Australian Private Midwives Association: WA Health Department statement on Home Birth

Thursday, October 14, 2010

WA Health Department statement on Home Birth

Home Births

In Australia there are a small number of women who elect to have home births. In WA, approximately 200 women have a homebirth each year representing between 0.65-0.8% of all births.

Some countries have higher rates of planned homebirth. For example around 2% of all births in the UK are homebirths and in the Netherlands this is much higher at around 30%. In these countries the infrastructure for safe home birthing is well established and outcomes are usually positive.

There has been controversy about the safety of births at home with differences in opinions between health professionals and sometimes it may be difficult to obtain a balanced view.

In 2007 WA Health commissioned a review of evidence into Models of Maternity Care. This review discusses the safety of planned home births by women of low obstetric risk.

The review concluded that
"Planned home birth with a qualified home birth practitioner is a safe alternative for women determined to be at low risk of pregnancy complications." view full review-see page 11 (external site) (PDF 1.22MB)

You should be aware that your midwife will advise transfer to hospital if complications arise and that there should be a clear plan in place with your local hospital to allow a smooth transition to hospital care, should it become necessary, at any point during your pregnancy, labour or birth.

Some women opt for homebirth after a prior birth experience within a hospital environment that may have not met their expectations. For a few of these women homebirth is not a safe choice due to pre-existing medical problems or previous pregnancy or birth complications. If this applies to you we encourage you to make an appointment with senior members of midwifery and medical staff at the hospital to discuss your concerns. They will then be able to support you to ensure your next birth experience will be more rewarding.

If you are considering a homebirth make sure you are fully aware of the potential and often unpredictable complications that may arise during labour and birth before you make your choice.

Community Midwifery Program WA (external site) provides continuity of midwifery care for low-risk women who are planning to birth at home.
Royal Australian and New Zealand College of Obstetricians and Gynaecologists Homebirth statement (external site) (PDF 520KB)
Royal College of Obstetricians and Gynaecologists Homebirth statement (external site) (PDF 84KB)
Report: Review of home births in Western Australia (August 2008) (external site) (PDF 445KB)

WHO ARE WE?

The Australian Private Midwives Association represents midwives in private practice. The association is focused on the safety of women, the ability of women to access quality midwifery care across Australia and the partnerships between women and midwives. APMA supports women’s choice in maternity options within a framework of quality and safety and believes in women being able to access midwives in all settings. APMA unites all midwives seeking to provide continuity of care for women.

APMA strives to provide midwives in private practice with information relevant to their practice and advocacy in the political process.

Enquiries:
Joy Johnston joy@aitex.com.au
Marie Heath NSW and National 0407 266004
Clare Lane (Vic) 0416 130219

APMA POSITION STATEMENT on PLANNED HOME BIRTHS WITH A MIDWIFE

1. We support home birth with a midwife in attendance for women who have uncomplicated labours. 2. We support and adopt the International Confederation of Midwives’ (ICM) Definition of the Midwife (2011), which is foundational to all midwifery practice, including homebirth. 3. We support the right of every woman to access a midwife as the primary maternity caregiver who works in partnership with the woman throughout the episode of care, who is able to be the responsible professional in attendance at the birth either at home or hospital, and who is able to make appropriate referral and transfer of care when required. 4. We support the right of a midwife to practise privately in a fee-for-service or funded relationship with the client, or to take up employment. 5. We support only those regulatory restrictions that are able to pass the ‘public interest’ test: “How does this promote health and wellbeing in the mother and baby?” 6. We support an expectation of equity, including equal pay for equal work throughout a midwife’s scope of practice. Midwives who provide primary maternity care are entitled to the same public funding, the same opportunity to charge a fee-for-service, the same access to hospital referral, and publicly supported indemnity insurance, as medical practitioners providing the same maternity services. 7. We support processes by which midwives are able to gain experience and mentoring in order to commence and demonstrate competence in homebirth practice. 8. We support seamless and reliable processes by which midwives are able to make hospital bookings for women planning homebirth, and arrange transfer to the hospital in a timely way when needed.