Homebirth: defend a woman's right to choose

September 13, 2009
Issue 

In June, a raft of new legislation was presented to parliament to in effect, outlaw homebirth midwifery in Australia. Indemnity insurance would be a legal requirement for medical practitioners, under a new national registration and accreditation scheme.

Private insurers don't cover homebirth midwives, and the government decided not to subsidise their indemnity insurance. Given the new laws, this will leave midwives in a position where, if they want to perform homebirths, they will be doing so illegally.

The September 4 Sydney Morning Herald said that from July 2010, about 200 independent midwives would be deregistered. They faced fines of up to $30,000 if they continued working.

But this is not simply an attack on independent midwives. It is a further attack on women's freedom, on their right to choose if, when, and in what manner to have children. In most states and territories, abortion is still on the criminal code. So, for simply exercising their right to control their own fertility, women, their doctors and even their partners face potential criminal charges. The case now before the courts in Queensland illustrates the archaic consequences of such laws.

Women who do choose to go through with a pregnancy are now being told they have no choice over where they give birth: homebirth is not an option, unless midwives are prepared to practise uninsured and face the consequences.

But what is in effect criminalisation will not put an end to homebirth, it will merely force it underground. Women will continue to assert their right to choose if, when and where to give birth, and pro-choice campaigners will continue to campaign to have state and federal laws taken off women's bodies.

The attack on homebirth midwifery has prompted a protest campaign, culminating in a large rally in Canberra on September 7. Despite the cold and rainy weather, more than 2000 people from across Australia attended. The rally demanded government funding and insurance for homebirths,

Beginning at the Aboriginal Tent Embassy, the rally marched to Parliament House. It was addressed by Justine Caines from Homebirth Australia, Liz Wilkes from the Australian Private Midwives Association, Lisa Metcalfe from the Maternity Coalition, Greens Senator Rachel Siewert, opposition health spokesperson Peter Dutton, Family First Senator Steven Fielding, independent midwives and others.

The crowd reacted disapprovingly when addressed by Labor senator Claire Moore, who defended the legislation. The rally was organised by Homebirth Australia and the Maternity Coalition, and was supported by the organisation Joyous Birth.

A rally was organised in Adelaide by the Homebirth Network on the same day.

The rally was the largest protest defending women's rights in Australia for many years. As a young Cairns couple are now set to stand trial on charges relating to an abortion, it is a significant time to be campaigning in defence of women's right to control their own lives.

Under increasing pressure, federal health minister Nicola Roxon met state and territory health ministers on September 4, days before the rally. She announced that a transitional clause would be inserted into the draft national registration and accreditation scheme legislation. This clause would give midwives unable to obtain indemnity insurance temporary exemption from this requirement until June 2012.

However, campaigners say this does not solve the problem; it simply defers the ban on homebirth midwifery for a further two years.

The Greens intend to move amendments to the legislation in the Senate to ensure access to private practice midwifery without financial penalties for the midwife.

Metcalfe told Green Left Weekly that access to homebirth was a question of women's right to choose. "It is a feminist issue in the sense that women are the ones who have the babies", she said. "Restricting women's right to decide where they have their baby and who they have their baby with is a violation of human rights."

Metcalfe also pointed out the importance of having homebirth as an option in the context of increasing restrictions on hospital maternity services. "[Homebirth] is one of the few ways they can access maternity care in many areas of Australia", she said.

"I'm not just talking about remote communities. I'm talking about places like the Blue Mountains and Kiama [in NSW]. In this situation, access to private practice homebirth has become absolutely critical."

Defending maternity services in public hospitals is also very important. By restricting access to homebirth while closing maternity units in hospitals, the government is leaving pregnant women with limited access to essential care.

Metcalfe said there were problems with the two-year exemption as well: "It isn't just a simple matter that midwives will be exempted for two years from the requirement for indemnity insurance", she said.

"There are rules attached to the exemption. Midwives have to be on a register. They will have to inform women that they have no insurance. There are increased reporting requirements; they will have to report every birth. This is about restricting women's access to midwives, rather than facilitating access."

Like the campaign to take abortion completely off the criminal code, the campaign defending access to homebirth won't go away until it wins.

Metcalfe said: "The first thing will be to identify how restricted private practice midwifery will be in the next two years. We have to keep the pressure up to ensure that indemnity insurance is made available to midwives."

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