Home births threatened in Australia

Not enough noise is being made over plans that will threaten Australian women's right to give birth at home with the help of a midwife. Proposals contained in the draft Health Practitioner Regulation National Law, due to come into force in July 2010, will effectively eliminate midwives' ability to legally attend home births in a professional capacity. As I understand it the bill requires midwives to be able to access insurance to be able to be registered, insurance that in turn is only available for midwives working in hospitals. This precludes the possibility of registered midwives attending home births, and for good measure the bill proposes a $30 000 fine for midwives who do attend home births in professional (but unregistered) capacity. (More information on the bill is found at http://www.joyousbirth.info/homebirth-is-not-a-crime.html , with further links at the bottom of the page.)

I find this proposal absolutely abhorrent, for three reasons.

1) It isolates and stigmatises the work that midwives do at homebirths by implying that it is dangerous and unreliable medicine, and thus cannot be insured.

Midwives are highly trained professionals with specialist knowledge. Those that attend home births have particular knowledge of how to make women comfortable in their own home and how to encourage women to listen to their bodies. There is plenty of evidence to suggest that such elements of birth - safety, familiarity, autonomy and control - are crucial to positive outcomes from the birth process. There is also plenty of evidence to suggest that hospitals often do not have or exercise such knowledge, preferring to implement protocols and regulations, often against women's wishes. In particular, women giving birth in hospitals frequently complain of being prevented from moving around during labour, of being given interventions they do not want, and of being given set time-limits in which to give birth. This sort of medicine should not be considered any more 'safe' or 'reliable' than giving birth at home, given the emotional and physical trauma that can be involved.

2) It penalises women who wish to exercise their choice to give birth at home.

Women have been fighting for decades to increase their choices and autonomy throughout the reproductive process. In 1973 the Boston Women's Health Book Collective published their ground-breaking and best-selling guide/polemic, Our Bodies Ourselves, which not only taught women about their bodies but also proposed radical alternatives to conventional Western medicine. Central to their analysis was the importance of autonomy: a woman's ability to choose according to her needs, needs which she herself determined. The book drew upon and inspired the work of many women setting up alternative healthcare services for women (and by 'alternative' I don't necessarily mean anti-Western, I mean services for women run by women) and was part of a wave of women demanding that their rights around healthcare be recognised.

Against this backdrop, the move to restrict homebirths to those that are either a) unassisted or b) illegally assisted by midwives, risking a $30 000 fine, is a major step backwards. It is paternalistic and patronising, and assumes that women (and midwives) do not know what is best for women giving birth. It prevents women from trusting their bodies, and will damage some women's ability to have an empowering experience.

3) It sends the message that home birthing is not a natural or safe practice.

This is simply not true. Women experience complications in childbirth wherever they happen to be, at home or in hospital. If a professional midwife is in attendance at home, it is her responsibility to make the decision to move a woman to hospital, should she need intervention, with plenty of time. This is a crucial part of her job. Thankfully, such cases are in the minority, and usually result in a positive outcome. Of course, hospitals cannot guarantee a live birth, and every year women face the tragedy of the death of the baby even when they have followed all conventional advice. Furthermore, as mentioned above, there is evidence to suggest that women experience less trauma when made comfortable in their own home, than they do within the unfamiliar and at times confronting environment of a hospital. Naomi Wolf (Misconceptions) and Sheila Kitzinger (Birth Crisis) have both written considered but passionate critiques of the ability of hospitals to bring about anxiety and stress during childbirth, seeking to change the very attitudes that are contained in this draft legistlation: that doctors know best, that hospitals are the best (only) place to give birth, and that women who argue otherwise are ignorant. They are not alone, and there are thousands of books, pamphlets, websites and support groups designed to push for greater recognition of the relatie benefits and/or dangers of both hospital-assisted and home births.


Many women value their ability to give birth at home and will be devastated if this option is taken away from them. I myself have been put off this option due to the uncertainty surrounding the future of home-births (and it must be said, the prospect of making arrangements for a birth in Castlemaine from Alice Springs). I hope that for future pregnancies I will be more settled (waiting to settle down, after all) and will be able access a registered, legal midwife to help me labour at home. But this won't happen if we don't fight. To make your opposition to this bill known, write to:

The Health Minister, Nicola Roxon (Nicola.Roxon.MP@aph.gov.au)
Your state or territory Health Minister - they are all in this together.

Sign the petition here

And tell your friends and family all about this - it's vital we make MORE NOISE!!