Sunday, August 9, 2009

VICTORIA TO PILOT NEW HOME BIRTH OPTION

PRESS RELEASE From the Minister for Health

VICTORIA TO PILOT NEW HOME BIRTH OPTION
Friday, 07 August 2009
Victorian families will more birthing choices thanks to a Brumby Labor Government pilot program.
Health Minister Daniel Andrews said a pilot program would be established at two Melbourne hospitals to trial public home birth services.

“The Brumby Labor Government is taking action to provide Victorian families with world-class health services,’’ Mr Andrews said.

“Home birthing has been a popular option considered by women expecting straight-forward, uncomplicated births.

“The Brumby Labor Government will pilot a public homebirth program at two hospitals, and then evaluate the model to see if it can be more widely offered through the public health system.’’

Until now, the only option for women seeking a home birth has been to engage a private midwife at their own expense - but lack of indemnity insurance is an ongoing issue.

Mr Andrews said midwives employed through the pilots would be covered by their hospital’s indemnity insurance.

“Victorian women now have more options and choices in models of care, more continuity in care and carer and more detailed information, enabling them to make more informed decisions regarding maternity care.

“This new pilot program will give Victorian families greater choice in maternity care and provide women with greater control of their birthing experience.’’

Mr Andrews said that as a result of the new directions set out in the Future Directions for Victorian Maternity Services in 2004 Victorian women now have experienced increased continuity in their care throughout and after their pregnancy.

Mr Andrews said the Victorian pilot model has been established following consultation with consumer groups, maternity health professionals; including leading maternity obstetricians and midwives. It will also draw on the experience and learning’s of programs in Western Australia, South Australia, the Northern Territory and NSW.

“Trailing the Victorian model where homebirth could be part of the public system is consistent with the Commonwealth recommendations, and would ensure that women opting for home births would still fall directly under the umbrella of hospital services should any complications arise,” Mr Andrews said.

Around 166 Victorian women home birth with a mid-wife in private practice each year. The hospitals participating in the pilots will be finalised and announced shortly.


THIS STATEMENT CALLS FOR A FEW COMMENTS:

Firstly, let's get our numbers correct. The most recent published data from the Department of Human Services, the same Department that published this press release, reveal that 253 women gave birth at home in 2007. For more detail on these births, click here. (Where did 166 come from?) The number of midwife-attended* homebirths in Victoria has been increasing each year, and it has been more than 166 since 2004, when 181 homebirths were recorded.

Secondly, we are told that the "Victorian pilot model has been established following consultation with consumer groups, maternity health professionals; including leading maternity obstetricians and midwives." Enquiries made amongst MiPP members, who are the midwives providing homebirth services for almost all the women giving birth at home in this State, failed to identify any independent midwife who had been involved in these discussions. The Department of Human Services knows which midwives provide homebirth services, because we send data forms, with our names on them, to the Department's Perinatal Data Collection Unit, after each birth. Several of our members attend 30+ births in the year; others fewer. We also receive, from the Department, the annual 'Homebirths' report.

The Age article quotes Fiona Hallinan, "an independent midwife who has protested against the Federal Government's changes, says she doubts the scheme will attract sufficient staff to get off the ground."

We shall see!

We understand that the (as yet unannounced) Melbourne hospitals from which the pilot homebirth schemes are to operate will be Sunshine and Casey. Women who live within a relatively small radius of those hospitals may be eligible for homebirth.


Note:
* 'midwife-attended homebirths' distinguishes these births from 'born before arrival' (bba) births and intentionally unattended births (sometimes called free births).

5 comments:

midwife said...

"Mr Andrews said the Victorian pilot model has been established following consultation with...leading maternity obstetricians and midwives". Yes - most of whom have NEVER attended a homebirth or are not doing so a regular basis! Who were the token consumers, I wonder? Not a very transparent process, Minister Andrews!

Their arrogance astounds me. MiPP have been told that we "are not the only midwives with homebirth experience". No - but we are the LARGEST collective of private midwives in Victoria, with the MOST experience of homebirth. We also face the challenges and realities on a daily basis.

That they can't even be bothered to collect or quote accurate figures is very telling.

Two sites will not be enough to cater for the demand or needs of all women. What are all the other women expected to do? Homebirth with a private midwife needs to remain an option for all Victorian women.

Joy Johnston said...

The following comment was received by email:

My concern as a potential home birth mother is that I currently live 32 km from Casey Hospital and 38 km from Sunshine Hospital, from the public funded home birth programs running in other states, this means that I am not eligible, along with the majority of women in Victoria.

The proposed programs are pilots and are on trial, which given the past performance of public hospital programs could just disappear at whim, we have all seen it happen before.

It was mentioned that after these programs are evaluated, they might be extended to other locations. We have homebirth now, in most locations over Victoria …….. so much for improving services in the bush, again country women are going to be the poor second cousins to their city sisters.

We don’t need to evaluate homebirth services, what we need is for the governments, both State and Federal to get serious about the broken maternity system and investigate the over-servicing, intimidation tactics and horrific outcomes in the hospital based system.

I’ve got a proposal,
1. The Victorian Government sub contract the services of private midwives to provide publicly funded services to women (regardless of location).

2. The Victorian government legislate that all Maternity Service Providers MUST collaborate with Sub Contracted and Private Midwives.

3. That all Sub Contracted and Private Midwives have full visiting rights to ALL Victorian hospitals.

4. That there are no restrictions on the program, it is not up to an insurance broker, a bureaucrat in some city office or a hospital board who’s closest encounter to birth was via a Monty Python sketch to decide where or how a woman births.

5. Lastly, still enable private midwives to practice. If we can hire a private obstetrician then we should be able to hire a midwife.

I will accept nothing less then full access to the midwives of my choice and birth in a location that I choose.

No half baked schemes, I am not going to accept crumbs when I already have the whole cake.

Anon.

davidbaer said...

Influence can be defined as the power exerted over the minds and behavior of others. A power that can affect, persuade and cause changes to someone or something. In order to influence people, you first need to discover what is already influencing them. What makes them tick? What do they care about? We need some leverage to work with when we’re trying to change how people think and behave.

www.onlineuniversalwork.com

Shane said...

This is great news. I have recently met two of the midwives and one obstetrician working in this program and it seems wonderful. I am keen to read the evaluation and to hear of the outcomes, in terms of women's satisfaction, neonatal and post-natal morbidity and mortality,caesarean rates and maternal morbidity and mortality.
I suggest you change the word "learning's" to lessons; it will scan much better and the punctuation will be correct.

Joy Johnston said...

Thankyou Shane for this comment and the editorial advice. The sentence you have identified as incorrect is "It will also draw on the experience and learning’s of programs in Western Australia, South Australia, the Northern Territory and NSW."
This comes from the Health Minister's press release - which I have copied without change. It seems that someone in that department doesn't understand possessive and plural. (We know that midwifery blogs are read by people in government departments, so thanks for pointing it out.)

The other recent piece of news is that this year 2011 Southern Health Network is planning to extend the publicly funded homebirth program to Monash Medical Centre in Clayton.