Re: Independent Midwives

[Andrea Bilcliff]

Dear Senator,   Thank you for your reply. I was not aware that Senator Eggleston was previously in the medical profession, although I had my suspicions from the tone of his emails!   The issue of "adequate and accessible medical back-up" is a central one. Midwives are experts in the care of healthy women during pregnancy and birth. Obstetricians are experts in complicated pregnancy and birth. The roles are complimentary and there should be no competition between the two. Midwives do not wish to perform caesarean sections any more than obstetricians wish to spend hours with a woman in labour. Midwives seek to refer and transfer to the medical back-up WHEN NEEDED. However the current system prevents this from happening.   I am not sure which "midwife representatives" at the senate enquiry into childbirth you spoke to, but I can most definitely assure you that midwives are legally liable for their actions with or without the presence of a doctor! I refer you to the internationally accepted definition of a midwife:   "A midwife is a person who, having been regularly admitted to a midwifery educational program, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery. She must be able to give the necessary supervision care and advice to women during pregnancy, labour and the postpartum period, to conduct deliveries [assist the birthing woman] on her own responsibility and to care for the newborn and the infant. This care includes preventative measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help..." Yes, both professions should be working together for the best outcomes for women. The Government should also be working with both professions and ceasing to support the current medical monopoly of the maternity system. Yours sincerely, Andrea Bilcliff.   ----- Original Message ----- From: Tchen, Tsebin (Senator) To: 'Andrea Bilcliff' Sent: Friday, July 20, 2001 5:43 PM Subject: RE: Independent Midwives Dear Ms Bilcliff,   You are probably not aware that Senator Eggleston is a doctor and before going into the Senator had a practice in outback WA.  So he would have a good idea on how a birth's natural process might turn out to be a life-threatening medical process.   Alan Eggelston is an open-minded and easy-going person, so I think you can be sure that he does not discount the benefits of natural child birth to both the mother and the child - provided there is adequate and accessible medical back-up.    I am not sure if midwives are legally liable the way obstetrecians are.  My impression from evidence I heard from midwife representatives at the senate inquiry into child birth was that they are not.  I don't think the midwife representatives claimed any expertise for assessing the condition of the festus, and they apparently were releived of their responsibilities during birth once a doctor took over.  Your argument that child birth is a natural process and should be allowed to take place naturally is a central theme, but I have yet to hear a representative midwife practitioner state categorically at what point a child birth is no longer natural but the health of both the mother and the baby is still unimpaired.   I think the real issue should not be whether there is a "best" child birth procedure or which profession is "best" at child birth, but how these professions should work together to ensure the best outcome.   Tsebin Tchen