I'm getting sick of going round and round in circles with this debate. How
do you reply to these people that think too many births end in emergencies
for it to be safe and just don't understand why we don't need/want ob's
and
hospitals within 2 mins reach? That think if it means saving even one life
we should not have the choice?
Does anyone have some links to the best studies showing the evidence of
safety of birth away from hospitals? ie free standing birth centres and
homebirth
I know I can wade thorugh the internet and find ones like the cochrane
review, but I know that many of you may have them easily to hand, so if
you
can spare a minute to forward them I would be grateful. I am not receiving
the majority of ozmid emails at the moment (not sure why) so could you cc
my
email address in the reply so that I actually get them.
[EMAIL PROTECTED]
Much appreciated thankyou
Honey Acharya
Friends of the Birth Centre Townsville
----- Original Message -----
From: "Andrea Robertson" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Thursday, September 22, 2005 7:05 AM
Subject: [ozmidwifery] Indigestion at breakfast....
Hi everyone,
This was not a good read over breakfast this morning. Miranda Devine is
known for her right wing views, but this was almost too much to bear.
Where
do these dinosaurs live, and where do they get their stats from?
Andrea
PS She's thoughtfully included her email address.....
------------------------
Mum and baby are caught in the middle
September 22, 2005
Midwives and obstetricians differ over the risks of birth centres away
from
hospitals, says Miranda Devine.
IT WAS rather ironic when the two pregnant women starring in a story on
ABC-TV this week about a new style of doctor-free natural birthing centres
were rushed to hospital for the ultimate in medical interventions.
At the beginning of The 7.30 Report story on Monday, one woman was sitting
in a chair in the midwife-led birthing unit in Ryde, grimacing in pain
from
contractions. By the end of the story she had a cute little baby, but only
after a 20-minute ambulance ride to Royal North Shore Hospital and an
emergency caesarean.
The other woman, was also transferred to hospital for an induction when
her
baby "refused to come".
Advocates of the stand-alone, midwife-led model of birth units, segregated
from hospitals, claimed this proved the model worked well. "The midwife
has
been able to recognise when there were problems or when the labour looked
as if it was going to deviate from the normal," Sally Tracy, associate
professor of midwifery practice development at the University of
Technology, Sydney, said.
But obstetricians are understandably unhappy about being expected to pick
up the pieces at the last minute of a childbirth gone wrong, with the
inevitable legal ramifications.
It's ear trumpets at 40 paces as midwife groups and obstetricians bicker
over the risks involved in setting up birth centres a distance apart from
major hospitals. But the NSW Government is pressing ahead with plans to
open more midwife-led birthing units, with two already open: in Ryde and
in
Belmont, near Newcastle. Home-birth trials are also in place.
The Australian Medical Association complained this month that the Health
Minister, John Hatzistergos, hadn't even consulted them about this radical
change. As a result, the minister is meeting the association's NSW
president, John Gullotta, today to discuss the new model, among other
matters. Such are the sensitivities that Gullotta would not comment until
after the meeting.
But the association's obstetrics spokesman, Dr Andrew Pesce, a consultant
obstetrician at Westmead Hospital, was happy to speak, minutes after
delivering a healthy baby boy yesterday afternoon. He was keen to point
out
it was a vaginal delivery to a mother who had previously had a caesarean,
thus demonstrating his non-interventionist credentials.
He has come under heavy attack from midwife groups since he began speaking
out on the new units. He and his "industrial organisation" are accused of
fear-mongering because of a prospect the Medicare pie might eventually
have
to be shared with midwifes.
But there is more than enough work around for the shrinking ranks of
obstetricians, and this Federal Government is unlikely ever to fund
midwife-only birth centres.
Far from being alarmist, what Pesce has to say is reasonable. "We're not
against midwife care or even midwife-led birthing centres . It's the
segregated model of care we don't want . We don't want to be picking up
disasters six hours later."
Indeed. Why remove birthing centres from hospitals so that an ambulance
ride is necessary in case of emergency, just to prove a point?
A policy of universal, all-natural childbirth is wonderful if you can
afford to lose a child or a mother along the way, as used to happen in
Australia. A quick tour of a cemetery tells the story of our obstetric
past
when the death of mother or child, or both, in childbirth was far from
uncommon, as were brain damage for the baby and permanent disability for
the mother.
No one wants to pathologise childbirth but nor should we kid ourselves it
is risk-free, particularly with increased levels of obesity in women and a
rapidly rising maternal age, both factors which can cause complications.
In 1975, the median age of a first-time married mother was 24. By 2002 it
had risen to 30.1, and in more affluent parts of Sydney it is even higher,
matched by a rise in caesarean rates.
The reality of childbirth in Africa, where medicalisation cannot come soon
enough, is that one woman in 16 dies from complications in pregnancy and
childbirth - more than half a million women every year, or one death a
minute, according to the World Health Organisation. In Nigeria alone, as
many as 800,000 women suffer from obstetric fistula, an injury caused by a
difficult labour, that leaves a woman incontinent, and, in Nigeria,
shunned
by her community.
Australia, by contrast, is one of the safest places to give birth in the
world, according to the organisation.
"Australian women are now 40 times less likely to die during pregnancy or
childbirth than they were immediately before the Second World War, and
perinatal death rates in 2004 are a third of 1972 rates," wrote doctors
Caroline de Costa and Stephen Robson in a paper published last year in the
Medical Journal of Australia.
We can largely thank the "medicalisation" of childbirth for these
advances.
But, as seems to happen eventually with just about every human endeavour,
the advances have been taken for granted and ideology has turned
medicalisation into a dirty word.
"In other areas of medicine, achievements of this magnitude would be an
immense source of pride, yet obstetrics is perhaps the most criticised of
all specialties," wrote de Costa and Robson. "Obstetricians have embraced
evidence-based practice, and the onus should be on proponents of
demedicalisation to prove their case. It should not be a heresy to ask
whether an increase in maternal satisfaction is a fair and reasonable
trade
for a decrease, however slight, in safety for the baby. After all, our
babies will have to live with the consequences."
Instead, proponents of demedicalisation have politicised childbirth to
such
a ridiculous extent that learned papers on the subject are written
invoking
feminist theory and the writings of the French postmodernist and S&M
aficionado, Michel Foucault.
"Reflecting on practice to theorise empowerment for women: using
Foucault's
concepts" is one title in the Australian Journal of Midwifery. Using "a
postmodern, feminist praxis approach", Kathleen Fahy of the University of
Newcastle's school of nursing and midwifery examined "how power operates
in
the medical encounter with the childbearing woman".
For Pesce, when he delivers a baby he is interested in only one outcome: a
healthy mother and child.
<mailto:[EMAIL PROTECTED]>[EMAIL PROTECTED]
-----
Andrea Robertson
Birth International * ACE Graphics * Associates in Childbirth Education
e-mail: [EMAIL PROTECTED]
web: www.birthinternational.com
--
This mailing list is sponsored by ACE Graphics.
Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
--
This mailing list is sponsored by ACE Graphics.
Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
