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obstetric monopoly

I wish homebirth was illegal

By | consumers' rights, midwives, midwifery, reproductive justice | 30 Comments

This may surprise you all but I sometimes wish homebirth was illegal.*

 

Recently I saw a kind woman asking online what would be nice in a basket for her friend due to have her babe at home in the near future. There were lots of heartfelt suggestions from massage vouchers to biscuits which can be eaten one handed while breastfeeding a newborn. My first thought, because I tend to run away at the metaphorical mouth, was human rights. I’d like a basket of human rights, please. Gift wrapped? No no, just the same as everyone else’s would do, thanks. I don’t want a plastic bag, I brought my own calico number with a political statement on the side. But then I thought, actually what we need isn’t only human rights, what we need is an enemy that is honest about their actions. Why don’t they just make it a crime to birth at home? That’s what everyone wants, it would make it so easy to prosecute us all. Send the midwives to prison. Take the children. Give the women years of community service or minimum security gaol. Re-educate partners to their roles in preventing women’s exercising of their human rights. Bang. Done. No more mealy mouthed “expanding choices” double plus good speak, just a refreshing burst of honesty: birth outside of a hospital and we will put you in gaol. Simple.

 

I hear fairly regularly from consumers who’ve had GPs tell them homebirth is illegal. Do they really think this? I find it problematic to imagine GPs being so ignorant about law but then it’s also problematic to imagine that GPs would fail to inform us about the full range of options available to pregnant women. That couldn’t be, could it? After all, when I go in and ask what drugs are available to asthmatics no one says, “Well there’s only this one and that one, there are no others, they’re illegal!” Of course birthing outside of a hospital is in no way illegal in Australia. Not at all. There is no Act which says anything remotely like that. Those who seek to remove human rights are far more clever and strategic than that.

 

The far smarter plan, of course, is to create as much fear and shame as possible around birth generally and birthing outside of hospital and hope that women and their families will police themselves right out of homebirth. It also means that politicians never have to own up to their actions, they can continue to swathe them in the rhetoric of choice. Removing most women’s access to midwives who would support them to birth at home is obviously “expanding women’s choices”, in the same way that episiotomy protects women’s perineums from damage. It also gives us nothing to concretely struggle against because all opposition to this Orwellian “reform” is like struggling with fairy floss. You bite down on this massive ball of poisonous, highly coloured crap, only to feel it disappear to grit between your teeth. The more they can tie us up in Senate enquiries, letter writing, inventing new overseeing bodies, writing new position statements that no one but the writers of Yes, Minister understand anyway, desperately trying to understand what the hell all the rules make, the less we have something concrete against which to struggle. The brilliance of the blanket suppression of birthing rights is how it’s a hydra of massive proportions and no matter how many heads you confront, there are more waiting and no song to lull Fluffy to sleep.

 

A simple Act of parliament making us criminals would be something open, honest and able to be confronted. If birthing outside of hospitals is so dangerous and irresponsible why isn’t it illegal? Why are we fined for failing to restrain children in cars if birth is the place where all the risk lies? Instead we struggle with the abuse of judicial power which can be wielded in coronial courts where there is no onus of proof and there are no real rules of evidence. When coronial processes are treated like prosecutions but the prosecution is on the same team as the judge, and the justice is tailored to the opinions of counsel assisting, there is no justice. These are proceedings which have no judicial credibility but are clearly tools of punishment and oppression targeting some of the most vulnerable families and professionals in the country on the back of personal tragedy. When grieving women’s babies are used as the weapons to flog their midwives and our decision making processes are ridiculed with caricatures of Bad Mothers put abroad in a colluding media, there is no hope of freedom, dignity or compassion. The law is being abused and employed as a weapon of social control to keep women in line. It’s very difficult to explain to people that no, it’s not illegal to birth at home but only midwives in this category can support women in that category (but only with ante and postnatal care, not the birth) and this national body decides who’s in and who’s out. There is no governing body meant to divide up consumers into the Yes or No baskets, it’s been left to midwives instead so those who maintain registration risk losing it every time they take on a woman outside of the Yes basket. Given how obstetrics works, the majority of women are in the No basket and yet they birth just fine at home. Some midwives stand with women and refuse these categories. Some are exploiting it to make money. Corrupt systems breed and support corrupt behaviours.

 

Our communities struggle with mischievous and vindictive reports to DoCS by hospital staff and disgruntled collaborating midwives who now work under the direct control of obstetricians in another one of those “expanding women’s choices” things that make no actual sense when brought out into daylight.

Women are bullied, berated and punished if they transfer to hospital.

Families are refused birth certificates and experience intrusive questioning with no legal basis when applying for birth certificates and the baby bonus.

Families are threatened with court orders removing children, women are threatened with being sectioned and midwives can be too scared to accompany clients to hospital in dire circumstances because to do so would leave them open to harassment by hospital staff.

Women are threatened with DoCS reports (or actually reported) for refusing to feed babies with artificial baby milk.

Midwives are having malicious and baseless reports made against them by hospital staff which tie them up for long periods of time unable to practise.

Women are reported to DoCS for breastfeeding older babies and children and cosleeping is considered a suspect activity.

Women have had police turn up on the doorstep because hospital staff have reported them for not turning up to be induced or on suspicion of planning a homebirth.

Hospital staff are making reports to the police and coroners in circumstances which wouldn’t raise an eyebrow in hospitals.

There are no laws making hospitals or people who work in them to be the birth police, charged with protecting babies from their mothers’ decision making. It is simply a culture of bullying and control which lives like quicksand on the lesser trodden paths of our society. It is one of the biggest open secrets in Australia at the moment. The press won’t cover it, politicians won’t own up to it, we’re called paranoid and conspiracy theorists when we try to tell people about it. The growing numbers of us facing coronial proceedings are beginning to spread word of this among the legal community who are dealing with circumstances most have never seen, nor imagined before, in long and varied careers. Equally interesting is how only some stillbirths outside of hospitals achieve inquiry status. (And sadly, very very few in the hospital system.) It’s clear that it depends who you are, or who the attending midwife is, before your baby’s death attracts the notice of the state.

 

I think that we are going to reach the peak of obstetric control in Australia in the next few years. They will never succeed in forcing us all into hospitals to birth but they are willing to give it a good go. If they would all just be honest about it and criminalise us, we could run a repeal campaign. Community campaigns changed laws in each state which criminalised homosexual sex, a consenting activity between adults which occurs in people’s homes, generally speaking, and which was rightly judged to be no one’s business but those consenting. I have friends in Sydney who talk about having to rent two bedroom flats so that real estate agents wouldn’t tell the police two men had rented premises with one bedroom. They talk about midnight raids on private homes, dragging them out of bed under suspicion of having had sex. We moved on from that, when can we move on to accept the idea that adults birthing in their own homes are equally entitled to the protection of the law or to simply be left the hell alone? The difference, of course, is that homosexual sex was between men who were unlikely to be pregnant. Their bodies are different from the contested public zones of women’s bodies where nothing we do is private and we walk around in a permanent state of consent. We will have equal marriage rights in this country long before women’s bodily autonomy is recognised in law. Actually I doubt our bodily integrity will ever be enshrined in law. The goal posts controlling our lives can never be brought to so concrete a form nor our oppression challenged in such a profound way. Far better to keep us all believing the myth of this equality we have supposedly reached now we’re allowed to vote.

 

  • That’s a joke. Sort of.

Throwing out the lies with the birth water – Sydney screening!

By | consumers' rights, homebirth campaign, reproductive justice, surgical discourse | One Comment

Throwing out the lies with the birth water is a documentary about a woman’s right to give birth at home. It outlines the key issues for birth choices in the Blue Mountains, NSW. It follows one woman’s journey before, during and after her homebirth. It questions the definitions of risk in birth and the notions of choice. This a hot topic in the marginal Federal seat of Macquarie.

The documentary has been largely shot in the Blue Mountains of NSW and also features footage of the major protest rally that took place in Canberra last year attended by over 4000 protesters.

The Blue Mountains supports a high number of home births that occur nationally each year. Legislative changes that have come into effect from July this year with restrictions and requirements will limit birth options for women. Many women in the Blue Mountains who choose home birth will have to go to hospital, they will have no choice.

An inability to attract obstetricians and anaesthetists to the local hospital in Katoomba means regular staffing shortages and closures. Women often have to travel to Nepean or to Lithgow to give birth. There have been roadside births en route to hospital. The documentary includes an interview with a women who had to give birth on the side of the road as a result of this shortfall.

Throwing out the lies with the birth water is a 50 minute documentary being made by Rani O’Keeffe. A sneak preview rough cut of the documentary was screened at the Edge Cinema in Katoomba on Saturday 31st July to a packed and enthusiastic audience.

THROWING OUT THE LIES WITH THE BIRTH WATER

Rani O'Keefe

Come one, come all, to the screening of this great documentary by Rani O’keefe.

Bring your partners, bring your friends, bring your family. (babies and children welcome)

When: Tuesday 17th August 2010
Time: 7:30-9:30pm

Cost:$10 per ticket

Where: Mu-Meson Archives at Crn Parramatta Rd & Trafalgar St, Annandale; at the end of King Furniture building up the steel staircase.

RSVP: Please contact tia_aimee@hotmail.com register tickets. Payment will be on the night at the door.
Facebook event here.

Legal Regulation of Pregnancy and Childbirth

By | consumers' rights, feminism, reproductive justice, surgical discourse, surgical monopoly | No Comments

Via the ever marvellous Feminist Law Professors. As personhood of the foetus is foisted on Australian women via the backdoor of homebirth legislation, we should be paying attention to this.
Legal Regulation of Pregnancy and Childbirth

Courtney G. Joslin
University of California, Davis – School of Law


The Child: An Encyclopedic Companion
, University of Chicago Press, 2009
UC Davis Legal Studies Research Paper No. 205

Abstract:

This piece, a short entry in The Child: An Encyclopedic Companion, examines the legal regulation of pregnant women. In particular, the article discusses whether and under what circumstances the state can force pregnant women to undergo unwanted medical treatments or physically restrain or punish pregnant women for engaging in otherwise legal conduct when the state believes that these interventions are necessary to protect the fetus from potential harms.

Accepted Paper Series

More Henci Goer writing

By | consumers, consumers' rights, feminism, surgical discourse, surgical monopoly | No Comments

I’m in danger of becoming a groupie. I was already wildly grateful for her work but after a morning of reading about pole dancing being a sport, how Australia lacks women in parliament, and how women aren’t too fussed by the unspeakable misogyny of Tony Abbott (and neither are men), it was such a relief to read something that actually acknowledged women as human and deserving of human rights.

Go forth and enjoy.

The NIH VBAC Consensus Conference: Will It Pave the Road to Hell with Good Intentions?

We rightly should applaud any effort that helps women and clinicians decide between planned VBAC or repeat cesarean but lament any attempt to curtail a woman’s right to refuse surgery, be it on clinical or nonclinical grounds. VBAC is a right, not a preference, a right, let me add, not abrogated by the clinician’s opinion of its wisdom. It does not matter if you, me, and everyone on the planet were to line up and say to a woman VBAC is a bad idea in your case, she still has the right to say “no” to surgery. Clinicians and institutions must be brought to accept their ethical and professional obligation to provide best practice care to every woman wanting planned VBAC. If the conference fails in this task, then whatever it accomplishes, it will fall short of its duty to childbearing women with previous cesareans.

Joyous Birth’s senate submission Part the Fiftieth

By | consumers' rights, homebirth campaign, midwives, midwifery | One Comment
If only people saw violence against birthing women so clearly.

If only people saw violence against birthing women so clearly.

Not content with sharing the lurve of the previous enquiries into who really owns women’s bodies  human rights Homebirth in Australia, here is the submission sent today to the next enquiry which I predict will find that women want midwives and to be in charge of their own birth and will result in the AMA’s final victory over our human rights as we lose the right to homebirth with the midwife of our choosing. Cynical? Bitter? No, just realistic.

10 December, 2009

Joyous Birth, the Australian homebirth network

http://www.joyousbirth.info/

Ms Claire Moore

Chair

Senate Community Affairs Legislation Committee

By e-mail: community.affairs.sen@aph.gov.au

Dear Senator Moore

Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills

We are opposed to the amendments that have been introduced to the above bills which would require midwives to enter into formal “collaborative” arrangements with medical practitioners. To implement a situation where a medical practitioner has veto over the actions of a midwife, and consumer, is anything but collaborative. It is a nonsense to refer to such methods as collaboration when they are clearly in direct opposition to the reasonable person’s understanding of such a term. Appropriate accessing of obstetric services when, and as required, by consumers and/or midwives already exists in demonstrable forms so there is no need to force this unworkable model onto unwilling participants.

It is an accepted fact worldwide that midwives are the best and most appropriate careproviders for women. The World Health Organisation has made it clear that routine obstetric care for healthy women is damaging to women.

WHO’s Care in normal birth: a practical guide (Geneva, 1996) states:

Women and their babies can be harmed by unnecessary practices. Staff in referral

facilities can become dysfunctional if their capacity to care for very sick women who need all

their attention and expertise is swamped by the sheer number of normal births which present

themselves. In their turn, such normal births are frequently managed with “standardised

protocols” which only find their justification in the care of women with childbirth

complications.

Midwifery is a specialised profession which provides a distinctly different model of care to birthing women from that of obstetrics. It is not a branch of nursing but a separate profession. Nursing is the care of sick people and midwifery is the care and support of pregnant women within a social and community framework, not a medical or surgical framework. This misunderstanding is an historical confusion peculiar to Australia which has not occurred in other countries, where superior care and outcomes are plain to see.

The AMA website reads in total defiance of international example, stating that ‘Obstetricians are the most appropriate care providers for women.’ Obstetrics is the care and management of pregnancy and birth where abnormality, illness or complications have been detected. As with other specialist or surgical branches of healthcare in Australia, there should be no reason for obstetricians to be the first port of call for healthy pregnant women. As demonstrated time and again internationally, to do so only increases surgical rates and iatrogenic complications, and reduces consumer satisfaction and overall safety. For obstetricians to claim they are appropriate healthcare resources for most women is an outrageous claim unsupported by evidence or logic and clearly driven by profit.

Across Australia, the existing medical monopoly has resulted in the overwhelming majority of women undergoing routine, institutionalised obstetric services. The result has been rising rates of intervention and rising rates of infant and maternal mortality and morbidity. Australia’s perinatal data bears witness to this.

What has not been accurately measured is the rate of psycho-social trauma to women and their families as a result of this medicalised approach to maternity services, and the repercussions throughout society as a result. Trauma as a result of unnecessarily managed births and no right of informed refusal is a common experience for birthing women.

Let us be reminded that the leading cause of maternal death in Australia is suicide.

This legislation seeks to remove consumer-driven homebirth from Australia and force women to birth in hospitals. Many women choose homebirth because of previous experiences of the hospital system and the negative effect it has had on them, their children and their families and communities. Some women choose to avoid this by birthing their first and subsequent children at home. In any case, the drive to remove this right can only be viewed as a major insult to women and families who choose homebirth as well as those citizens who value women’s reproductive freedoms as human rights.

In New Zealand and the UK, around 80% of women choose the Midwifery model of care. It is patently obvious that when the vast majority of normal births are attended by midwives there is a reduction of infant and maternal morbidity and mortality in comparison with Australia.

The AMA’s propagandist methods seek to pose a false debate around safety and manufacture  a way for the community to be distracted from the real issues here – the right of women to autonomy around basic healthcare decisions. Neither obstetricians, nor politicians, should be permitted to dictate how consumers birth their babies. Australia’s signature to the 1995 Beijing declaration makes us accountable on a world stage for this proposed removal of women’s reproductive freedoms.

The proposed amendments, if passed into law, will create a restriction of practice for midwives and will curtail the freedom of consumers to choose an appropriate model of care.

As countless surveys and reviews have found, midwifery care is what Australian women want. It is holistic, inexpensive and with benefits to communities at every level. It is clearly inappropriate for midwifery in Australia to be manipulated by doctors.

The 2008 report, Improving Maternity Services in Australia – A Discussion Paper from the Australian Government (Canberra, 2008) states:

All facilities should offer women choice of carer and place of birth, more education and should promote midwife-led care across the continuum. An enormous obstacle is private obstetric charges, as obstetricians may be hesitant to forgo lucrative incomes of up to $9,000 per pregnancy, with some Sydney doctors reported to be charging up to $12,000 and earning collectively up to $1.4 billion per year.

It also recommends the following:

The state and national governments must shift the emphasis from a medical model of care to a social model of care in childbirth that encompasses women’s needs holistically rather than focussing on the clinical aspects of pregnancy and labour.

and

Women and families should be actively encouraged to take control of their pregnancies and be supported in their decision making.

The implementation of this pernicious and dangerous legislation would completely contradict the findings of the government’s own report in order to pander to what is in essence a trade union. Surely the provision of healthcare is to attend to the needs of the consumers not the political desires of the AMA.

Similarly, the Review of Homebirths in Western Australia (Subiaco, 2008), undertaken for the Department of Health WA, states:

It seems apparent that the maternity systems are, for some women, too medicalised and restrictive, and do not meet their needs. It is our impression that some women, who in other models and systems would not be ‘eligible’ or recommended for homebirth, seem to be choosing this option as a surrogate means to access midwifery continuity of care and waterbirth. This issue was apparent in both metropolitan and rural areas. The reviewers believe that the choice to give birth at home or in water will continue, as will the choice to have a vaginal birth after a caesarean section. Therefore, developing systems to support safe and satisfying systems of care that provide childbearing women with a diversity of options is essential.

This lack of choice, echoed as it is within hospitals, traumatises women, leaving them shattered and brutalised after experiencing conveyor belt maternity policies. It would be a grave error indeed to force this upon women.

The birthing women and families which are represented by this submission wish to let the government know that we will not back down from challenging and protesting this attack on our human rights.

Women would be pleased to speak to this committee about their experiences of both birth trauma and homebirth. Consumers should be the bulk of those consulted in this process since it is on our bodies that the outcome will be written.

Yours sincerely,

Janet Fraser

National Convenor, Joyous Birth

Australian homebirth network

On behalf of the women and families of the Joyous Birth communities nationally.

The Real Birth Wars *graphic warning*

By | consumers' rights, homebirth campaign, montages, surgical monopoly | No Comments

Those not from around here might need a little explanation about this post.

The dude in the suit peering at the baby he’s imprisoned in a plastic box, away from it’s mother, is Dr Andrew Pesce, current head of the AMA. I heard a rumour he’s a docbot or was that a godbot? Either way, I’m sure it’s not true, he’s a surgeon so he must be wonderful, right?

The woman in the glasses in parliament is our current Health Minister, Nicola Roxon MP who has kindly dropped Australian women in deep shit due to allowing the docbots free reign over our bodies and human rights.

Nice.

So a birth activist has created this montage which I have to warn you contains graphic footage of violence and brutality like caesareans, stirrups and women in terrible pain and anguish. In any other scenario it would provoke howls of appropriate outrage but you know, birth, women, babies, hospitals, no one considers that scary but those of us who’ve seen through the emperor’s clothes and know there’s not a lot of lifesaving going on but there is a lot of moneymaking occurring.

And let’s not forget what Professor Hannah Dahlen said at the recent senate enquiry after which legislation to put surgeons in charge of birthing women and remove midwives as primary carers was put before the house:

The leading cause of maternal death in Australia is suicide.

The Real Birth Wars