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Written By

Katherine Kokkonen


College of Healthcare Sciences

Publish Date

10 May 2019

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The fight for women to birth safely at home

No one is more invested than a mother when it comes to giving birth. However, changes in insurance could mean that mothers who want to give birth at home will have that option taken away. What will this mean for women and midwives?

When a woman is about to go through one of the most astonishing and life-altering experiences of her life, why deny her the option of being in a place where she feels safe and comfortable? Women might soon face the possibility of no longer being able to access midwives who provide services for home births.

Professional Indemnity Insurance is a legislated requirement for midwifery registration in Australia. However, no Professional Indemnity Insurance products covering birth are available for privately practising midwives to purchase. In recognition of this, the Federal Government agreed to exempt birth for these midwives from this insurance requirement. This exemption will expire in December 2019.

Unless the Federal Government extends the exemption or insurance companies develop a product for privately practising midwives, women who choose to give birth at home will have limited options. Publicly-funded home birth models exist in New South Wales, Northern Territory, West Australia and South Australia, but not in Queensland.

“Women will always make choices that meet their needs and the needs of their babies,” Marie McAuliffe, Senior Lecturer at JCU’s College of Healthcare Sciences, says. “If there are no models available that meet those needs, women might make choices that are outside of the recommended healthcare options. The worry is that some women will choose to free birth.”

A free birth is when a woman gives birth without a trained healthcare provider in attendance. This is different from a home birth, where a trained healthcare professional (such as a midwife) provides birthcare in the woman’s home. Marie says while health professionals consider hospitals to be safe, there are many reasons why women might not feel that way and instead choose to give birth at home.

Meeting women’s needs

“For birthing women, hospitals are not always seen as safe places,” she says.

“Their perception of what happens in hospitals is often related to an experience they might have had or someone close to them has had. Often, this is unrelated to a birthing experience.”

Marie says some women might not feel culturally safe or respected in a hospital, so they will decide to give birth at home. Having worked as a midwife for about 40 years, Marie has seen how consumers have been trying to influence birthing practices in Australia. At the heart of the issue is the need to listen to women and provide them with the type of care they want so they can give birth safely.

“My experience is that when there have been models made available to women where they feel safe, the numbers of free birthing fall.”
JCU Senior Lecturer Marie McAuliffe

“If healthcare systems are able to provide the access to the type of care that women want, then women will use those services," Marie says. "Either the Federal Government needs to extend the exemption or the insurance companies need to develop a product so that private practice midwives can continue to provide the option of home birthing services that women want.”

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Dr Marie McAuliffe

Senior Lecturer

Marie McAuliffe brings clinical experience from her midwifery and neonatal practice into her position as a Senior Lecturer in Nursing and Midwifery at JCU. Her experience as a clinician, educator, and administrator in regional and rural health services informs curriculum development and learning and teaching methodologies across JCU’s Nursing and Midwifery programs. These programs are focused on the development of a skilled and resilient nursing and midwifery workforce, fit for the rural, remote and tropical health care contexts.

Marie's research interests include women’s health, models of maternity care and midwifery education using mixed method research methodologies. Marie’s PhD examined the experience of women admitted to intensive care (ICU) during pregnancy or birth.