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Sunday
Aug292010

Woman as Fodder: Australia's Obstetric Monopoly

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Guest post by Julie Bell

It is outrageous and undemocratic that the Australian government has paved the way for obstetricians to rort the system and have handed obstetrics a monopoly over maternity care, while pushing through legislation against intense opposition from parents and midwives, to provide obstetricians with legal right of veto over the midwifery profession, and while depriving independent midwives of insurance and Medicare coverage.

This means that women cannot access the midwifery model of care, cannot access homebirth or independent birth centre care, but are forced to have a corporate-model-style ‘McBirth’ in massive abattoir-like profit-driven institutions which are high-tech, risk-averse, and offer fragmented care instead of continuity of care with a midwife a woman chooses herself. It eliminates midwifery as an autonomous profession, ends a check & balance system between midwifery and obstetrics, and renders midwives to be nothing more than subservient obstetric nurses within a totally medicalised, techno-phile system.

In the hospitals here, I often hear the obstetricians refer to themselves as “doctors” and to the midwives as “nurses”. It sets up an institutionalised hierarchy that does nothing for normal birth, normal breastfeeding and the ability of well women to choose gentle birth options. This is leading to higher rates of birth trauma, lower rates of breastfeeding and sets women’s rights in Australia back 50 years. Women deserve a choice, and this legislation has taken that essential human right from women, disempowered midwifery and given obstetricians unchecked power that will facilitate further corruption.

Obstetrics is a billion-dollar industry and women are merely being used as fodder for this industry, as smaller birth units offering more personalised care to local women are being shut down across the country, despite storms of protest from local parents, who then have to contemplate driving for hours in labour to large centre institutions. (Road-side births are becoming more common as a result. It’s safe to make women drive for hours in labour to a more profitable institution and give birth in the back seat … but a planned homebirth with expert midwives skilled in facilitating normal birth is ‘unsafe’???) Having seen the ‘big boys’ in the USA successfully marginalise midiwifery birth, medicalize normal physiological birth, create a ‘labor-bypass’ culture, and drive homebirth underground, the obstetricians of Australia want the same.

An obstetric monopoly is not right or healthy for any society. However, when a billion-dollar industry is as stake, what is optimal for women and babies becomes secondary to matters of greed, power, profit, litigation issues and what the insurance companies (owned by doctors) dictate.

What women and babies choose want and need in order to thrive becomes merely a game of words. What we want, what we need, is CHOICE - and it is clear that up to 80% of women would actively choose midwifery care if that choice was available, as it is in New Zealand. This is a choice that must be made available to women in remote areas and to indigenous women, who are currently inhumanely evacuated hundreds of miles from their country, their people and their vital spiritual and social support networks, to give birth alone in a ‘white man’s’ institution … and they wonder why there are complications and non-compliance.

Obstetrics is a billion-dollar industry, fuelling the profits of insurance companies, pharmaceutical companies and obstetricians … but we don’t have the money to insure midwives, fund homebirth or provides culturally-sensitive and appropriate care for the most disadvantaged women in Australia? What a con. The check for allowing an obstetric monopoly to snuff out the womanly arts of midwifery and normal birth & breastfeeding has not yet been presented. The voice of women, mothers and midwives, is not being heard. Big business and a greedy, corporate style approach to delivering maternity care has a lot to answer for. Midwifery must be an autonomous profession, and supported as a check to, and alternative to, the excesses of the obstetric model of care. All maternity care must be woman-centered and woman-led, and women themselves must have the final say in what is ‘safe’ for themselves and their babies. Until women have such self-determination in their own care and well-being and that of our babies, and until midwifery is on equal footing with the medical/obstetric juggernaut, we will continue to see rising rates of intervention, financial corruption & waste, post-natal trauma, lowering rates of breastfeeding, and the art of natural birth and mothering will continue its demise.

When there is ‘blood on the carpet’: when a woman gives birth under her own power, with birth attendants she has chosen herself, in a place of privacy, trust and peace… a lot of ‘fat cats’ don’t get paid. 

And that is the bottom line in the obstetric-midwifery turf war. It is not about ‘safety’. It is about control - and greed.

 

Find Julie Bell of Melbourne Doula Birth Support on Facebook 

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Reader Comments (9)

http://www.guardian.co.uk/world/2010/aug/29/sicily-doctors-birth-brawl-claims

August 30, 2010 | Unregistered CommenterAnonymous

Love your work, Julie. *kotc*

August 30, 2010 | Unregistered CommenterJanet

Great to see a little about the Aussie saga on here, even better to see it's written by my awesome doula :D Thanks Julie (and Jill!)

August 30, 2010 | Unregistered CommenterSarah

Here are some links to bring our US counterparts on the political debacle in Australia currently:

Maternity Coalition
http://www.maternitycoalition.org.au/home/modules/content/?id=1

Homebirth Australia
http://www.homebirthaustralia.org/

Homebirth: Midwife Mutiny in South Australia
http://www.homebirth.net.au/ -

Joyous Birth
http://www.joyousbirth.info/

My blog - "But can I still have a homebirth? Aren't they making it illegal?" - a collection of recent articles on the issue
http://melbournedoula.blogspot.com/2010/06/but-can-i-still-have-homebirth-arent.html

August 30, 2010 | Unregistered CommenterJulie

Paule, Thank you for that...I've been saying it for a long time...insurance has done nothing but harm the patient/care provider relationship, and deprive people of choices they would otherwise have. It works for crises when you have to suddenly come up with a ton of money, but for every day medical care there has to be a better way. For profit hospitals...same thing.

Just wondering what the Queen of England (who is the Queen of Australia, and the supreme governor of Australia) thinks about homebirth? If she is sympathetic to midwives, she does have the power to overturn Australian laws, from what I understand from my Australian friends (although she rarely gets involved). I don't know what specific things she can overturn, if there are any restrictions on that, etc., but it may not hurt to try to appeal to her based on human/women's rights, outcomes, *and* cost if no headway can be made within the local system in Australia. Just a thought...but I have no idea if the Queen would be sympathetic to the cause or not...

Anyone know?

August 30, 2010 | Unregistered CommenterAnne

According to Wikipedia, Queen Elizabeth II was born by c-section AT HOME!

I vaguely remember that Prince Charles was the first of the royals to be born in a hospital, but I could be wrong. I'm pretty sure that all the royals in my lifetime have been born under OB care (notable, since midwifery is the norm) in the hospital.

August 30, 2010 | Unregistered CommenterLiz Chalmers

Brilliant Julie.....well written, yes it is about obstetrics being a mutli million dollar business, with power and great political influence....again not listening to what women want.... and in regards to the Royal Family.... Princess Anne is the patron of the Royal College of Midwives..... and they are very sympathetic to the cause

August 30, 2010 | Unregistered Commenterinfomidwife

Anne, this is far too trivial for the Queen or even the Governor General (her representative here in Australia) to concern themselves with. Generally they stay out of domestic affairs unless something is deemed so drastic that it is thought the Australian parliamentary system cannot function without them stepping in to sort us out. As the majority of Australians and parliamentarians don't give a rats about independent midwifery or homebirth, there's not enough controversy for The Queen or GG to get involved. Also, if The Queen or GG were to get involved it would most likely ruffle feathers between them and Australians/cause discord in their foreign relations (for example, some of us are still pissed off about the GG sacking our PM in 1975), hence something has to be fairly drastic for them to get involved.

August 31, 2010 | Unregistered CommenterSarah

Just wondering what the Queen of England (who is the Queen of Australia, and the supreme governor of Australia) thinks about homebirth? If she is sympathetic to midwives, she does have the power to overturn Australian laws, from what I understand from my Australian friends (although she rarely gets involved). I don't know what specific things she can overturn, if there are any restrictions on that, etc., but it may not hurt to try to appeal to her based on human/women's rights, outcomes, *and* cost if no headway can be made within the local system in Australia. Just a thought...but I have no idea if the Queen would be sympathetic to the cause or not...

I am not sure how the Queen would feel, as I understand it, she gave birth at home and in the presence of many people as is the protocol when giving bith in the royal family for members of the house of Lords to be present, I would assume her births would have been a public spectical and made her feel vunerable but I doubt very much if she would step in as the monarchy has no say in Australia's legislation, we are now and forever removed from England, the Queen is only a figurehead now and the only reason for us to stay attached to England is so we can call upon them in a time of war. As we are a colony of England they can not refuse aid to us.

August 31, 2010 | Unregistered CommenterYasmin
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