Page 307 - Week 01 - Thursday, 10 February 2022

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(c) CHS continue to work through Recommendation 3 – The homebirth option should be offered to primiparous women who meet low risk criteria, have a health pregnancy, would like a planned homebirth and are fully aware of the benefits and risks, including a literature review, data analysis and consultation with key stakeholders. Insurance implications are also being explored. CHS anticipate completion of this work in November 2021 for implementation as part of the Homebirth Service at CHS.

(2) Recommendations 4,5 and 6 discuss expansion of the geographical boundaries of publicly funded homebirth including the possible establishment of a Publicly Funded Homebirth Service at Calvary Public Hospital Bruce (Calvary). Initial conversations have occurred with ACT Ambulance Services (ACTAS) and the Insurance and Legal Liaison Unit for CHS about the possible expansion of the boundaries, ambulance response times and policies.

(a) ACTAS have advised they undertake all necessary hospital transfers associated with childbirth as required and are not limited by current homebirth boundaries.

(b) The initial discussion identified that ACT Insurance Agency (ACTIA) would require evidence for extending the boundary line. Future discussions are planned with ACTIA once further work has been undertaken to determine potential expansion details, including reviewing the larger catchment areas of long-standing publicly funded homebirth programs in the other Australian States and Territories.

(3) ACT Health Directorate (ACTHD) and CHS are leading a Joint Maternity Project to develop an action and implementation plan for reforms to the maternity system. ACTHD and CHS have been working with Calvary to understand current demands and opportunities to help inform the implementation plan.

(4) Currently the midwives at CHWC do not have visiting rights at Calvary.

(5) Women participating in the publicly funded homebirth service will be able to choose a water birth at home with informed consent, however due to the current COVID-19 response endorsement of this option has been delayed.

(6) All midwives attending homebirths in the ACT as part of the Publicly Funded Homebirth Service have been credentialled to provide care for women during a waterbirth at home.

This credentialling includes updated procedure "Water immersion during labour/birth", participation in waterbirth under the supervision of an experienced midwife, completion of e learning module – water emersion for labour/birth and practical education on bath evacuation. This education/credentialing is recorded on the education database within CHS.

(7) As of 16 August 2021, student midwives will be able to attend a homebirth in an observation role, if a woman who chooses homebirth is one whom they have engaged in a continuity of care experience and the woman consents to having the student within her home for labour/birth.

(8) Due to the current staffing profiles within Maternity at CHWC, this recommendation has been excluded at this time.

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