argue
that this is an issue that just effects 80 midwives and the 1% of women who
choose to birth at home in this country is just ridiculous and will surely
then see the demise of midwifery as we know it in this country.
Adjunct to this issue, powerful people and their institutions keep getting
away with slandering midwives and their profession without calls to put up or
shut up. Just recently in a report on this issue in the Sydney Morning
Herald, (Sat July 7 2001) Mr David Brown, General Manager of Guild Insurance
publicly stated that midwifery is "a highly litigious area", offering no
evidence of proof for such statements. Mr. Brown should be made account for
his words or suffer the consequences of defaming of the midwifery profession.
AMA president Karen Phelps hits the Federal Health Minister Michael Woolridge
with a threat of legal action after he questions her qualifications to
practice medicine and its front page news in every newspaper and TV channel
in this country, right down to their menu and dessert choices at their even
more publicly viewed reconciliatory luncheon !!!! Mr Brown publicly defames
the whole of the Australian midwifery profession and no one gives it a second
thought !!
This issue needs to be brought to the forefront of public awareness and be
dealt with once and for all. We require your assistance and those of your
team at the Australian Democrats to do this. We need someone to listen and to
cotton on to the great conspiracy that is denying Australian women and their
families the right to choose for themselves how, where and with whom they
birth their children.
Yours in birth,
Tina Pettigrew
Birthworks
Independent CBE and aspiring Bachelor of Midwifery Midwife.
Convenor, Australian Bachelor of Midwifery Student Collective.
Tel: 0402677351
" As we trust the flowers to open to new life
- So we can trust birth"
Harriette Hartigan.
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