Tuesday, January 31, 2012

the death of a mother who gave birth at home

There is no easy way to present this issue. The word 'death' confronts us with an absolute reality.  A maternal death is shocking. A baby and her sister have lost their mother, a man has lost his beloved wife and the family have lost a daughter, sister, friend ...

Here's the story so far, as it has been presented in the online and print media and television today.

Herald Sun, Lucie van den Berg - Mum dies in home birth tragedy
The Age, Megan Levy - Home birth mum's tragic end
Channel 7 News
Mia Freedman at mamamia
Herald Sun blogger Susie O'Brien - Homebirthing is just too risky
The Punch blogger Tory Shepherd Home births are prone to many complications 
[and hundreds of comments to these blogs]

The submission made by Caroline Flammea, Nick Lovell and daughter Lulu Lovell to the federal government's Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills

The opportunity for sensational headlines was not lost.  'Home birth death' filled half the front page of the Herald Sun today. 

Victoria's Health Services Commissioner Beth Wilson is reported as having said she had "long held concerns about home births when medical back up may not be immediately available."  Perhaps Ms Wilson is unaware of the usual practice of homebirth midwives to arrange transport to hospital, and collaboration with specialist medical services when complications are detected. 

One would wonder if there are also "long held concerns" about the many smaller public hospitals and private hospitals that do not have medical personnel on site 24/7.  Surely no-one imagines that all pregnant women should be herded into large baby-factory hospitals that process births like cars off a production line?

One would wonder if the thankfully infrequent examples of sudden and unexpected death of a previously well mother who gives birth spontaneously in large tertiary level hospitals also lead to knee-jerk reactions and pronouncements before all the facts of the case have been considered.

This is not the time to argue the safety of home birth.  The sympathy of every midwife and every person who cares about working for better births is with this family, the midwives who attended the birth, and all the health service personnel and paramedics who provided care to a woman and her family in her last hours. 

Birth has never been safer, for mother or baby, than it is in this country today.  As rates of caseareans increase, and rates of complications related to placental implantation increase, new life-threatening risks will arise for those women.  The midwife's challenge, to work in harmony with natural physiological processes, is as real and as important today as it has ever been.

Link to the report Maternal Deaths in Australia 2003-2005 (AIHW 2008)

[Any opinions given in this article are those of the writer, Joy Johnston, and are not necessarily those of other members of the collective, Midwives in Private Practice.]


Pier said...

thankyou Joy for your comments and I agree with your summary and observations. This is a difficult topic to discuss. My deepest sypmathies to all directly involved. Pete Malavisi.

Joy Johnston said...

A statement has been repeated by several reporters that no maternal deaths have occurred in relation to homebirth in Australia in about 20 years. This is incorrect. I have found two mentions:
Maternal deaths in Australia 1997-1999, page 17
Maternal deaths in Australia 1994-1996, page 21

The AIHW National Perinatal Statistics Unit’s Maternal Deaths
Series is available from the Institute’s website

Kat said...

A tragic event is made sadder by the tendency of traditional media to suggest a causal link between the setting for this birth and the poor mother's passing before the facts have come to light.
While we will all pause to relect on this loss, know that amongst supporters it only magnifies the importance of experienced and committed midwives being available and enabled to attend a woman's labour wherever she chooses to birth.
In solidarity and sorrow,

Joy Johnston said...

The following message has been received from an obstetrician in Victoria:
"After this terrible tragedy ... I know what a close group you in the homebirth group are, so I know that all of you would be finding this time quite difficult. When things go wrong it can be a terribly lonely time when you question yourself as a clinician - we've all been there. Not sure I have any good advice on how to get through these times, except hang in there and keep your friends and family close.
"Anyway, I'm thinking of you at this time."

Emma H. said...

Is there any further news on this sad happening? I wonder why it's not headlines every time someone dies in hospital...