At 18:48 +0800 29/11/03, Sally Westbury wrote: >Dear Andrea, (Jo and Justine) > > >To begin I am really concerned as a midwife and as a homebirth mother at the tone of >this letter and feel I want to respond to some comments that have been made. > >It is really important that these questions are asked in order to have thought >through as many possibilities as we are able, to end with the best solution. I >welcome and encourage all of us to think about this move to hospital based homebirth. >With this in mind I would like to raise my own personal perspective and concerns. > >Why are we modelling a service based on a UK model when we have a model that works >here in Western Australia?? (I would be greatly distressed if our services homebirth >rate was 43% I do acknowledge that given their high risk setting this may be adequate >but the women that will be using this service will be screened as low risk.)The >Community Midwifery Program has a homebirth rate of 72%!! Why is no-one looking to >our own home grown homebirth service? > >To hear that a hospital based caseload midwife is no different from an independent >midwife is a surprise to me. There great differences about an independent midwife who >employed by a women and a hospital based midwife who is employed by a hospital. The >greatest difference is who we work for. > >Surely a safe midwifery practice has it own guidelines for consultation and transfer? >The possibility that this service is being set up to be guided/supervied by >obstetrics is of great concern? (We have seen how this fails in birth centres that >have high transfer rate in a medical climate that seems to wish our great birth >centres to fail) Why not midwifery guidelines? A midwife should have midwifery >guidelines. These do not automatically agree with obstetric guideline but does not >mean that she is taking risks with the women's health! For example some midwives >support VBAC at home.. this does not agree with obstetric guidelines but does not put >a woman's health at risk or risk the midwives legal safety!! > >' > >The big advantage of the hospital based home birth service is that it will > >be free. Women who cannpt afford a private practitioner will not be > >excluded from having a home birth as happens now. THe people involved in > >setting up this service have vast experience of home birth in the UK and > >elsehwere and are dedicated to providing the best woman-centreds care they > >can. They wouldn't want anything else! > >We need this propject to go ahead, and quickly. At the moment we have no > >homebirth service that provides safety for the woman in terms of insurance > >and this is a worry for both women and their midwives. Let's all support > >this model rather than be trying to pick holes in it before the facts are > >known and it has even had a chance to be tried and tested! There are some > >very dedicated midwives out there who are trying to create the best birth > >options for women and they need out support " > >I would like to point out that 'we' do have a free homebirth service that is >community based, supported by state and federal funding and fully insured. We do have >in now in Western Australia. > >Why are we not looking to our own. We have a model that has been tried and tested in >Australia. Why are 'we' not looking to our own for information and support. > >The Community Midwifery Program has worked long and hard to maintain autonomous >practice whilst working within agreed guidelines to provide free homebirth services. > >What political campaign is happening that we may end up with a hospital based >homebirth service instigated by imported experts, supervised by obstrtic experts >rather than the community based model established by local activist and midwives >which is driven by midwifery models of best practice and women's needs. > >So there it is� my personal perspective. > >I am supportive of government funding of homebirth but not at any cost. > >Sally Westbury > >Homebirth Mother/Activist since 1984 > >Homebirth Midwive since 1992
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