Australian health body backs home births

Press, 2 December 1987, Page 51

Australian health body backs home births

By

RADA ROUSE

NZPA-AAP Canberra In a significant policy turnround, Australia’s premier health advisory body has backed home births as safe for most mothers and criticised hospitals for failing to meet the needs of consumers.

The National Health and Medical Research Council (NHMRC) says its review of medical literature found that concerns about the safety of home births were not substantiated.

"We concluded that if you give careful consideration to the individual and the skills of the attendants there is no reason to assume that birth is any safer in hospital," said an N.H.R.M.C. spokeswoman. Dr Cathy Mead.

A report by the counril’s working party on home births endorsed by the 104th congress has called for the develop-

ment of more homelike birth centres in hospitals and criticises obstetric services for “outmoded and insensitive labour ward practices.”

“There is no medical need for labour wards to resemble operating theatres,” the report says.

Dr Mead said outmoded practices included predelivery shaves and enemas as well as attitudes which prevented women trying different positions for birth, such as squatting. She did not expect the N.H.M.R.C.’s change of policy to result in a big increase in the number of women requesting birth at home, or in a backlash from doctors.

“Home births make up only half of 1 per cent of all births, so even if the numbers doubled, it would not be a significant threat to anyone’s income.” Modern technology was vital to women with particular pregnancy prob-

lems, so that screening of women before delivery was vital, said Dr Mead.

“Women should be able to make their own choice about their place of birth depending on their geographical location, factors relating to their pregnancy and the professional and support services available to them,” the report said. “Many obstetric services are not meeting the expressed needs of many of their consumers and all hospitals should address this.”

The N.H.M.R.C. called for new courses to prepare graduates for independent midwifery practice and suggested that a single direct entry programme for midwifery should be developed. Dr Mead said the council believed the courses should be provided by colleges of advanced education rather than in teaching hospitals. However, additional education

in neonatal resuscitation and emergency management of a sick newborn baby would be best acquired in a hospital setting.

The N.H.M.R.C. noted that the trend to home birth was increasing, with an estimated 1068 planned home births last year.

Dr Mead said the council’s previous policy, dating from 1978, had called for the development of birth centres in hospitals in a bid to reduce the number of home births. But although birth centres had been established in big centres, there had been no lessening in demand for home birth. The Women’s Health Committee of the N.H.M.R.C. established its working party on home birth in March last year after becoming concerned about the increased polarisation of the medical profession and the home birth movement.