TO: MINISTER FOR HEALTH
FROM: DIRECTOR XXX DATE: 30th March 2011
SUBJECT: A NATIONAL INSURANCE FOR HOMEBIRTH ATTENDED BY MIDWIFE
PURPOSE: To provide you with information related to a contemporary controversial debate on national indemnity insurance for homebirth attended by midwives.
BACKGROUND (Policy History) 1. Childbirth especially homebirths - is a contemporary issue of competing within two occupations -medical practitioners and nurses qualified in midwifery. 2. Homebirth is about 0.2% of births in Australia, preferred by some women from Indigenous background or residence in remote areas. In Australia, legislation requires all
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ISSUE (Policy context) 8. Homebirth Australia- a consumer group that advocates for homebirth, stated that "Women have the right to have control over, and decide freely and responsibly on all matters relating to their sexual and reproductive health” and women who choose homebirth to maximise their chances of health and wellbeing are the only health consumers without the protection of indemnity insurance. The Australian Medical Association (AMA) considers a woman choosing Caesarean section without any medical need totally acceptable and the Australian taxpayer funds the huge cost for it. This group lobbied to two senators and asked the Commonwealth Government to provide appropriate funding and insurance protection for homebirth care. 9. According to the Australian College of Midwifery (ACM), homebirth midwives have consistently been denied premium support. Figures from Community Midwifery WA relating to homebirths between 1995 and 2005, showed the death rate at 0.3 %, which is lower than the death rate for all births at 0.4 %. Statistically, if people chose homebirth through community as midwifery programs, it is about a 7% Caesarean rate, whilst it is 53% in private hospitals. A recent Cochrane review observes that there is only one Randomised Controlled Trial (RCT), concludes that “there is no strong evidence to favour either home or