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Doctors to be in charge of midwives, homebirthing and of course, women

Today there were yet more rallies across Australia to draw attention to the immoral legislation currently before Parliament which seeks to remove women’s human rights and criminalise independent midwifery.

Maternity Coalition have put together a document which explains clearly the changes to the legislation and what they mean. My rage is hard to put into words because how many ways can we say “Human rights, that’s all we want!” in the face of this blatant oppression?

A statement I wrote on behalf of Joyous Birth, one of the rally supporters was also read out today in Victoria.

We are heading into a dark place for women in this country, a place not previously considered possible by most people and even now many of us struggle to grasp the full implication of these ill considered laws.

This is not about risk, or lobby groups, this is about our lives, our families and our wider communities on whom the impact of birth is everpresent. As we constantly hear from every corner, our hospital system is in crisis. It is a system designed to manage sickness in sick people. It is anachronistic to think that this can also serve the needs of healthy women experiencing a normal part of their lives or the needs of families to gain appropriate support around birth and parenting. Birth is a social event, not a medical emergency. It is performed by women, it is not delivered by doctors. It is a normal part of the continuum of human existence, both everyday and extraordinary each time we birth. Forcing women to engage with any system which does not meet their needs is false economy predicated on a philosophy that we are not entitled to decide for ourselves.

There is no other primary healthcare provider in this country who is treated like a second class citizen in the way independent midwives experience. The furphies promoted by the government, opposition and particularly the press are designed to sway public opinion with half truths and obfuscation. Homebirth has been a path for women in this country since before it had a name and yet now our right to decide for ourselves where and with whom we birth is being removed from us by law. I am not an incubator. I am a woman, a human being with basic human rights to self determination and the right to decide how I will approach my own healthcare and what happens to my body and my children. I want my family to flourish not simply survive in a system where more than one in three women will experience major surgery instead of birth.

The ripple effect of how our hospitals impact on birthing women is a serious problem in our society. Birth trauma is unspoken, unnamed, ignored and women are leaving our hospitals distressed and unsupported. This is not birth, this is delivery. Birth belongs to women, not bureaucrats, nor careproviders, simply to women. Laws which are clearly aimed at removing immediate and appropriate access to the only careproviders suitable for most women are untenable and immoral. We can vote but we can’t achieve genuine reproductive freedom.

The government has left us with no choice here despite every other mode of birthing being supported. We don’t seek special treatment, we simply seek the fulfilment of human rights and the right to bodily integrity. The lobby groups which have achieved this victory for a misogynist and wealthy special interest group should feel ashamed at their dash to control women’s bodies and births into which they have no business intruding. Surgeons for surgery, women for birth, midwives to support those who choose them. It’s a simple enough equation. 99% of births wasn’t enough for you?

We stand together today on the brink of this disaster, watching our human rights disappear into a vortex of rhetoric and false promises but we are not duped. We are not going away, we cannot support a system in which we, our daughters and our granddaughters are not recognised as sentient beings but relegated to handmaiden status. Stand strong, put women first and birth will follow. Justice and logic are on our side and we are proud to stand shoulder to shoulder with other women and men who seek nothing more than simple births where women and babies are honoured.

You can read the MC document below. Sorry about the crappy formatting, I thought getting it here was more important than fixing that up.

Australia’s National Maternity Consumer Advocacy Organisation

Doctors to gain veto powers over midwives and birth choices

On 5 November the Government announced that the “Medicare for midwives” Bills would be amended
to require midwives to have “collaborative arrangements” with “medical practitioners” before being
eligible for professional indemnity insurance or Medicare rebates:

Doctors must approve each midwife!s entry to private practice:


Midwives will be required by Commonwealth law to have “collaborative arrangements” with
“one or more medical practitioners” before being eligible for Commonwealth-subsidised
professional indemnity insurance (PII).

PII will be a prerequisite for a midwife to enter private practice, under new national registration
laws, being enacted state by state.

Doctors will be able to unilaterally withdrawal from collaborative agreements with a midwife,
rendering her uninsured, and legally unable to practice in a private professional capacity.

This legally mandates medical control over midwives’ ability to register and work in private
practice.

This will be set in Commonwealth law, which can only be changed by Commonwealth
Parliament.

These provisions are contained in the Health Legislation Amendment (Midwives and Nurse
Practitioners) Bill 2009.
Doctors must approve women!s access to Medicare rebates for midwifery care:


Midwives will also be be required by Commonwealth law to have “collaborative arrangements”
with “one or more medical practitioners” before their services are eligible for Medicare rebates.

This allows medical control of individual women’s access to midwifery care.
This is potentially defacto “parallel regulation” of the midwifery profession:


Medical practitioners will control the registration status of midwives, despite their being a
discrete, separately regulated profession.

Medical professional organisations could set guidelines for collaborative arrangements,
potentially forming defacto regulatory standards for midwifery endorsement and practice.
This gives doctors right of veto over women!s choices in birth care:


Any model of care – women’s choices in birth care – using private practice midwives, or
developed under the Commonwealth’s new arrangements, will be subject to medical control or
veto.

This gives medical practitioners unprecedented control over women’s choices and access to
care.

The proposed legislation is anti-competitive:


One group of providers will be able to control consumer access to another group of providers
of the same business service, e.g. antenatal care.
“Collaborative arrangements” may be legally restricted to privately practicing doctors:


The amendments do not specifically include hospitals as able to form collaborative
arrangements with midwives. They require medical practitioners to be “of a kind or kinds
specified in the regulations”.

It is unclear whether a hospital, health service district or authority may be included within the
definition of “one or more medical practitioners”, but it appears unlikely.

Doctors who are employees of public hospitals can’t make “collaborative arrangements” as
employees of the hospital they work for. They work for the hospital, attend their workplace
when rostered on and collaborate in line with hospital policies.

A range of very serious consequences would flow if these arrangements were restricted to
privately practicing doctors. Consequences could include:
o
No new midwifery models in public hospitals.
o
No private midwifery practice.
o
No homebirth care from midwives in private practice.
o
Practice midwives in private obstetricians rooms could be the only viable model of
private practice or Medicare-funded midwifery.
The amendments do not improve “safety” or “continuity” for Australian mothers:


Midwifery is a profession with standards, guidelines and codes of practice developed to ensure
the safety of midwifery care in any setting.

Doctors, who are trained in a different skill-set, do not have the expertise to safely control
midwifery practice.

Continuity of care has been a fundamental goal of the midwifery reforms. These amendments
make this continuity much more difficult to deliver.

No provision is made in the amendment specifying that collaborative arrangements will be
based on patient safety or continuity of care. Medical practitioners will have veto on their own
terms.
This brief represents the best information available to Maternity Coalition on 9 November 2009. We
are actively seeking ongoing clarification and dialogue with Government in order to ensure women and
families have access to accurate information.

For full text of amendments go to:

http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;adv=yes;db=;group=;holdingType=;id=;orderBy=priority,title;page=7;query=Dat

aset%3AbillsCurBef%20Dataset_Phrase%3A%22amend%22;querytype=Dataset_Phrase%3Aamend;rec=11;resCount=Default

For more information contact: Bruce Teakle 07 3289 0231, teakle@maternitycoalition.org.au

Doctors to be in charge of midwives, homebirthing and of course, women

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