Friday, December 23, 2011

"homebirthing is a sensitive and controversial issue"

The report said “homebirthing is a sensitive and controversial issue”.
The irony of this statement was clear when it appeared in Improving Maternity Services in Australia – The Report of the Maternity Services Review (2009). Homebirth continues to be both sensitive and controversial today.

Maternity Coalition's Summer 2011 issue of Birth Matters devoted significant space to the extremely sensitive and controversial end of homebirth; "high-risk homebirth". MC President, Ann Catchlove, wrote a deeply personal and moving column referring to the death of a baby in a highly publicised homebirth, that "I hope that we will have realised that the way to respond to "high-risk homebirth" is not by prohibition and persecution but by seeking to understand why women make decisions and giving them real options within the system. Meanwhile, in the here and now, a mother is being treated in a most unfair and unjust manner. We need to stand up and say that is wrong."

In an article published in the (UK-based) AIMS Journal Vol 23 No3 2011, Joy Johnston (who is also the author of this blog) wrote:
The constant recurring theme in Australian and international midwifery regulation is the public interest. The Australian medical profession considers obstetric supervision of all maternity care to be in the public interest, and assesses midwifery as incapable of delivering optimal and safe maternity care in settings outside obstetric surveillance. The issue of home birth is the pimple on the end of the maternity system’s nose. It won’t go away, it hurts when touched, and it’s a real nuisance.
The large 'Birthplace' study [click here for link and comment] looking at place of birth in the UK is to:
effectively be replicated in Australia from 2012 with a NHMRC funded birthplace study led by Professor Caroline Homer from the University of Technology, Sydney. Feeding in to the Maternity Services Review recommendations for more research and national data collection, the study will investigate outcomes from about 45,000 births across public and private hospitals including birth centres, freestanding midwifery units and homebirths, both publicly and privately funded. “We need to continue to grow the evidence and what has to be unpacked are the important pieces of information for women – their chances of a normal birth versus a caesarean section or their chances of good outcomes versus bad,” Homer said. “We haven’t had a big national study which clearly defined intended place of birth at onset of labour, not at 12 weeks. Smaller studies have also been a bit vulnerable because of their low numbers.” (quoted from Nursing Review, 21 Dec 2011)
MIPP is currently undertaking a REVIEW OF PLANNED HOMEBIRTH FOR ‘AT RISK’ WOMEN IN VICTORIA, 1999-2009. The data for this audit is being prepared by the Victorian Perinatal Data Collection team. Women included in this audit are those identified as ‘at risk’, having been recorded as planning to give birth at home in the care of a midwife, and that they have one or more of the following obstetric risk categories: Multiple pregnancy; abnormal presentation (especially breech); preterm labour prior to 37 completed weeks of pregnancy; post term pregnancy 42+ weeks; and previous caesarean birth. It is anticipated that at least one paper for publication in a professional peer-reviewed journal will come out of this review, and it is hoped that valuable information will be highlighted.

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