Erika's response to the Maternity Services Review

I welcome this review and would like to have my point of view considered.

I am a mother of 2, a doula for over 10 years, life coach, coordinator of BaBs - Birthing and Babies Support groups and a supportive member of Maternity Coalition. I feel passionate about seeing change in our maternity services that would enable real choice for the birthing women of Australia.

I find that the work I do as a doula illustrates the lack of support in the current maternity system:
# Couples gain clarity that they did not have before regarding the birth options available to them and the possible benefits and risks associated with each.
# Couples are guided more effectively in how to make an informed choice (and then encourage trust in themselves to speak up) in order for them to gain some sense of control of their choices and birth experience.
# Couples are seeking doula support so they will have some degree of continuity of care through their pregnancy and birth.
# Couples welcome the tangible support offered through meeting a woman's needs for physical support, emotional care and practical helpfulness at the labour and birth.

This kind of support I believe should be offered by the woman's care provider first and foremost, not from additional services which they have to pay for out of pocket.

I would like to see women of Australia to have affordable choice to birth in the hospital, birth centre (attached and separate to the hospital), home or community setting.

A good definition of informed choice is one in which:
- Accurate information is provided – the information presented is based on ‘state of the art’ knowledge.
- The specific points where choice is available are detailed and outlined.
- The advantages and disadvantages of the various options are given.
- Enough time is given for consideration of the physical and psychological implications of each choice.
- There is information included about any potential risks, flowing from specific decisions, presented in a sensitive, non-threatening manner.
- Crisis decisions – based on information which is unavailable to the parent(s) – are delegated to the medical attendants.
- Emotional support is available, regardless of the decision made.
- Evaluation is made to ensure that information is understood.

Many Ob's and GPs do not have or do not give the time to provide this kind of supporting service to the women they are caring for. The model where I see this most often is with one on one midwifery care at home births, 'Know Your Midwife' programs in hospitals and some team midwifery programs.

Best practice, statistical evidence, the WHO and many many positive stories from the women themselves illuminate the fact that government should expand the services of the midwives practice in the home, community and hospital setting.

I believe midwives would be helped by the government if they could:
* access Insurance
* be paid through the Medicare system
* maintain status as carer of their client when collaboration and consultation with other health professionals deems it as necessary
* be supported through fair legislation that reflects the rights of a midwife to practice her skill
* be suported with guidelines enabling more streamline collaboration and consultation with other health professionals when necessary
* provide additional necessary services???

As a tax payer I am frustrated that families are paying for health care in areas where substantial savings could be made with no greater risk to women and their families. In Maternity Services birthing families and tax payers are paying for specialist services before there is any proof of need for it. Midwives are experts in normal physiological childbirth and by their definition are the most appropriate health carers for birthing women. I believe the New Zealand model of Midwifery services offers a more appropriate structure that Australia could learn from, in addressing some of these issues.

Erika Munton

Birth Works - Birth Attendant/Life Coach
-----------------------------------------------------
www.birthworks.info
erikamunton@yahoo.com.au