Title: FW: Next Weeks program with Dr Wooldridge and Ms Macklin

Dear Norman Swan

Would you please ask Dr Wooldridge and Jenny Macklin to address the costly, high levels of intervention in Australian Maternity care which continue despite the recommendations of a decade of national and state reviews as well as the outcry by consumer organisations.
 
For example the most recent Rocking the Cradle (1999) Senate Community Affairs Committee Report into Childbirth Procedures stated;
"More than a quarter of a million babies are born every year in Australia.  Childbirth is the single most important reason for hospitalisation and accounts for the highest number of occupied bed days."  
Yet the only outcome of this Senate report seems to be a call to reduce the number of ultrasound's performed on healthy pregnant women, because ultrasound's cost this country more than the entire antenatal budget.  
 
Meanwhile our hospital based maternity services like other medical specialities, remain inadequate to the needs of their clients, as evidenced by public concerns about related matters such as waiting lists and the levels of Australian mothers with post natal depression.
 
But in the media outcries in these concerns band-aid measures are only offered except in programmes such as Four Corners which have examined the disproportionate levels of treatment in Australia compared to other countries such as UK where there is no "fee for service".
In regard to our maternity services the aforementioned reviews and their repeated recommendations have been to increase access of Australain families to midwifery models of care, which are women cntred and low intervention.
 
Internationally the Evidence Based Cocherane Database and World Health Organisation recognises midwives as the most cost effective and appropriate care for the majority of women (80-85% is an accepted figure), rather than the obstetric based model which is costly and appropriate for a minority of women requiring specialist care.
Yet currently in Australia only approximately 3-5% pregnant women have access to midwifery models of care but they reap high levels of satisfaction and health outcomes hence are supported by consumer organisations such as AIMS, Maternity Coalition, Homebirth Australia.
Meanwhile in NZ where women choose their Lead Maternity Carer under their national health system, 70% choose midwife care and it is not coincidental that the maternal and neonatal outcomes are the best in NZ's records.
 
What are the major parties going to do to break the inequity of access of Australian families to evidence based best practice models of maternity care (such as the Comminty Midwifery Program WA) and lower the financial and social costly high levels of intervention in Australain childbirth in- line with the recommendations of the aforementioned reviews?
 
yours sincerely


Denise Hynd

"Having a baby in Victoria." (1990) Final report of the Ministerial review of birthing Services in Victoria.

"Options for effective care in Childbirth." (1996) National Health & Medical Research Council.Canberra.

"Rocking the Cradle; A report into childbirth procedures." (1999) Senate Community Affairs Committee.

"Select Committee on Interventions in childbirth." (1995) Legislative Assembly of WA.

"Effective Care in pregnancy & childbirth" (1999) Enkin, M, et al. Oxford University Press (A summary of the International Cocherane Database)

Dodd, J & Reibel T "Birth Transforms Her: A report on birth choices,
adjustment to parenting, breastfeeding and postnatal depression."
2000 Community Midwifery WA Inc Fremantle.

Evaluation of the Community Based Midwifery Program (1998). CMWA & Centre for Research for Women.

Evaluation of the Community Based Midwifery Program (2001). CMWA & Centre for Research for Women

Shearman Report NSW (1989)

Having a baby in Vic (1990)

ACT Maternity Services Review 1994

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