As far as I know no one is saying Women cannot have ahome birth. Surely the author belives in small government, The Gov should give basic care ie Hospital birth, and if you want something different the go for it but you pay for it. I don't see what the issue is.

I agree Kenny,

Too often proponents of home birthing argue that the government is trying to prevent, or make illegal home birthing. This is not true, and the author attempt to argue this by attacking everything from hospital equipment "needles and gas, probes and clips through to forceps, extractors" to government spending. Hidden away in this argument is the true facts - "extending indemnity cover to include community midwifery will come at a cost."

If mothers choose to give birth at home, as they are freely allowed to, then the financial risk involved (insurance) should be on the patient, not the taxpayers.

The essential question is whether home birthing is regarded as a legitimate form of medical or health practice. If so, then there can be no rational reason why it should not have a Medicare number i.e. a basic fee paid by government. Personally I fail to see why a low risk mother, especially if not a primip, and where there is good, fast, ambulance access to dedicated hospital beds, should not be regarded as legitimate when carried out by a qualifed midwife under specified circumstances. I do not share Andrew Laming's rather touching belief that the shock troops of the opposition are not specialist obstetricians. The real problem however lies not in Medicare paying for the delivery but with the the cost of private indemnity which, for obstetrical practice, would be prohibitive for midwives. The only possible solution would be for the Government to assume the role of insurer...this would be a major new initiative and one that I would think politically unacceptable to taxpayers.

I agree Gorufus, the issue at hand is more a financial constraint rather than anyone telling women where they can or cannot give birth.

The problem as I see it is that the cost to insure home-birthing midwives who are practicing on their own, in the home of the pregnant woman, would be astronomical.

The home-birthing midwives are the sole person responsible for running a safe birth for that mother and baby. If anything goes wrong, and we all know that births are not always routine, then the midwife does not have the financial backing of hospitals or the health department that hospital based midwives have.

The government is never going to agree to financially back that kind of risk. Like people who want to try IVF, or have non essential plastic surgery etc, the potential home-birth mother should be prepared to pay for this extra insurance expence if they choose this birth method.

Most big hospitals now have good birthing suites that provide as close to the home-birth experience as possible, while still having medical help close by.

Australia is not as small in distances as New Zealand or England, where home-birthing is more common. The homes in those countries are much closer to hospitals and ambulance services should anything go wrong with the birth.

The medicare system is there to ensure that citizens get good safe treatment.

Home births require a dedicated nurse to travel, and not be available to anyone else, and require the back up of the ambulance service.

Home birthing is thus more expensive for no health benefits, and so I can understand why the funding has been withdrawn.

I'm shaking my head at these comments - what a load of twaddle! I wonder if any of those who have sent comments have ever come within cooee of a professionally attended homebirth? I have been to a homebirth (safe, beautiful, 'uneventful') in Melbourne early thismorning, and find this airing of ignorance almost amusing.

There is absolutely no basis for arguing that homebirth is less safe, more expensive, or wasteful of scarce resources than any other birth option. If you want to make life more safe you had better ban birth alltogether. The safest way for most women to proceed with birth is to labour spontaneously, without drugs to take away pain or to stimulate labour.

Andrew Laming, I appreciate your clear statements supporting homebirth, but your argument that excluding homebirth is about government overspending doesn't impress me. The risk profile of homebirth is extremely low. Homebirth numbers, and potential costs, are a mere drop in the government's maternity bucket. Supporting homebirth will not increase birth numbers.

But you are right saying that 'bad policy in 2 years is still bad policy'.

One point that is overlooked is that indemnity insurance has nothing to do with safety or even with compensation for those who are harmed as a result of health care.