Wednesday, August 17, 2005

Midwives on Medicare

Yesterday the federal government revealed that they will consider allowing midwives to charge for their services through Medicare. Today the AMA spokesman said they would support the move "providing the level of patient care does not change". But what if it goes up? What if more women have satisfactory birthing experiences because they are able to have the midwife of their choice, and maybe even afford a home birth?

Midwives are already the main providers of care for women giving birth. A healthy woman with a normal pregnancy and labour probably won't even see anyone else throughout her labour. (I had a 36-hour labour and the obstetrician arrived just in time to hand me the baby after I'd delivered him. The midwives, who were with me throughout, were supportive, knowledgeable and just brilliant.) One obstetrician told a magazine I worked for that most of his time was spent "catching healthy babies" -- in other words, doing something that a midwife could do just as well, but getting paid a lot more for it.

The really disappointing thing about the government's shift of priorities on this issue is that it's actually not a matter of recognising the value of a midwife's participation in the labour and birth process. Instead, it's bowing to the pressure on the system from malpractice suits: more GPs are refusing to do deliveries, and country hospitals can't get obstetricians, because they can't afford the insurance. Even if it's not for the "right" reasons, at least now midwives may get some recognition for their important role in childbirth and parents may be able to make a choice about who attends them at a normal labour and birth.

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