Home births

Tracy - posted on 09/13/2009 ( 8 moms have responded )

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Home births back on agenda for LaborFont Size: August 01, 2009

Article from: The Australian

CANBERRA is reconsidering its controversial exclusion of home births from a new midwifery indemnity scheme, before a Senate challenge to the draft legislation.



Federal Health Minister Nicola Roxon revealed yesterday she was looking at whether the government could accommodate home births in the $25 million indemnity scheme.



"I recognise that a very small proportion of women would like to have home births and (I) am currently investigating if there is some way that we can provide this as an option without making the proposed midwife indemnity insurance unaffordable," she said.



The scheme was welcomed by midwives, when announced in the May budget, as a precursor to next year's expansion of their powers to prescribe subsidised medicines, order publicly funded tests and claim Medicare rebates.



Private midwives had gone without insurance cover since the indemnity crisis at the start of the decade, putting their ability to practise at risk under a new national registration scheme for health professionals that also takes effect next year.



But support for the budget decision fractured when the draft bills revealed home births would not be covered under the new indemnity arrangements.



Not only would home birth midwives continue to lack cover, they would also for the first time be stripped of their professional registration from next July for failure to secure adequate insurance. Unregistered midwives who continue to practice beyond that date could face a $30,000 fine.



Greens senator Rachel Siewert announced yesterday the party would demand changes to the midwife indemnity bill and/or draft national registration legislation, saying the government had made a mess of its attempts to improve maternity services.



"If their planned approach is about providing better choice and safer deliveries, it's going exactly the other way," she said.



"Parents who have already had home births have said to me, 'we will never go back to a clinical situation so we will free birth'. That will put them into a much more dangerous position than before."



Opposition health spokesman Peter Dutton said the Coalition would "be open to negotiating with the Greens".



"I have real concerns that the government is essentially putting in place penalties for midwives who assist in a home birth and essentially they're going to drive the practice of home births underground."



Another Artical 7/8/09

http://www.essentialbaby.com.au/parentin...





I personally would not do it myself but I think it should be available to those who wish to have a home birth. I think midwifes should be able to be insuranced and registered to carry out home births. Not doing this puts parents in danger of unqualified midwifes carryout home births, which puts mum and baby at risk of injury or death.



What are your opinions on home birth?

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Mary - posted on 03/02/2010

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I personally would never do it....the downside of being an L&D nurse is that I've seen entirely too many horrific things, often on women with absolutely no risk factors. There is no way to predict a prolapsed cord or placental abruption, and it can happen with a first or fifth baby...mother nature doesn't particulary care. Having a competent, licensed practioner in your home isn't going to prevent it, and there are precious few minutes to spare with an oxygen deprived baby. Brain damage is a huge risk when you are waiting for an ambo to arrive and transport you to the hospital, even if you live right next door to one.

However, I do support a women's right to choose a home birth, and by no means do I think it should be illegal. I especially support it for someone who has already had a successful, full-term vaginal delivery. As I said, I would never consider it myself, but I recognize that it is fairly safe for many, many women, and can be an incredible life experience. As long as a women is fully aware of the possible risks, and is willing to accept a fair amount of responsibility for whatever outcome (good or bad), then the choice should be hers to make.

THe biggest hurdle to this in the US is liability, and malpractice insurance. You cannot exactly blame insurance companies for not wanting to cover CNM's (certified nurse midwives) who do them. Unfortunately, our culture is one of needing to blame SOMEone when things go badly, and holding them financially accountable if the outcome is less than perfect. The statute of limitations for a lawsuit involving delivery is 21 years (this gives the child a chance to reach adulthood and bring suit themself!). The financial rewards in these cases is staggering, and not necessarily justified. Often times, there is not definitive proof of malpractice or blatant negligence...just a child that is in some way delayed, or less-than-perfect, and an "expert" PAID witness for the parents who says they would done things differently. The case is decided by a jury of non-medical people, who have no clue about obstetrics, and are making decisions based on emotion and sympathy, not medical facts.

Until this system changes, you are going to have a hard time persuading malpractice insurance companies to change their stance on covering CNM's who are willing to attend homebirths. The other problem is that those CNM's willing to do home births must have an obstetrician who is willing to back them up, and step in if surgical intervention is required. Their are fewer and fewer OB's who are willing to take that risk because of the malpractice implications. As it is, an OB with absolutely no bad outcomes, and years of experience is paying a minimum of $150,000.00 PER YEAR in malpractice insurance. Whether or not an individual state allows homebirths is irrelevant...most midwives simply cannot afford to do them. It is also why birthing centers across the country are dwindling...they are just not financially viable. As well intentioned and dedicated as any practicioner is, they do still have to eat.

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Johnny - posted on 03/02/2010

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Where I live, in British Columbia, homebirth is covered by medicare and we have licensed midwives that do both hospital births and homebirths. It is possible to have the same midwife for a hospital birth, and then have her come back the next time to handle a birth at home. When I had my daughter, I did it through a clinic where the midwives and OB's work together in partnership. You have the same chance of getting an OB or midwife for a clinic visit or your delivery. The clinic did not handle high-risk pregnancies needing a higher level of monitoring. The OB's and midwives in the program will both deliver at your home if you so choose. Homebirths are becoming increasingly common here, and the University of British Columbia has recently conducted a study that found they were actually having much better post-natal outcomes than hospital births for mothers with low risk factors. (I'll try to post it later).

There is always a risk of something happening with every birth. I had a significant post-partum hemorrhage with my daughter. I was in the hospital and thought that being there had saved my life. But at one of my play groups, I was talking to a mom who had the same thing at her home birth, and her midwife was totally equipped to handle the situation and it was managed just fine. She went to the hospital later on that day to be checked out by an OB just to be sure everything was fine. That set my mind at ease a bit, and I plan to attempt a homebirth with my next pregnancy, as long as everything is going smoothly. In our system, you register at a hospital anyway, let them know you will likely be having a homebirth, and if you need to go into the hospital, they will welcome you. One of our good family friends is an OB/GYN and she has stated that she feels like maternity care here has improved since midwives were welcomed into the system. Her experience is that she can now focus her care on moms who are most at risk and let natural births take their course with midwives.

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In the UK homebirths are covered by NHS midwives. Even when you go to hospital, if your pregnancy has no complications you will have your baby delivered by midwife. The main difference being at hospital your midwife will be some random stranger. At home your midwife is the same person that you've seen throughout your pregnancy.

I had a homebirth with my second and my standard of care at home was much higher than that I'd recieved in hospital with my first. My midwife was much more attentive to my needs at home. I was much more relaxed. I felt my wishes was much more respected as they weren't trying to free up a bed!

I've heard numerous times people from different parts of the world state that homebirths or atleast assisted homebirths are illegal. Homebirths can be very safe but only with proffesional support incase thing go wrong. There also needs to be additional safety procedures in place. I had to have an extra scan at 37 weeks to check presentation and to make sure the cord and placenta weren't in a position to cause any concern. I was given a huge lists of circumstances where I would have had to go to hospital either prior to starting labour or any complications during labour. During labour I would have been transferred by ambulance if anything even minor had gone wrong.

What would happen to a woman who had opted for homebirth with an unregistered midwife? If that midwife faced prosecution for even being at the birth? Would she take the action thats in the best interest of mother and baby, not matter how minor the complication or would she try and deal with herself?

Kylie - posted on 09/14/2009

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I agree with you, it should be an option. The home birth they showed was so lovely too. I'm glad they showed the story about what can happen when home births happen illegally, it was very sad but something that the government needs to think about. Making it illegal is not going to stop it from happening and it could lead to unnecessary deaths. The part where the doctor who did the c section made the baby wave at the camera while he was still half in his Mum was disturbing...

Tracy - posted on 09/14/2009

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Yes I sure did. I found it really interesting and thats how I got the idea too :)

I had no idea that the government was going to make it so hard for midwives and parents that choose to have home births. Its wrong to force people to do such an act against the law. I wish the system could work together. Home birth does not suit everyone but it should be an option.

Kylie - posted on 09/13/2009

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haha we had the same idea...did you watch Sunday night on channel seven last night Tracy?

Tracy - posted on 09/13/2009

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Sorry I must have uploaded this question at the same time. I was having computer issues at the time.

Sharon - posted on 09/13/2009

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I think its a nice idea.



Its not a risk I would want to take. I realise most births are relatively uncomplicated but its that chance that something could go wrong.



I think some women are so determined to have it their way no matter what they opt for homebirths. They claim comfort but really? Comfort over safety?



Because of my issues not having a doctor in attendance was never an option.



I also don't think the public should foot the bill for it.



But it would be AWESOME if hospitals would get behind midwifery and provide a set of rooms for it. Maybe set up like a typical home, problem would be keeping it sterile but lets face it, how sterile is the average home?



Midwives here are seriously under fire. Which sucks. I read of a case up in NE America - where the baby died. The mom didn't want to press charges but the state did. Claiming she was negligent. Poor woman, from what I read it didn't seem she was at fault at all. She no longer midwives.

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