This might also be a problem for women who did what I did. I took my homebirth midwife into to hospital with me, along with my homebirth doctor for two my children's births. I wasn't a ideal candidate for a home birth and the third option meant that I had people I knew, who shared the same philosophy about child birth attend me, while being in hospital.

Penalising the home birth midwives in this way, might mean the women who want this third option will also miss out.

While the author is stating that the new legislation makes home birthing illegal, that is not the case. What is happenning is that the mid wife's right to access insurance and indemnity is being withdrawn.

If the patient is prepared to sign an indemnification for the midwife, this insurance is no longer required, and the home birth can go ahead.

Insurance and indemnification is for when things go wrong. And while the literature indicates that home births are just as safe for 90% of births, it can also be said that for difficult births it is not.

If there are complications at home, there are no facilities to handle it and the outcome is often much worse.

Car insurance is invalid if you break the road rules, because you have deliberately increased the chances of a negative outcome.

I am sure some insurance company will provide the requisite insurance for a premium.

Personally, I am amazed by this debate over rights to homebirth etc.. We hear so much about the rights of the mother to a wonderful birthing moment but so little about the children that must live with the consequences of the birthing moment for the rest of their lives. What must be held at all times paramount is the future health of the child. The mother's experience during her hours in labour is, in reality, trivial in comparison to this. My wife is an obstetrics registrar and has a medical degree from Europe. She will tell you that the difference between homebirth in the Netherlands and homebirth here is that, in the Netherlands, you are never more than 10 minutes away from a hospital.

Even apparently normal births can go wrong and can give problems that midwives working in homes are simply not trained and/or equipped to handle. The risk may be small for many but the consequences for the child (and the mother) can be devastating. Women - don't prioritise the value of your birthing moment above the health of your child. It is incredibly selfish to do so!

Childbirth was a very dangerous time for Women for most of our history. Modern health care hospital births is what has made this risky event far less risky, the mentality that drives people to home birth, seems to me as the same one that drives some people views on vaccines. I'm sorry but I think Midwives should be given the protection and status they deserved. I don't see why we the public should pay for risky choices by fringe groups. The author has not augured her case very well; in a democracy minority views should be heard but not always acted on.

"Dr Hilary Joyce, the new president of the National Association of Specialist Obstetricians and Gynaecologists, dismissed the significance of this ban"

and later...

"Such a paternalistic provision,"

Look on the bright side. You girls have evidently reached equality with us men. Evidently we can both be paternalistic.

The original article states

"that for uncomplicated pregnancies, home births carried out with proper support are just as safe as hospital births."

The problem with this is that you do not find out until it is too late that there are complications.

What is the point of having a homebirth midwife at a hospital?

It is societies responsibility to protect women and their children from dangerous irrational practices. THE PRACTICE SHOULD BE BANNED.

Hospitals are dangerous places full stop! I wish I'd stop hearing about friends who have contracted nasty infections after being admitted, the last one near fatally. Of course there are risks with childbirth, and as previously stated, I wasn't the ideal candidate for a homebirth, so came up with a third solution.

The hospitals when I was having my children seemed to recognise that there is a risk of being in hospital, and discharged healthy Mums and bubs with support from a visiting nurse pretty quick smart.

For healthy women with no evidence of complications, and in reach of hospital assistance in case of problems, and a readiness to seek that assistance early, home may be best. A relaxed and calm place with a experienced midwife, surely can help the birth on. I recently read a peice by a English doctor who wanted to ban Dad's from the birth saying it inhibited the mother giving birth. Seems that control is the order of the day.

Monica,

Excellent article. Just know that most commenters on this site (and all sites?) are cynical instant experts with nothing better to do than dump their anger on easy targets. This seems to be true no matter what the topic or opinion.

So don't take their negativity too seriously.

Just to elaborate further on what Shadow Minister has stated, indemnity insurance is not being withdrawn from home birthing midwives, it's just that they will be required to pay for their own indemnity insurance, the same as any other health professional is currently required to do when in private practice.

If a health professional is employed by a public hospital, then the hospital pays their indemnity insurance premium. If they work in private practice, then they must pay their own insurance premium, based on the risk associated with the field that they work, and their estimated income generated from their practice.

I don't think that midwives specialising in home birthing are to be outlawed, it's just that these private midwives will be required to pay their own insurance, and rightly so.

When any health professional performs a procedure that has inherent risks (eg. home birthing), they can be legally responsible for any adverse outcome where they may be judged to be negligent. I think that home birthing midwives have been out of the legal firing line until now, so they will need to implement risk management policies and will probably think twice about taking on some cases. Surely this is a good thing for the safety and welfare of women?

'Excellent article. Just know that most commenters on this site (and all sites?) are cynical instant experts with nothing better to do than dump their anger on easy targets. This seems to be true no matter what the topic or opinion.'

.....

.....

I think he's nailed it! Too true!

Let's face it, men really shouldn't even be able to talk about giving birth let alone being there. It's secret women's business. I think male doctors who are obstetricians are part of a secret misogynist conspiracy to take away women's maternal power. They fear the life giving power of women, and get cheap thrills out of examining their private parts too.

They don't understand or appreciate the pain of giving birth, so they should be arrested if they even discuss the topic. They have NO RIGHT to any opinion whatsoever!

It's even debatable whether men should have any involvement in childrens lives at all. They're all potential paedos!

There is nothing to stop a mother giving birth to a child at home.
All that happens is that if the birth goes wrong and the baby is injured there is no insurance to help support the injured baby.
There must be some reason why insurance companies think that there is a high risk to home birthing if they don't provide indemnity insurance to midwives.
All those actuaries can't be wrong.

Once again its all about the 'woman's rights". Has anyone thought about the rights of the child to a safe passage to this planet. Oh that's right all that matters is me.

I'll leave the insurance aspect of this alone as I'm not in a position to comment.

If there is a substantiated increased risk (and significant enough to matter )to the child associated with being born in the home then the parents rights should have little bearing. If that risk is not clearly demonstrated then it's not the business of outsiders to determine where the child is born.

Perhaps proximity to a hospital should be a valid factor in individual decisions, involvment in any relevant pre-birth checks which might help to determine the associated risk in those cases.

My gut feel is that the impact on the mothers emotional state of having the birth in a location where they were comfortable would bring some benefits to all during the lead up to the birth.

It would be interesting to know what statistical patterns exist in the health (physical and mental)of those born in hospitals and in the home. Perhaps leaving aside the results for those known to be at special risk prior to the birth.

R0bert

Making this debate into one about paternalism is not especially useful. Detractors of home birthing are not sitting around thinking about how to oppress women, they are concerned mainly for the welfare of chidlren. In my own case if I had considered a homebirth myself and my oldest child might not be here today.

There is possibly some room for movement in homebirthing as long as some safety aspects are considered - proximity to hospitals, qualifications of midwives, monitoring by an obstetrician for potentially difficult cases. As for insurance, well it seems to be a reality of the medical profession these days.

The most important thing at the end of it is a healthy and safe delivery for mother and baby.

Monica, A beautiful piece. Forget the misogyny on this list. How dare a woman actually have any deciding factor in her body and her baby. Ah just a vessel with clearly no interest in what she has nurtured. Go home boys. The subject matter may be homebirth but as Monica says there is something much bigger at stake, women's rights. I say women not the Australian Medical Association will choose how where and with whom they give birth. Oh and for all the die hard blind faith in medicine types have you forgotten that it is this inherently sick system that protected Dr Jayant Patel and Dr Graeme Reeves for all those years. Women in the majority of cases will protect themselves and their young. I support a woman to choose homebirth.

Lottie,

Haha, I knew I'd find a supporter. A kindred spirit. We're the only two on this topic who know what's really going on here.

pelican,

'Detractors of home birthing are not sitting around thinking about how to oppress women, they are concerned mainly for the welfare of chidlren[sic].' (I've changed my mind, I'm getting to like this sic business now)

Oh come on! They're a bunch of misogynists trying to oppress women! You're just blind! Are you a feminist? I mean a real feminist? You're letting down the sisterhood. Now, where's anti... I'm thinking, are all feminists like pelican, or like Lottie? I'd like to believe they're all like Lottie.

Actually. pelican, you must stand up and be a real woman, and distance yourself from the likes of Lottie!

Here's an idea thats really going to annoy some people! Lots more women giving birth at home.

Currently Australia is in the grip of a swine flu epidemic. So far we have been lucky and the flu while nasty and with some mortality is not paticularly virulent. Unfortunately pregnant women, and those who are have just given birth are at greater risk of becoming extremely ill with this disease.

I'm sure hospital's hygiene standards to counter the risk to pregnant women and those giving birth are scrupulous.

What though if we get a flu that is as virulent as the Spanish flu? In such a situation with hospitals dealing with vast numbers of extremely ill patients, maybe keeping healthy pregnant mothers at home to birth would be a better option.

It might not be a practical option as it would need to be medically supported, and as babies come when they like, there might not be enough staff to cover it, but its just a thought. Certainly home visits for pre-natal checks might be a better option and keep pregnant women out of waiting rooms with sneezing people, and similarly out of the hospitals who would be treating the victims of such a epidemic.

When my Mother-in-law gave birth to her last child in England, a home birth was the norm, in her area. It wasn't any big deal. So approached sensibly a home birth shouldn't be regarded as that much of a liability either.

Houellebecq
Gosh you're a stirrer. I am sure you would like to believe lots of things, whether they are valid or not is another matter.

Who defines what makes 'real woman' or a feminist? You!

Lottie, what about a child's rights - such as to a healthy life? Is that not more important than a woman's right to self-determination in the act of giving birth? What would you think if your mother had selfishly insisted on a homebirth and you had ended up handicapped for the rest of your life?

Houllie

"I'm thinking, are all feminists like pelican, or like Lottie? I'd like to believe they're all like Lottie."

Feminists are as diverse as any other group of people.

Now repeat the above 20 times, maybe your brain will eventually get it that women who believe in equality of opportunity for all people are not a homogenous group, but hold a variety of beliefs from whether they should have a choice of home birth, hospital birth or whatever. Also that the "Lotties" have as much right to express an opinion as the "Pelicans", the "Fractelles" as well as yourself. I know how much it must irritate you that you cannot dismiss all feminists as being hairy fat dykes, poor you. I guess that members of the Ku Klux Klan must feel as irritated by blacks for not fitting their narrow little stereotypes either.

As for home-birthing, if there are no health reasons, why shouldn't a woman bring her baby into the world in a calm and peaceful environment? How is this "selfish"?

As a midwife and a mother, I feel I have some knowledge on this subject.
I am not an advocate of homebirths in this country because most women are too far away from hospitals if something goes wrong.
And believe me, things can go awfully wrong, even with the best of planning.
I have read up on the history of birthing, and have found that originally all women gave birth in their homes with the local midwife in attendance. More women and children died during childbirth than lived during this time.
Doctors were often called when all else had failed, but were often not successful in saving mum or babe.
As time went on, it was found that if a doctor was called earlier in the labour, when things first started to go wrong, then the outcome was usually so much better.
Thus, it became more desirable then for women to have their babies in a medical setting, close to all help for all eventualities.
The mum and baby mortality rates became lower and lower as the years went on.
Now we women have a choice of just having midwives deliver us, with Doctors near by if problems arise.
That's not to say there are no fatalities or problems if birthing in hospitals of course, but I would say there is no case for going back to the days of all of us birthing well away from a doctors help if the worst should happen.
That would be a huge mistake.

suzeonline

I don't think anyone is suggesting a return to the old ways of birthing, just a more humane approach to such an important event. Some hospitals (mostly private) have had special birthing centres constructed, just so a mother can give birth in serene rather than clinical surrounds - while still close to medical aid should an emergency occur.

What concerns me here, is the implication by some that women are incapable of making the best decision for themselves. Most of us are not brainless, selfish twits and if we can bring our babies into this world in the best way possible we will choose that.

Cheers

Fractelle,

Not too cluey are you. I'm wasting my time I fear.

pelican,

Maybe you can explain to Fraccy .

'Who defines what makes 'real woman' or a feminist? You!'

Yep. I do. And Fraccy or Gynx normally define what a real man is. i.e. anyone who makes a show of disagreeing with antiseptic with lots of indignation.

See, in any gender thread there are a few rules.

a) antispetic must be there.
b) Fractelle must be there.
c) Fractelle must position herself as a victim before the thread even gets started.
d) CJ must pipe in early with a wise crack at anti.
e) anti must mention promenarians.
f) Fractelle must state that she isn't interested in a gender war, regardless of the fact that it's for that very reason she is present.
g) Col will say something profound and entertaining. He always does.
h) If it's losing momentum, or becoming tame, I'll generally try and kick it along.
i) Fractelle will ask where all the 'real men' are if people are ignoring anti or egging him on to stir things up. CJ may get a special mention here. Robert will be a little put out if he doesn't.
j) anti will rave on about feminists even when everyone has gone home.
k) Fractelle will mention 'broad church'
l) SJF will pipe in with something from a gender studies text book circa 1973.
m) I'll wet myself laughing.
n) Yabby will sya something that's charming, honest, smells of common sense, but with seriously misogynist undertones.
o) James will mention circumcision.
p) It's getting late, so anti will start on about universities.
q) Some weird person will make weird irrational arguments while arguing with antiseptic always under a different name.
r) New feature - Scouts!

s) Romany will pop in to remind us all again that she lives and works in China!
t) pynchme will drop bombs of heavily researched (that's heavily biassed too) feminist propaganda just to get anti excited, then leave him cold for a week with no reply to his retort.
u) anti never understands he's being messed with in this way.
v) anti may say something that actually is hard to refute and is quite a good point, but since it comes from anti it gets ignored.
w) Fractelle will point out how abusive anti is.
x) I'll look through all the posts and often not find anything particularly abusive, certainly not as bad as some of the stuff that he's copped.
y) There's a strange 4 or 5 posts that are actually about the original topic right near the end.
z) All the women have left, as the men are just getting too ridiculous. Seeing as how they started out by addressing a topic about women being raped by discussing how bad men have it because there is a minister for women, I'm always surprised it too that long.

My first daughter was a difficult delivery. she was born in hospital, delivered breach although her mother was being prepped ready for a caesarian.

Had my ex-wife had a home birth, I doubt they would have both survived.

My recent long-term partner had had a first birth home delivery. It did not go smoothly and she beleives her first son suffered oxygen starvation during delivery. He subsequently had a difficult life, dealing with a borderline intellect (borderline with retarded) poor emotional and impluse control.

To be honest, whilst I would never assume it was my ultimate choice, I would seriously ask any woman who was considering a home birth only to proceed with i ift her previous deliveries had been free of drama and certainly to only consider having her first delivery in hospital, with all the services on hand.

The alternative, whilst it may seem a nice notion, is to impose serious avoidable risks upon the unborn child.

Fractelle: “I don't think anyone is suggesting a return to the old ways of birthing, just a more humane approach to such an important event … so a mother can give birth in serene rather than clinical surrounds - while still close to medical aid should an emergency occur.”

How can anyone argue against choice or serenity? Pure motherhood stuff for those that wish it, yet far enough away from the clinical paternalism to allow for alternate outcomes, if one was so to desire it at the last minute. Women’s business should remain women’s business, right? But with safety and serenity.

Houellebecq, you’ve now spoilt my sense of surprise. It now seems futile reading on.

most readers appear to be overlooking one of the main points in this article. That despite current and proposed policy and current public opinion about homebirths, the peer review literature shows that homebirth is as safe an option for low risk women than hospital. Peoples personal opinions keep ignoring this point! The past head of the WHO is a home birth advocate based on the science. Most of thee studies also show that morbidity stats for women and their babaies is higher in hospital. paternalism in this case relates to those in power NOT recognising the science in addition to their attitudes about self determination for women.

MsMoo

While your post is completely correct, on topic and rational. You have interrupted a flow of vitriol from Houellebecq and other disenchanted males in their splatter gun targetting of people who hold different opinions from them.

This topic is not really about a woman's right to choose how she births, it is actually a meeting of Whingers-R-Us.

I think you're making progress Fraccy!

'.. *people* who hold different opinions from them. '.

Normally you would say

'.. *women* who hold different opinions from them. '. Or 'daring to hold an opinion while being female.'

Well done!

Really. xx