Planned homebirth is a sensitive and controversial issue in Australia after several cases in which either the mother or child did not make it due to complications. The fact is that there is a lack of public funding available to make it possible for all homebirths to be carried out and supervised by registered, qualified, and experienced midwives who are backed by hospitals.
According to a 2014 report by Australian Mothers and Babies, 0.45% of all women who gave birth in Australia in 2012 did so at home. The data also shows a total of six fetal deaths occurred that year out of 1,180 homebirths. The data here, however, doesn’t include babies who were born alive and died a few hours later, despite these deaths being common amongst homebirths.
Regardless, many women choose to have their babies at home. After all, they have every right to choose how to give birth, and since it’s difficult to get a publicly funded midwife these women often have no choice but to seek private help. If this is the case for you, you’re not alone.
The right to choose and the right to be informed
The fact remains that there’s possibly a higher risk of complications occurring when you give birth at home. Because of this, your doctor and midwife have the responsibility to encourage you to deliver your baby in a safe environment where you’ll have access to qualified and competent obstetrics.
But if you are adamant that homebirth is the best option for you and your child, consider all the information before making the final decision, especially in the case of a high-risk pregnancy or previously traumatic births.
At the end of the day, the final decision rests with you, as it’s your right to choose where and how you give birth to your child.
What could go wrong during a homebirth?
It’s impossible to predict what could happen during a homebirth, however there are enough stories that show how risky it can be. And from a legal standpoint, in some instances these deaths are treated as crimes.
While there’s no doubt that tragedies also occur in hospitals, many homebirth deaths have had coroners conclude that the mother and child could have been saved if the birth had been had in a hospital.
- In 2009, a baby girl in New South Wales died soon after birth due to a hypoxic episode, which medical experts suggested could have been caused when the cord was tangled around her neck during the delivery. The NSW Deputy State Coroner said that the mother’s choice to opt for unsupervised homebirth cost the baby her life. The mother was only being assisted by two people, neither of which held medical qualifications. Medical experts said if a qualified midwife had been present then the baby would have likely survived. Instead, the baby was taken away as ‘evidence’, her death was investigated as a crime, and the home was treated as a crime scene.
- During 2012 in Victoria, a baby girl almost died two weeks after her hospital backed homebirth, because – her parents claimed – the midwife took almost an hour to arrive. The parents claimed that the publicly funded homebirth programme had failed them, and that if they had been told that the midwife would be delayed then they would have taken the ten minute drive to the hospital.
- Another case in South Australia involved a ‘birth worker’ who has been linked to several unsafe homebirths that had been inappropriately planned and were outside her scope of practice. Magistrate Michael Ardlie expressed that there were features of those particular pregnancies that made them unsuitable for homebirths, therefore leading to the tragic outcomes. The birth worked has since been fiend and is permanently banned from delivery midwifery-related services.
- Similar cases echo overseas. In 2010, doctors in the UK established that a mother who bled to death just hours after giving birth at home shouldn’t have taken the risk due to complications that occurred in a previous pregnancy. According to the report, her private midwife had insisted to her that homebirths were safe. The midwife was accused of brainwashing the mother into home delivery, and of multiple errors including failing to realise that about a third of the placenta was still in the woman’s uterus.
A shocking truth: Not all midwives are insured
Whenever you pay for professional services, ask the provider to confirm that they have professional indemnity insurance cover, just to give you peace of mind knowing that in case of an adverse event, you’ll have some form of financial support from their insurance.
However many people underestimate the real cost of legal action, which could at times cost well above the $100,000 mark. They don’t ask their midwives whether they have professional indemnity insurance, mistakenly assuming that everyone who works in the medical field is licensed, experienced, and covered.
Likewise, many people may not be aware that since the collapse of the international insurance industry in 2001, private midwives who provide a homebirth service are no longer able to obtain professional indemnity insurance. This has led to a significant reduction in the numbers of midwives offering homebirth, and has also meant that parents could be taking a huge risk when choosing midwives and birth workers to assist in home delivery.
It’s a tricky issue. The National Registration and Accreditation Scheme requires that registered health professionals hold professional indemnity insurance, yet private midwives who assist in homebirth settings are exempt from this requirement until December 2016
This means that if you’re planning for a homebirth and are engaging the services of a private midwife, it’s your responsibility to ensure that they’re not only qualified and experienced but also insured.