Fed: Maternity system needs overhaul, doctor says

AAP General News (Australia)
04-06-2009
Fed: Maternity system needs overhaul, doctor says

SYDNEY, April 6 AAP - Australia's maternity system needs to provide better care so
pregnant women feel confident giving birth in hospital and not at home, obstetricians
say.

National Association of Specialist Obstetricians and Gynaecologists (NASOG) president
Dr Andrew Pesce says he knows of four infant deaths after home births in the western Sydney
area in the past nine months.

He says homebirths, with or without midwife help, increase the risk of infant death
threefold, compared to a three in 1,000 chance of a full term baby dying in hospital.

Dr Pesce said women had the right to choose where they gave birth, but needed to know
the risks of home births.

"We're not talking about unavoidable deaths due to congenital abnormalities or prematurity
that no-one could have avoided," he said.

"We're talking about fully-grown, normally termed babies."

Homebirth Australia secretary Justine Caines said infant deaths after homebirth would
increase unless the federal government offered funding support.

The government's maternity services review, released in February, rejected commonwealth
funds for homebirth and said professional indemnity cover for a federally-funded model
that included homebirth would be limited.

"If you think that there's been four deaths ... from free birth now, what's going to
happen when there is no option of homebirth for any woman?" Ms Caines said.

"If that's the case ... that is very, very serious and I'd be saying very clearly to
(Health) Minister (Nicola) Roxon, look out for some more unless you want to appropriately
support registered midwives."

Ms Caines, who delivered all her seven children at home, said women chose homebirth
because they wanted to be treated and supported by one person throughout pregnancy and
birth.

"In the hospital system, be it public or private, there could be three or four ...

labouring women at any given time, so one midwife is darting from room to room.

"If that's considered safe, I'll be a monkey's uncle - that is an overstretched system."

Dr Pesce said the government should focus on improving the continuity of care for pregnant
women in hospitals.

"They should be focussing on a system which provides continuative care, so women get
to know the midwife and the doctor who is going to be looking after them," he said.

"As opposed to now, to save money and because of workforce difficulties, care is fragmented.

Women might see 12 or 13 different people during the pregnancy."

He said the homebirth debate should not overshadow the need to improve obstetric care
for indigenous women and mothers in rural areas.

AAP sg/evt/ht

KEYWORD: HOMEBIRTH

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