Medical News Today ran an article today on the Australian Medical Association’s backlash against the proposed changes to the country’s maternity services.
Dr Capolingua said the real test of the report is not in the recommendations, but the policy it generates. “We will keep government accountable for any changes that lower the bar on the health of women and their babies,” she said.
“It is not enough to run maternity services on the belief that birth is a natural process. When things go wrong, and they often do, women need immediate access to an obstetrician, an anaesthetist and a paediatrician. This access saves lives.
“I fear the introduction of a system where women are pressured into having a ‘natural birth’ that puts them and their baby at risk. Too often in other countries, including New Zealand, the midwife model means obstetricians are only called in when the ‘natural birth’ has become a medical emergency.
“Rather than expanding the range of services available to women, the New Zealand experience saw the virtual abandonment of GP obstetrics in rural areas.
“Any policy that doesn’t seek to improve our current world-class survival rates for mothers and babies must be viewed with deep suspicion.”
This coverage is a public response to the Australian government’s recently publicized review on maternity services. Additional coverage was found on WAToday:
The Australian Medical Association has accused Federal Health Minister Nicola Roxon of being “gung-ho” about the role of midwives and misrepresenting the findings of the Government’s maternity services review.
A report released yesterday by the Commonwealth chief nurse and midwifery officer Rosemary Bryant recommends an expanded role for midwives — but only if they meet “an advanced level of professional education and experience”.
The changes could potentially allow midwives to prescribe medicines, open private group services and contract their services to hospitals. Midwives would also be given access to the Medicare system, although the report did not recommend Commonwealth funding for home births.
The AMA is claiming that doctors and hospitals can’t afford to stay in business, especially in rural areas, if their services are only used in emergencies. They assert that, not only is everything fine with the current medicalized maternity system, it’s “world class” and therefore they are suspicious of granting more autonomy to midwives, who do not have the interest of mothers and babies in mind.
The all-or-nothing modus operandi is impeding progress in maternity care. Using the rudimentary “live mother, live baby” measure of success, the AMA not only ignores Australia’s skyrocketing Cesarean rate, but it promotes it as “world class.” Their argument is that doctors will run out of business, especially in rural areas, if more midwives attend births. They need the bodies of pregnant Australian women just to remain afloat financially, regardless of whether their services are actually necessary.
Citing New Zealand as an example, Capolingua essentially issues the threat that obstetricians will pack up and leave rural areas if they don’t get enough customers and the AMA will hold the government accountable for any changes that “lower the bar on the health of women and their babies.” For their necessary services to remain available in rural areas, they must therefore continue to subject healthy women to unnecessary maternity “services” at the expense of, coincidentally, the health of women and their babies.