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Legislative Assembly for the ACT: 2005 Week 08 Hansard (Wednesday, 29 June 2005 2005) . . Page.. 2473 ..

Question so resolved in the negative.

Amendment negatived.

DR FOSKEY (Molonglo) (4.58), in reply: I stand to speak to a shadow of my own motion. This seems to be one of the hazards of majority government. Nonetheless, the point is made.

Nothing that the minister has said has persuaded me that Canberra’s women are going to end up with greater choice of birthing options or more access to midwife-led care. The preface to the pregnant pause report contains the following statement.

Sadly, the committee heard anecdotally that midwives and members of the community, on finding out about this inquiry, responded by saying, “Oh, just another report that won't go anywhere.”

How right they were, or could be! It is now more than 12 months since this report was tabled in the Assembly and we are still waiting for a response from the government. There has been no improvement in maternity services. Indeed, the waiting lists have had to be closed off even earlier so that women have to apply for the birthing centre at five weeks pregnant. We have lost a year of potential work and a budget cycle that would have given us the opportunity to address the recommendations.

I think this is a major insult to those who participated in the inquiry, including those who gathered and presented evidence and those who shared their personal testimony. Any objection that the government might have to these recommendations cannot be on the basis of women’s safety. The report gives details of research to the effect that the OECD countries with the lowest perinatal and maternal morbidity and mortality rates are those with comparatively low rates of obstetric intervention in childbirth and where there is widespread use of midwives as the primary care givers of pregnant and birthing women.

There can also be no objection on the basis of cost. Firstly, recommendation 9 calls for a cost-benefit study into models of maternity services to be undertaken, and that is a study that could have been done while the government was preparing its response. Secondly, research evidence suggests that midwife-led services are actually less costly than obstetrics-led services.

A cost analysis research project in New South Wales conducted in 2001, and I am happy to give the government the reference if it wants it, compared the cost of a new model of community-based midwife-led maternity care with standard care in an Australian public hospital. The average cost of providing care through the community-based model was more than 25 per cent less per woman compared with standard hospital care—$2,579 compared to $3,483. These cost savings were maintained even after costs associated with admission to special care nurseries were excluded. The cost saving was sustained even when the caesarean section rate in the new model of care increased to beyond that of the standard care group. Further research conducted in 2003 proves that one-to-one continuous midwife care is not expensive and results in lower use of epidural and caesarean section. In contrast, the initiation of a cascade of obstetric interventions during

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