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
“Maternity Services Review: Medicare payments to OBs up from $77m to $211m since 2004.”
“Quickhit: Maternity Services Review and Homebirth”
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.]
Categories: gender & feminism
I am disgusted, too. Thanks for writing about this and good luck fighting it.
Thank you for posting this. Feminism needs to embrace birth as a human rights issue and I hope that your entry will encourage women who haven’t put the two together yet to see that birth is as much a feminist issue as is abortion, childcare, domestic violence and everything else that affects women in any way.
The “glass half empty” taunts are so incredibly insulting. It’s the constant sacrificing of women’s needs to what is perceived as the need for the majority despite the reality that cutting rights off from one woman, removes that right from us all. Sucking up to the AMA and RANZCOG to get a title that recognises midwives as Professionals while handing over the women who choose the only genuine midwifery in this country is gross, vile, collaboration. That tiny minority are always the most vocal for the rights of all birthing women and now we’ve been totally shat on by those midwives and the government alike. This isn’t an erosion of our human rights, it’s a big fat fucking slam in the face in one fell swoop. How dare anyone try to tell women what they can and can’t do with our bodies?! If this was a blanket ban on “elective” caesareans I can only imagine the fury that would be unleashed. As it is, a little removal of a basic human right just passes through without a whisper.
Be afraid, all you who don’t see this as your struggle. Got vagina? Got oppression.
I have been wondering if it’s difficult to perceive the reality of this legislative ‘reform’ – if ordinary people don’t see it the way I do.
You have said it well. It is oppression. The midwife is on the brink of extinction. Whatever we will become next year, even though the title midwife will continue, is likely to be less of the authentic midwife and more of the agent of a service that is so closely risk managed that the rights of the individual to choose and determine their own directions are lost.
I’m just shocked. I don’t know why – your posts have made it clear time and again what we’re dealing with here.
Sign the petition, and attend the rally!
Read Roxon’s press release here: June 24: “Historic Step Forward for Midwives and Nurse Practitioners” (That would be Newspeak):
She needs to read the Maternity Services Review again. The only reason the chickenshit non-midwife reviewer didn’t recommend funding homebirths was that the AMA wouldn’t like it. Was that it might be politically a bit difficult.
Since when did a Labor government bow and scrape to the AMA’s demands? They don’t even represent doctors, let along midwives, birthing women, or evidence-based care.
Here’s that excerpt again from the Maternity Services Review (my post on the issue):
This. Roxon moved from this to kicking independent midwives and their clients to the kerb.
It is utterly disgusting that our rights are being taken away in this manner. It should also be noted that women’s homes are already treated as crime scenes if something goes wrong during a homebirth, unfortunately.
Yes perhaps it isnt too late to have some impact on the coming changes – perhaps.
The issue around having that impact seems to me to be the question of “What do we really want?”
Ive had a look at the HB Australia petition, which is calling on the government to supply midwives with insurance ‘just like it does for OBs’ – but as a midwife offering homebirth care, I actually dont want a bunch of insurance company number crunchers dictating to me who I can and cant care for through the provision of insurance.
Dont get me wrong, I want women who choose to birth at home to have the same financial safety net as her sister in the system, but the reality of that is that if insurance is ‘available’ then it will be mandatory for me to have it – as it is already proposed. Bet you anything that that insurance will not cover anything to do with all of the ‘risk factors’ so eloquently described above. It doesnt now for those midwives who have the backing of the hospital and access to all those machines that go ping that make birth so safe [/sarcasm], and it definitely wont for those perceived renegade Luddite midwives whose anecdotal experience flies in the face of current evidence [for a given and appallingly narrow value of ‘evidence’].
So the petitions and the rally succeed, and midwives get insurance – and what happens to all those women who arent ‘normal’ enough to be included in the insurance company’s strict homebirth criteria? What happens to those midwives who say yes I’ll help you birth wherever you want to all those ‘abnormal’ women? Sorry but how is having insurance a ‘win’ for either the women wanting something other than hospital-based care, or the midwives who are currently able to provide that care? [ok, by ‘able’ what I really mean is ‘pushing shit uphill’].
I’ll be in Canberra, but I dont think I’ll be signing any petition that is going to mean I will have exactly the same insurance and ‘selection criteria’ as those ‘hospital in the home’ programs currently being hailed as the latest greatest thing. To quote Star Trek, its homebirth Jim but not as we know it.
I thoroughly agree, Midfairy. Insurance and the acceptance of homebirth as a viable choice is one step. The ultimate step is extending to women their right to self determination and bodily sovereignty. And I’ll also be in Canberra.
Only 9 comments, huh? Women just don’t get it. We struggle for the basic human right to decide when to achieve pregnancies but we don’t seem to follow it through to see that it is just as vital that we are offered the full exercise of our human rights in birth as well.
Women give birth, this makes birth a feminist issue.
Women live, this makes life a feminist issue.
I’ve spent years of my life in the struggle to support women’s right to access effective, safe contraception and the right to terminate pregnancies and yet now I see no long line of women behind me defending my right to give birth as I choose. Birth is a reproductive choice, it’s an area that feminism has almost totally passed by. Those of us who identify as radical feminists and who work in supporting birthing women are out on a lonely little demonised limb here and it deeply saddens me.
Women’s right to bodily autonomy is at the heart of feminism. Isn’t it?? It’s all the same issue and yet the fine for asking a midwife to attend your birth will be $30,000. Why is that acceptable?
Someone explain to me why birth isn’t a feminist issue and I’ll shut up. Please, someone defend that to me in a cogent manner. Give it your best shot.
The government is seeking to force women to birth in places which have no regard for human rights, where women are drugged, silenced, raped, coerced and belittled as a matter of course. Help me see why more women aren’t outraged about the whole kit and caboodle.
No one’s going to be able to explain to you why Birth isn’t a feminist issue, blessed, because no one here believes that.
I know how frustrating it is when something you care a great deal about isn’t widely commented on, but I have to admit, I’m at a loss as to what to *say* about this. Partly that’s influenced by living in Canada. This week in Halifax they’ve opened up a midwife clinic, which is getting a great deal of support. I’m appalled that Australia seems to be going in the opposite direction.
This is a fantastic post, thanks! This is a basic human right, for a woman to choose where she can birth and with whom.