Home birth within the NHS works well in the UK and in New Zealand with guidelines for practice that are in place to protect the Consumer and the Midwife providing services. This is an opportunity for Consumers and Midwives to access an alternative to the Birthing optuions available in Australia now, making informed decisions about their Birth choices .It should be embraced as a step forward in the right direction and a platform to develop an evidence based Midwifery service in Australia which includes choice of Home Birth, Domicillary Birth and Hospital Birth. Providing support for Comsumers and Midwives, negativity has no place here, it should be seen as a really positive option for women in NSW and would be welcomed here in QLD. Anne. ----- Original Message ----- From: "Jo Bourne" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, November 29, 2003 2:18 PM Subject: Re: [ozmidwifery] New models of midwifery care
> speaking as a consumer I would definitely view a public hospital run homebirth service as a second choice to a private midwife that I chose for myself - partly because of the choosing the best personality for our family an partly because I would be very frightened of the hospital controlled service having far more rigid and beurocratic rules and regulations about when OB care was required during pregnancy or when transfer was required during labour. I would most likely spend the whole pregnancy worried about the day that my assigned midwife said "well an OB has reviewed your notes and says you have to birth in hospital" (for some reason that I don't agree with). I was very fearful (at least at the start) of my first pregnancy that I would be forced into labour ward for a reason I didn't agree with but was able to tell myself "they can make me use the labour ward - they can't make me use the bed/drugs/whatever, its all the same floor of the building and same staff so I just w! > on't let it bother me". I would find it much harder to think soothing thoughts about being denied a homebirth at the last minute... I realise that the risk of being denied a homebirth might be much less than I think but intellectual knowledge is somewhat separate from the intense *feeling* of anxiety about my midwife not being her own boss and able to use entirely her own judgement about appropriate care in my circumstances rather than a very rigid rule book. > > We don't know if we will be able to afford a private midwife in NSW if we get pregnant here. We very much want a homebirth and are very near RHW so I hope this service gets off the ground as we may need to use it - but I do feel anxious about it as I didn't get the best impression of the hospital/birth centre there when we did a tour. RHW seemed very hospital rule oriented rather than woman centred. I came away with a sense of inflexibility so I feel anxious that the same hospital will be running the homebirth service... For example StGeorge seem to have a far more flexible approach to postdates and breech presentation than RHW. I would not be impressed to be forced to birth in hospital after 41 weeks or some other arbitary date set by the hospital managing the homebirth service. I would want to at least discus breech birth at home with my midwife and I know many IPMs would be open to this, I feel certain a service run from RHW would not only force a hospital birth but would! > be trying to force a ceaser. > > cheers > Jo > > At 12:02 -0800 29/11/03, Marilyn Kleidon wrote: > >Dierdre, Jo, Justine: > > > >Coming from another state I am a little confused by a few things: > > > >When would women who are having a planned home birth within these models of > >midwifery care have to go to the hospital? Do they have to attend an > >antenatal clinic at the hospital? If so how often? > > > >Why do you consider this model of care obstetrics based rather than > >midwifery/woman centred care? > > > >Also, why would you consider having a high transfer rate (hypothetically) > >from home to hospital birth being a reason for government funders to knock > >back NMAP? Surely cost could not be the answer. Internationally and > >historically homebirthing actually gets into trouble when the transfer rate > >is too low. Having trained in a homebirth midwifery school the mantra of our > >senior preceptors to new grads was "better too many transfers than too few". > >These were very wise words from wise women. The evidence does not say that > >homebirth is safer than hospital birth it simply says it is as safe as > >hospital birth for low risk, healthy women (all under the caveat of care > >with a known midwife). > > > >marilyn > > > > > >----- Original Message ----- > >From: "jo hunter" <[EMAIL PROTECTED]> > >To: <[EMAIL PROTECTED]> > >Sent: Friday, November 28, 2003 5:25 AM > >Subject: Re: [ozmidwifery] New models of midwifery care > > > > > >> I have to agree Deirdre. One of the huge advantages of homebirth with an > >> independent midwife is that the woman has chosen and employed this > > > particular midwife as her caregiver. The midwife is a guest in the woman's > >> home and is being paid directly from the woman, which in turn places the > >> woman much more in control of what occurs during her birth. > >> Whilst I think it is wonderful that these homebirth models are in the > >> pipeline and it opens the homebirth option up to many more women, it does > >> concern me, as women shouldn't need to go to hospital (ever during > >> pregnancy) to have a homebirth. > >> The midwives who will be working in the model may have little experience > >of > >> the unique work of a homebirth midwife and I worry that there will be a > >huge > >> transfer rate the minute something appears slightly out of the ordinary > >and > >> when we lobby Govts some more for the NMAP, they'll look at the stats of > >the > >> hospital run homebirth service and say no way, look at their transfer > >rate. > >> It doesn't mean this is necessarily going to happen, however it is food > >for > >> thought. > >> Deirdre, if their is a hospital run homebirth service I know for a fact > >that > >> the majority of (current) homebirthers in NSW will still want to employ an > >> independent midwife, regardless of the cost, to be with them during labour > >> and birth because many believe that they don't want it attached to a > >> hospital system and certainly don't want their births overseen by > >> Obstetricians. As well as those women who are seen as 'high risk' - VBAC, > >> breech etc I assume they wouldn't be permitted to birth at home through a > >> hospital run homebirth service. > >> I believe there needs to be strong consumer input to any model that is set > >> up - lets listen to the women and find out what it is that they want. > >> Jo Hunter > >> > >> ----- Original Message ----- > >> From: "Dierdre Bowman" <[EMAIL PROTECTED]> > >> To: <[EMAIL PROTECTED]> > >> Sent: Tuesday, January 01, 2002 5:02 AM > >> Subject: Re: [ozmidwifery] New models of midwifery care > >> > >> > >> > While I think that it is TERRIFIC that homebirth will finally be offered > >> as > >> > a choice. I think that the way midwives are compensated for this work is > >> > important to look at. The system in NZ is somewhat dodgy where payment > >is > >> > concerned. I would like to see funds made directly available to parent > >so > >> > that they may choose and fund their own midwife, not one assigned to > >them > >> or > >> > where couples only have the choice of recieving paid homebirth if they > >> > choose the few midwives set up through these schemes. This has the > >> > potential to damage the livelihood of midwives currently working > >> > independently of the system. > >> > > >> > Any thoughts???????? > >> > > >> > Dierdre B. > >> > > >> > -- > >> > This mailing list is sponsored by ACE Graphics. > >> > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > >> > >> > >> -- > >> This mailing list is sponsored by ACE Graphics. > >> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > >> > > > > > >-- > >This mailing list is sponsored by ACE Graphics. > >Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > -- > Jo Bourne > Virtual Artists Pty Ltd > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
