"The following Position Statement on Homebirth Services 2011 has been developed utilising extensive consultation with all submissions being considered by a Review Panel. The Review Panel consisted of nominees from all Branches (eligible midwives, private practising midwives, midwives providing public homebirth services and midwifery academics) and two representatives from the ACM Consumer Advisory Committee. It should be read in conjuntion with the Guidance for midwives regarding homebirth services 2011."Readers of this and other midwifery blogs will know that an Interim Position Statement on Homebirth, with a guidance document and lit review were released a couple of months ago by ACM. The position statement was endorsed by the Nursing and Midwifery Board of Australia, prior to the documents being circulated in the midwifery profession for comment. The full significance of this rapid endorsement by the regulatory body, of an 'interim' document, prior to consultation with the profession, is not clear.
The new Position Statement presents a clearer position than the previous one. One of the key stumbling blocks is what to do with women who choose home birth against the midwife's or other health service's advice. The new statement addresses informed decision-making, informed consent, and the woman's right of refusal, and acknowledges that "some women may choose a planned homebirth when this is not recommended by a health care provider. Women should continue to have access to midwifery care whatever they choose."
In a Croakey blog (the Crikey health blog), outspoken obstetric spokesman Dr Andrew Pesce states that:
"Until those individuals and groups which advocate for publicly funded home birth unambiguously and publicly state home birth is unsuitable for high risk pregnancies, their advocacy will remain at the fringes of the maternity system."Dr Pesce's concluding, and tantalising statement is:
"If they [those individuals and groups which advocate for publicly funded home birth] can cross that Rubicon, they might find that they have broader support than they realise."
I say this statement is tantalising, because it appears to be suggesting that obstetricians and mainstream maternity services would, with agreed boundaries, support publicly funded homebirth. That is happening in a variety of homebirth models, providing homebirth services for a small number of women around Sydney, Melbourne, Adelaide, Perth, Fremantle, Darwin, Alice Springs.
I wonder if that support would extend to home birth in the care of a privately employed midwife?