Unattended home births a worry

Press, 26 October 1982, Page 6

Unattended home births a worry

PA Auckland Some women are delivering their own babies at home because the Health Department has forced many qualified domiciliary midwives out of business, says the Home Birth Association. Dr Deryn Cooper, a spokeswoman for the' association, said the department’s system of paying home birth midwives meant most earned a maximum of about $BOOO year. Financial hardship and heavy opposition from the medical profession had forced six of Auckland’s nine domiciliary midwives to give up over the last year. As the number of. people wanting home births increased, said Dr Cooper,. many women were being forced against their wishes to have their babies in hospital “What worries us most is that some women are so dedicated to a natural birth at home that they are taking it into their own hands and

having their babies at home without a midwife." she said. Some parents were also resorting to using lay midwives, who were not qualified and had no formal training. “As far as we know there have been no deaths or injuries,” said Dr Cooper, “but the Home Birth Association would not condone the delivering of babies without a qualified midwife and medical practitioner.” In Christchurch, no unsupervised home births have been reported. But in the country and on the West Coast, home births without a midwife in attendance have happened in recent months, according to the Christchurch Home Birth Support Group. “It is not hard to get a midwife to attend you in Christchurch, nor is it difficult to get a doctor who will take responsibility for the birth,” said a spokeswoman for the group, Mrs Alison Locke, last evening. “Women in the country

who want to have their baby at home would have a problem. I suppose you cannot stop people from having a home birth if they have made up their mind about it,” she said. Mrs Ursula Helem, a domiciliary midwife in Christchurch since 1974 and one of two now contracted to the Health Department in Christchurch to deliver babies at home, said that there was no problem keeping up with the demand in Christchurch. “But I cannot visit women who are having babies at home when they live more than an hour’s drive from Christchurch.” she said. Mrs Helem said she had heard of a home birth in North Canterbury recently, without a midwife or doctor present, and she also knew of its happening on the West Coast. As far as she knew, Mrs Helem said, those births had been free of complications. Last year, Mrs Helem helped at about 50 home births in and about Christ-

church. About six a month were the most she could take on, because of the number of visits required for each one. she said. The complaint from the Auckland domiciliary midwives about poor pay was valid, she said, .it was impossible to make’ more than a certain amount each year, because of the limited number of patients a midwife could take on, and the limited payment for those patients. Midwives were paid by the Health Department $4.25 for one ante-natal visit. Any other visits had to be free of charge. Payment for the labour and delivery was $36, no matter how long it took. Then there was a maximum allowance of 14 post-natal visits, for which the midwife was paid $7.25 a visit, she said. “Because we are self-em-ployed, we have to allow for equipment, uniforms, tax, and other expenses out of this payment. We do get a small mileage allowance,”

Mrs Helem said. The health Department's Assistant Director of Clinical Services, Dr Dennis Feeney, said he was not aware of any unsupervised home births. “But if these people (the association) have this kind of information they should let us know. It is a matter of great concern to us.” Dr Feeney said women who wanted’ a home birth should make sure they had adequate medical supervision. “If they cannot get a domiciliary midwife, they have a duty to themselves and the baby to make sure they have access to a general practitioner or an obstetrician.” The department, he said, recognised the right of every woman to have her baby wherever she wished, and was not trying to kill the home birth movement. Dr Feeney said he believed that negotiations to increase domiciliary midwives’ fees had been going on this year. “It seems to have gone by the board now, I suspect because of the price freeze.”