This past month, we had Alicia Payne MP stand up in Parliament to ask the Prime Minister:
IS THIS ACCEPTABLE?
And his response?
That is why we are committing $150M to a road!
This sums up the state of play. The value of women is only as far as others will benefit.
We know that it is not the quality of the road that matters, it is the quality of the care and the ability to access it. During pregnancy, many rural women must travel to seek maternity care, especially in a continuity model within the expected birth location. Otherwise, care is fragmented and limited to basic checks without discussion. Preparation classes must either be travelled to, or sought online, as it can be logistically difficult to attend hospital provided ones.
Many women are travelling over an hour in labour, often passing a rural hospital on the way, but unable to stop there as maternity services are not supported. Or being induced to avoid the 'risk' of a Birth Before Arrival. Rather than providing evidence based best approach care, we expect women to travel in labour or accept unnecessary interventions.
Remote women must relocate from 36 weeks pregnant, to be near the birth place. At their own expense and arrangement. Many will choose induction, to reduce the costs involved with waiting.
The standard care system does not provide the means or encouragement to be prepared for the unassisted birth, we pathologise this normal physiological function, which instills unnecessary fear, this idea that you MUST have a medial attendant, in a medical facility else it is too dangerous.
Insurance issues faced by private practicing midwives, has seen a dramatic and frustrating reduction in private midwives over the last decade. Along with the lack of medicare rebate for these services, if you are one of the few with a private practice midwife in your area, you must also have the funds to access this option. This is not ok. Homebirth should not be a privilege.
This narrative MUST change.
We must return power to women, and their partners must be prepared. This is a critical for all women, but especially for rural women faced with long distances. As more and more birth services are centralised, and women are not able to access continuity of midwifery care, we will see an increase in avoidable interventions. Intervention has it's place, and a key role of midwives is to ensure that women have access to the necessary interventions in a timely manner. They also support women in understanding why it is necessary, and what their options are. This is critical for informed decision making and ultimately meeting the requirements of informed consent.
Midwifery is a profession that is currently not being used to its full scope. community based midwifery and decentralisation are key to humanising birth and creating much better outcomes and experiences for everyone involved.
Explore this issue further:
ABC Radio program - nightlife interviews two wonderful midwives
womensagenda: the PMs solution for women giving birth on the side of the road upgrade the highway
relevant blog posts:
are you prepared for an unassisted birth
five reasons to prepare for unassisted birth
we should be focused on choice not consent
from belief and fear to informed and confident
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