Last Monday I packed up everything I needed for my two small children and the three of us caught the train to Sydney. But this wasn’t a social visit where we went to the zoo or wandered along Circular Quay to The Rocks – we attended a rally to protest for women’s rights.
My children and I stood with 200 women outside the Minister for the Status of Women Tanya Plibersek’s Office in support of Australian midwives who rejected the Health Legislation (Midwives and Nurse Practitioners) Bill amendment proposed by Federal Health Minister Nicola Roxon earlier this month. Under the proposed amendment independent midwives will need to have a collaborative agreement with an individual doctor not a maternity service to provide care for women.
This is an issue that I think all women should be concerned about, because it is about a woman’s right to choose with, how and where they birth their babies.
The government is in the process of reclassifying midwives as care providers so they can be insured to provide complete care to women. A pregnant woman can hire a midwife of her choice, see that midwife throughout her pregnancy, have them present throughout the entire birth and then the midwife would conduct post-natal visits for up to six weeks.
It make sense to have the same professional provide care throughout pregnancy, birth and afterwards? This system has been operating in New Zealand for 14 years and 70-80 per cent of women now choose midwifery care.
Under Australia’s current system, women can choose shared care with their GP and the hospital’s midwife clinic, a birthing clinic or an obstetrician. Those women who are cared for during their pregnancy by an obstetrician only see the doctor for minutes each visit – and may not even have them present at the birth! How is this continuity of care?
The World Health Organisation recommends one-to-one midwifery care as the gold standard. This is what independent midwives provide so why do we have to fight for this?
Australian College of Midwives president Professor Jenny Gamble said the proposed amendment required midwives to have a collaborative agreement with a medical practitioner(s). “It’s hard to see the amendment as anything other than an attempt by the medical lobby to ensure doctors have a power of veto over the regulated professional practice of a midwife,” Professor Gamble said.
The Nursing and Midwifery Board already regulate midwives and to have a collaborative arrangement in place with a medical practitioner is an additional burden placed on midwifery but no other profession. Doctors are not the appropriate body or persons to be determining the fitness of midwives to meet Registration requirements.
Here on the Central Coast private obstetricians like those practicing at North Gosford Private Hospital, would be able to choose to collaborate with an independent midwife or not. This results in them having control over who and where this midwife can see women if they choose to collaborate. If they don’t and no other obstetrician does then she will not be able to offer her services to the women of the Central Coast. Essentially the doctors would have control over someone who is their competition.
The research shows that one to one midwifery care offers women better outcomes with less intervention and better service. Independent midwives offer 45-minute visits in the woman’s place of choice, are there for the whole labour and birth and visit the women and their babies at home for 4-6 weeks after the birth. This is probably why the obstetricians have pushed for this amendment to the bill, because they would have to compete with this level of service.
One of our leading obstetricians here on the coast apparently schedules 80 women for his clinic visits on Mondays allowing five minutes each and women have told me they sometimes wait up to three hours in his waiting room for pre-natal appointments. Women then might see him for a few minuets at the birth if every thing is going well, having unknown midwives tend to them through out their labour. Many of these women will be scheduled for induction (North Gosford has the highest induction rate in the state), or a caesarean. I have been told that one of our Central Coast obstetricians has a caesarean rate above 70% but I cannot confirm this, as sadly there is no law saying this information should be accessible to the public.
The issue is not about midwives refusing to work with other care providers, as they are happy to be collaborative with maternity services, such as hospitals and birth centre’s, and some have excellent working relationships with individual doctors. Collaboration with other professionals is a defining part of midwifery. The problem is doctors are their competition and look at birth from a totally different perspective. If midwives have to conform to a doctor’s practice, then the doctor could tell the midwife who they see can and can’t see, for example larger women, VBAC (Vaginal Birth After Caesarean), older women, home births, vaginal breech and vaginal twins might be off limits. This might be only because the doctor is not comfortable or experienced with these kinds of births, not because of safety or the skill level of the midwife.
It’s not about affordability either. Under this new bill, women will be able to pick their own midwife and claim it on Medicare or through their private health insurance.
The Australian Medical Association has pushed for this amendment because they are a union and a union’s whole purpose is to increase the pay of its members. New Zealand’s situation, where women can choose an independent midwife instead of an obstetrician, has scared the AMA.
All women should be very concerned of having this choice taken away from them and put in the hands of politicians and union members trying to make more money. It is not about them, their babies or their safety. It’s about us as mothers and mother-to-be.
Even if your choice is private obstetric care, you should still be concerned because this amendment could take away your friends or family members rights to choose where and with whom they birth their baby. I am sure you wouldn’t want the midwives to be able to tell the obstetricians that they can’t care for you?
I have already had my children and I am not fighting this cause for myself, but for my friends who are yet to give birth and my daughter. I am worried about what kind of care will be on offer when they have their babies.
If you are like me and worried about this issue please write to Nicole Roxon and/or your local senator and ask them what are the benefits for women and their babies from this move.
Thanks again for reading my blog.