Friday, December 11, 2009

enate Community Affairs Committee Inquiry into Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009.

To: The Secretary
Senate Community Affairs Legislation Committee
fax (02) 6277 5829.

Amanda Orbitani
680 Gembrook Road
Pakenham Upper, Victoria 3810

Dear Senate Community Affairs Committee,
Re: Senate Community Affairs Committee Inquiry into Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009

I write to express my concern about regarding the legislation which will force independent midwives to have “collaborative arrangements” with doctors before they are able to register and be eligible for Medicare and insurance support.. I understand that these bills will enable Medicare funding, access to the Pharmaceutical Benefits Scheme and professional indemnity premium support for midwives providing care for women to give birth in hospital..

I birthed my first child in a public hospital and my second at home under the care of two registered independent midwives. The two experiences could not be more different and the effect each had on myself and my relationship with my new child likewise could not be more different in how they impacted the both of us. We are all aware that the first days after birth have a tremendous impact upon the maternal bonding, success in breastfeeding rates, influence post partum depression rates and in many ways set the tone of the relationship for months and years to come. Ask any woman who has had a child - it's birth is something she will never forget and is impacted by for better or worse for the rest of her life. Should this legislation go through as it is written now, I am not sure what we will do. I have no wish to free birth. Neither do I wish to enter into the hospital system when I have no need to. Should a risk present itself and make it advisable to birth in hospital, I still want MY midwife - the caregiver I have chosen, who knows me and my family, whose care philosophy matches my own, who has extensive and specialist experience with natural births which hospitals cannot match and who has supported us through the pregnancy and birth of my daughter - to attend me.

The birth of my son was surrounded by orders, fear, bullying, threats to 'motivate' me that I would be cut against my will in a non-medically necessary, non-emergent situation and in direct contradiction of my written and express consent. Then once my son was born and I had no more use than a discarded wrapper after the candy had been extracted I was forced to throw myself into a wheelchair because they needed the L&D ward immediately despite being in shock and blacking out repeatedly, threatened with being allowed to "fall on the floor and crack (my) skull if I didn't stop" because she (the nurse) "was not going to throw her back out trying to catch me", slapped in the face with water repeatedly as I was still blacking out in the shower before I was finally left in a hospital bed, exhausted, upset, drugged and separated from my husband, family and friends. This was my sons introduction to the world. Sadly it is not unique or in light of many other womens experience, even necessarily a 'horrible' hospital experience.

My daughter was born at home, with the care of two midwives who attended me throughout my pregnancy. They were available to me at any time of the day or night I wanted to e-mail or ring. Throughout the pregnancy we determined what tests and care was necessary and I saw my GP and the OB for the hospital we had booked in case there was a need to change plans from a home setting to a hospital setting at any point in the pregnancy or labor. We saw that results from the sonography were copied to the midwives, my GP and OB. Likewise all other test results were coordinated so that all sets of caregivers were provided with the information and notations for their records, copies of all tests and results etc. My GP was willing to work with my choice, although it was outside his realm of experience and he was not certain how it would work. This required me to coordinate a bit and inform him of how homebirths with independent midwives usually worked. Our OB has had experience in working with independent midwifes, as he is one of few hospitals around here who will accept a booking from women who are planning a homebirth. Many hospitals are resistant to such bookings and do not want to know women who have a need to transfer their plans to a hospital because something has arisen in late pregnancy or in labor. The fact that this was the case meant that the nearest hospital I could book into was a 45 minute ambulance drive away as more local ones would not accept this sort of arrangement.

I had breakfast and danced through my early labor. I moved around my home, supported by my husband and son. When the contractions became more intense my midwives supported me gently while letting me maintain my space and focus. It was beautiful, joyous, respectful, powerful experience. My midwives whispered, "you're doing beautifully... I can see her head". It was a mere 3 hours labor and 4 minutes pushing before my daughter slid out into my hands and was in my arms. She looked at me and we gently cleaned her off and wrapped her. We walked to the couch to sit and have lunch, to chat and celebrate. I was nested in a pile of blankets by my roaring fire and cared for. It was easy, fantastic and amazing. The labor hormones left me feeling high on life for months. Not five minutes after she was born I told my midwives I couldn't wait until I could do it all over again - I loved my labor! That is something few people can say about their births. Nearly a year later I am still reaping the benefits of a natural, easy labor attended by midwives who supported me rather than harassed me. This was my daughters introduction to the world.

When I contemplate my third child, I cannot imagine choosing it's introduction into the world being a repeat of my first experience rather than my second. The amendments proposed however, will see that I nor any other Australian woman will have that choice. Our rights to choose care for ourselves and on behalf of our children will be stripped. Independent midwives will likewise be stripped of autonomy as their right to practice will be held ransom by doctors or OBs who have a long history and financial incentive not to support these midwives, along with the well known position of the AMA and RANZCOG against such rather than remaining responsible and accountable to independent registration and licensing body for their profession. These amendments will effectively put doctors rather than the women they serve in charge of maternity care in Australia with no other choice left to Australian women but to cow toe.

I respectfully submit that it is considered a basic and fundamental human right to determine what medical care we will receive, how and with whom. This is no less true for birthing women making choices within maternity care than any other group. Please respect our rights by eliminating these amendments and not implementing these unscrupulous limitations.

Yours sincerely
Amanda Orbitani