Sunday, November 8, 2009

Getting Political Over Private Midwifery Care in Oz

The government in Australia is not supportive of private midwifery- unlike countries like the UK and NZ. Here is a letter I wrote to go with a group of women tomorrow to meet Julia Gillard. I would have loved to have gone with, unfortunately I have a school trip arranged that cannot be changed.

The Honourable Julia Gillard, MP, Deputy Prime Minister

Dear Ms Gillard
Please let me introduce myself to you, and tell you why I am asking you to amend your government’s legislation, and ensure that midwives are enabled to practise midwifery privately.
I am a mother of 8 children. And have a degree in Social Work, with particular interest in Child Care. I have trained Nannies in partnership with the NZ Polytechnicon and have worked in homes for children in South Africa.

My first two children were born in South Africa, the next four in NZ and two here in Australia. My first child was born in a hospital in very distressing circumstances...extremely rude staff and a male chauvinist doctor, who made it obvious he would rather be home enjoying his weekend. I was stripped of all dignity and respect. The second child was in a private hospital under the care of a private midwife in the most serene and relaxing of circumstances. My labour was cut in half due to my body relaxing with appropriate emotional support.

I then went on to have 4 home births in NZ where the private midwives who, as in the UK, are well respected and have an excellent reputation for exceptional work within medical circles. With each new child my husband and I researched the statistics and medical information for home births and made an educated choice to birth at home as it is a very safe option for healthy Mums.

One of the best aspects of having a private midwife in NZ was that I was so exceptionally well supported in after care. I was one of the fortunate mothers who was surrounded by an excellent support group. But for many mothers in NZ, their post natal care is a life line! Not only was I visited by my community nurse but as soon after my baby was born I was visited on numerous occasions by my midwives and I cannot speak highly enough of this as a preventative program for training inexperienced mothers as well as having the added opportunity they have to seek out and find parenting problems before they can escalate to crisis proportions. When training for Social Work it was drummed into us, “Prevention is Better than Cure” But so often social work these days is putting the ‘band aid’ on after things have gone horribly wrong. Preventative programs not only save families and protect children but in the long run it saves the government time and money as fewer programs are needed for ‘mop up’ work.

Private midwifery is therefore not only about ensuring safe and healthy deliveries, it is about encouraging excellent parenting skills, being close enough to a woman to see warning signs and refer a woman for help if it is needed. This cannot be done with the present state health system. It puts many children at long term risk, I believe. As far as I know there are no community nurses who can visit a mother and baby in their home where there are no know problems....there is no chance of seeing a mother working with her own child in the home environment, unless a problem has already presented- prevention is therefore not a possibility.

For my seventh baby, I was a few weeks short of due date when I arrived in Australia having again had private maternity care in NZ. (Please note that all private midwifery care is free in NZ as it is seen as a basic right for mothers who chose this form of care. The NZ government pays for two private midwives to come to attend a birth. ) When arriving in Australia, I was very; very lucky to get into the Royal Women’s Natural Birthing Unit….it is the next best thing to having a private midwife. There was zero chance of finding a private midwife as I discovered when phoning around.

For my eighth baby I was also booked with the Natural Birthing Unit ( I had passed the screening tests and struck gold in the “ lotto system” of choosing clients, they literally draw your name out of a hat, as so many women vie for this option) Again at the last minute I was left to find new care as I was told that the two midwives who were looking after me were leaving the hospital ( one was retiring and another had personal family reasons for taking long term leave) and I could no longer remain in their care. I was only left with a 'State Hospital Option' as the private hospitals and private obstetricians felt it was too late to take me on. I was devastated as a few months prior a best friend nearly lost her baby in the usual State Hospital System, due to a foreign midwife not understanding the seriousness of her complications. If she had not returned in persistence to the hospital later that day she and her baby could have died, fortunately she saw a better midwife this time and she was rushed in for an Emergency Caesar. I was facing the hurdle of going to the same hospital and hoping I would not receive the same midwife.

Hospitals are for sick and dying people and for me personally not for birthing, unless there is a particular need in pregnancy or labour, or postnatal care. I had tried and tried at the beginning of the last pregnancy to find a private midwife - to no avail. The next best choice of a Natural Birthing Unit came to me by luck of the draw but was taken from me due the lack of midwives supported in this role. I should have taken this matter to a higher level at the time!

There are too few private midwives due to unnecessary government pressure. By a miracle at a fairly late stage in my last pregnancy again, I found Sonya Beutel, a private midwife in Toomoomba. I cannot speak highly enough of her professional manner and abilities! She is the most outstanding midwife I have ever had. It is the likes of her that you are intending to cut short in their professional medical ability to care way above averagely well for mothers and in their overall excellent professional service. Sonya Beutel even came with me to the Ipswich Hospital to talk with the obstetricians about our plans to homebirth and they gave us their consent, reassuring us they could help at any stage if we needed them. If your own state health care obstetricians can support your private midwives – why does our government not support them? I had my best ever labour with Sonya, as I was so very relaxed and happy. Again her follow up support was excellent and easily as good as the New Zealand system.

To compare this to your present screening process here in the Australian state system: when I wanted to go to Royal Woman’s Natural Birthing Unit, I had to go through their usual system for screening first. The midwives were inexperienced, unable to find the babies heartbeat due to the position of the baby and they hurt me during examination. They treated me unnecessarily like I was a social work case, rather than the social worker in their screening process for finding Mum's with problems, their process is excruciatingly clumsy and undignified, they do not have good people skills or counselling skills....and certainly the process is not conducive with any sensible mother with problems confiding in them with their superficial attempts to help. Again, I should have taken matters further at the time. How can you possibly compare this type of superficial screening and preventative program with the excellent, real relationship program our private midwives already provide! Instead of cutting back on private midwifery, more effort should be put into training midwifes well so they are capable of such excellent standard of care.

As an older and experienced mother, who has fought for human rights as a qualified social worker, I value the freedom of choice….medical and birthing choices is one of the most basic of human rights. I would be devastated to see this right disappearing for our future generation. I see it as medical regression, when so many first world governments support and encourage their private midwives in their excellent medical work.

My husband has a number of degrees in chemical engineering and mathematical modelling and has been totally supportive of the educated decision I have made to have a private midwife wherever possible. It not only takes a great midwife to deliver babies safely, but a relaxed and content mother. We need to have this choice given back to us as part of our basic dignity and respect needed as woman! It is a call for a basic human right!

Yours sincerely,
Joy Murray.

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