Dear Sally and all
I can't answer either of these questions.
The Age medical reporter Victoria Button got a piece about the Inquiry into
page 3 of today's paper (Tues). She gave particular focus to Jane Fisher's
claims that caesareans are linked to an increased incidence in certain
psychological disorders, and that subsequent pregnancies may reactivate the
condition.
The article reported that:
"The Australian College of Midwives called for a funding reform to allow
midwifery at all births."
I have written to Victoria Button with the following comment:
<This is not incorrect - but it is probably confusing to many readers. I
will attempt to briefly explain why.
All (or almost all) women giving birth in Australia probably do have
midwifery care. The problem is that the woman (consumer) is not able, under
current funding arrangements, to choose a midwife. Very few women are
attended by a known midwife. The concept of partnership between each woman
and her known midwife is central to the woman centred philosophy of
midwifery. Birth is not an illness. A midwife is not a nurse.
Funding for both public and private midwifery care is available only through
hospitals - which are controlled by doctors who do not understand midwifery
care. Public funding for all births includes a 'medical' component, but the
midwifery care is treated as part of the service. Antenatal care is
frequently provided in the community by doctors, and the funding is through
Federal government Medicare. Most of these doctors do not have anything to
do with the birth. Those who are involved in the birth do so through the
private hospital system, and rely on midwives to attend their clients
through labour, and call them in time to catch the baby. Of course, if there
are complications, that specialist is called to provide expert care. However
there is evidence that the involvement of specialists as primary carers may
indeed be a factor in increasing the likelihood of medical intervention.
This is one of the main issues that the Senate committee is attempting to
address.
Ten years ago New Zealand changed from a system of hospital based maternity
funding, similar to ours, to a system over which the woman has choice and
control. The woman may choose a lead maternity carer, either a GP doctor, a
specialist obstetrician, or a midwife, and this is covered by government
funding. The committee was particularly interested in the changes in
maternity care in New Zealand. A recent report quoted in our submission,
Maternity Care Provider and Outcomes, NZCOM 1998, in which the perinatal
mortality rate (number of babies who die) for births under a midwife lead
maternity carer was 3.6/1000, compared with 11.5/1000 for GP/midwife shared,
and 14.9/1000 for O&G/Midwife shared, was given a lot of attention. This
evidence suggests that it is extremely safe to choose midwifery care. The
only midwives in our country who work with a similar degree of independence
to our colleagues in NZ are homebirth midwives, and perhaps a few in birth
centres.
Women are eager to maintain control over their bodies and lives, especially
at a time of personal intimacy such as the birth of a baby. You did not stay
for the presentation by Maternity Coalition, but I would encourage you to
read their submission. I wish you every success in your efforts as a medical
reporter, that you will be objective, and present a true picture of the
issues you address.
Yours sincerely
Joy Johnston>
:
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Sally Tracy
Sent: Tuesday, 7 September 1999 9:55
To: [EMAIL PROTECTED]
Subject: Re: Senate Inquiry
dear Joy
many thanks for this briefing. I am going to represent AMAP on the 14th
Sept in Sydney. I need some feedback on two points.
a.. Does anybody have the latest reference for the spending on
ultrasound technology as part of the maternity budget? I have several
references but I want to be absolutely sure.......they all look so
unbelievably high!
a.. what constitutes 'early discharge' in the majority of practices? I
have conflicting definitions to hand. And when is a woman eligible for
visits by a community midwife, after discharge from hospital?
Many thanks in anticipation
sally
--
This mailing list is sponsored by ACE Graphics.
Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
