I’ve been meaning to write a big post on this, but it just hasn’t happened. So here’s a little one.
Read some background at
Then hop on over to Lisa Barrett’s blog (caution on some images), especially her latest post, EXTERMINATE, about the Health Practitioner Regulation National Law, which Health Minister Roxon is pushing right now, and the new legislation allowing some selected midwives access to Medicare item claims and insurance coverage.
The die is cast. It is likely that independent midwives offering homebirth services to women are going to be struck off and bankrupted in a year’s time. Midwives will only have access to these New(tm!) and Wonderful(tm!) registration conditions if they attend women birthing in hospital under the thumbs of medical “collaboration”; which, in practice, means the doctors set the rules on just who midwives are allowed to care for at all. According to RANZCOG’s latest statement (Royal Australian and New Zealand College of Obstetricians and Gynaecologists), “risk factors” that should trigger a referral to an obstetrician include not only previous C section or postpartum haemorrhage, but previous recurrent miscarriage, more than two terminations of pregnancy, postnatal depression, “morbid obesity” (Death Fat!), uterine fibroids, low maternal weight, or pregnancy beyond 41 weeks – and, get this – postpartum conditions such as the newborn having a poor suck. Because we all know obstetricians make fabulous lactation consultants. [/sarcasm]
And no matter how low-risk the woman nor how much she desires a homebirth, women will not be allowed to do so legally with a midwife. Because the legislation introduced this week will ban midwives from practising without insurance; and there is no insurance provider for homebirth midwives. So long, too bad, so sad. Good bye.
There will also be a penalty for “inciting unprofessional conduct”, of up to $30 000. One can only assume that this could apply to pregnant women who beg their midwife to attend their homebirth. Homebirth just got a whole lot more expensive. What about women who accidentally or ‘accidentally’ happen to be having a precipitous birth as the midwife arrives for a routine checkup? Perhaps women need to prepare to have their home declared a crime scene should such a thing eventuate – especially if something goes wrong, through nobody’s negligence but just by chance.
Or perhaps you’re a woman who lives in the right place and is lucky enough to get an assessment as to whether you can join one of the “hospital-in-the-home” style medically-controlled midwifery programmes: better hope you’roe not at risk of being considered too fat, too thin, too short, too tall, too old, too young, or that you’re carrying twins or your blood pressure tweaks a little one week or that you get a few UTIs or decline blood glucose screening or that your fetus has an irrelevant incidental or incorrect finding on ultrasound like a choroid plexus cyst or you walk under a ladder or see a black cat ; you’ll be out, and begging your midwife to not write down that extra kilo of weight gain or those three abortions you had a couple of decades ago could get you both in very hot water.
Independent midwives are devastated; midwifery students are crushed; and midwives unaffected by these changes are urging them to celebrate the “progress” being made, jeering at them for acting all “glass half empty”, and scolding at them that all they need is a glass of wine to cheer them up. Because they’re such a buzzkill and all, being sad and angry that their vocation is being destroyed and that women will no longer have access to choice in maternity care, that women will no longer have control over their own bodies. When they saw this coming a mile off, they were “doomsayers” who just needed to “trust”. Now, they’re harshing the mellow of the patriarchally-approved midwives. How dare they.
I’m fucking disgusted. As parts of the USA move toward a system of underground abortion provision through the threat of terrorist force, we’re moving toward a system of underground homebirth midwifery through the threat of State force. Anyone who thinks this is a good thing, raise your hand. All those with your hand raised, go have a glass of wine and feel ashamed of yourselves. All those without your hand up: write to Roxon and your federal MPs and Senators, please.
[Update 25 Jun 2009: substantially edited. I thought all legislation had passed, but it is proposed. This gives you more chance to do something. Things have moved inexorably to this point, possibly because the only outcry has come from homebirth midwives and their direct clients, who are a relatively small and marginalised group at this stage.]