----- Original Message -----
Sent: Saturday, November 29, 2003 8:17
AM
Subject: Re: [ozmidwifery] New models of
midwifery care
Dear All
I encourage all to have their say particuarly
consumers with previous homebirth expereince.
I concur with Sally and would add that I also am
sad we are following a model from overseas when we have a unique Australian
Model - a community based program established by midwives and consumers with
the backing of doctors also but ones who understand that most women can manage
fine on their own but more safely with a midwife they know and they have
accepted.
The English environment of birth is not that of
Australia those who have worked there know that most of the doctors there also
know and accept that women can birth fine with a midwife and they do not want
to interfere or come till the midwife says!!
Many of those UK obs who do not like the UK
system and want to deliver normal women come here!!
In my expereince
it is they and their colleagues who run our hospitals and our medical
services.
I understand Justine's fears having been in the
offices of politicians across the country and having seen so many services
withdrawn/restricted thru the pressures of 'others' when the outcomes are
fine and the midwives and women are happy!!
If we settle for less than NMAP or replication of
CMP will Australian women be expected to ask for nothing else!!
Some of the things I think consumers and
midwives contemplating support of this service need to ask is how many of
the women in this system will be 'allowed" to opt out of so many tests that I
found were routine in NSW that few of the homebirth couples I have known
refuse; eg;
12 or 20 week ultra sounds
GTT
GpB strep testing
genetic testing if an "eldery" primip or
multip
How long will they be allowed to stay home with
ruptured membranes?
How long past 40 weeks will they be allowed
??
Births with no VE with labours of 8 or more
hours??
Vitamin K
What of the Hep B & other immunisations??
When they refuse the giudelines will their
midwives be withdrawn ?
This is not the UK no health service is obliged to
provide a midwife for a woman who refuses to come to hospital?
And what of
the midwife who wants to support a woman who does not want to follow
giudelines??
CMP is the subject & desire of
NMAP.
CMP has better outcomes than
Albany,
CMP is run by women and
midwives,
in our culture of birth interventions &
domination with no other options I feel we can ill afford to settle for
less as a first option?
Denise Hynd
----- Original Message -----
Sent: Saturday, November 29, 2003 6:48
PM
Subject: RE: [ozmidwifery] New models
of midwifery care
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
