Page 2463 - Week 08 - Wednesday, 29 June 2005

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program does a very good job, it is constrained by the fact that it is controlled by obstetrics and is described in the report as “an add-on to an acute service”.

The report argues the need to have some maternity services controlled by midwives, rather than doctors. Midwives are specialists in normal births. They offer care and support to healthy women with normal pregnancies from conception, through birthing to some weeks after birth when a care and feeding regime is well established. There is a plethora of research that demonstrates that midwife-led care substantially reduces the incidence of birth complications and the need for intervention. It is therefore hard for me to understand why the government has not responded with some urgency to the recommendations of this report.

We should not be treating pregnancy as a medical condition. It is a natural process that, in the majority of cases, does not require medical intervention. There is also research that demonstrates that supporting a woman’s right to exercise choice and control over her care has significant benefits to her own wellbeing and that of her family. In particular, independent midwife-led services are often much more appropriate than hospital-based services for women who are vulnerable, and this includes young women, women from non-English speaking backgrounds and women who have had poor experiences with formal health services.

The pregnant pause report makes a number of very important recommendations, and I would like to highlight a few of them. I will start with the good news. Recommendations 16 and 17 call for recognition of midwifery as a distinct profession separate from nursing. This has been achieved as a result of the Health Professionals Legislation Amendment Bill. The bad news is that there are no independent midwives working in Canberra because of the problems with medical indemnity insurance raised in the report and not yet addressed.

The only other recommendation that appears to have been acted on is the upgrade of the neonatal unit at the Canberra Hospital, which received funding in the recent budget. The remaining recommendations are all important, but time prevents me from speaking to all of them so I have selected just a few. Recommendations 1 and 13 are concerned with the provisions of antenatal education and comprehensive information relating to pregnancy, birthing and postnatal care options available for women in the ACT.

It is important that women have information in order to have control during their pregnancy and to make informed choices. Currently, the antenatal education provided by ACT Health is offered towards the end of pregnancy, and that is unsatisfactory. For instance, women need to make choices about what kind of birth they want to have very early in the pregnancy, and I will mention this later, and therefore there needs to be at least one session for newly pregnant people to attend just to have those options, which are currently only available in a pamphlet, made clear to them. Community-based information sessions, such as the having a baby seminar which has been offered by the Women’s Centre for Health Matters, go part of the way to fulfilling that, but that one is funded on a project basis and may not therefore have longevity.

Recommendations 3 and 4 are about undertaking a needs analysis to determine the actual level of unmet need for the Canberra midwifery program and increasing funding to meet that demand. This program is oversubscribed to such an extent that most women need to

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