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Home birth gets the official nod in NSW

It was heartening to read the latest News Release from the Australian College of Midwives announcing that the NSW Department of Health has released a Policy Directive that supports and encourages the setting up of home birth services through the State’s Area Health Services.

Politicians often pay lip service to programs they think will win them friends and votes, yet often fail to follow up with appropriate legislation or regulations that enable services to be set up. In the case of home birth, the midwives and women of NSW have been lobbying hard for many years at both the national and State level to have home births made available on our national health service (Medicare). Privately, the NSW Department of Health has been muttering encouragingly, and now finally they have issued a directive that is binding on all Area Health Services in NSW. The full text is available on their website, but here is an excerpt:

Date of Publication 29 June 2006

Summary

This Policy Directive has been developed to reflect current evidence about the provision of homebirth. Area Health Services (AHSs), when providing public homebirth services, must comply with the standards set out in this document. Clinicians providing public homebirth services must be employees of, or have clinical privileges with, AHSs.

This document applies to: Area Health Services/Chief Executive Governed Statutory Health Corporation, Board Governed Statutory Health Corporations, Affiliated Health Organisations, Divisions of General Practice, Government Medical Officers, NSW Ambulance Service, Public Health Units, Public Hospitals.

Now that this Policy Directive is in place, it will be easier for Area Health services to set up appropriate home birth services for women. The South Eastern Sydney Area Health Service already offers home births as an extension of their Birth Centre Program at both St George Hospital and the Royal Hospital for Women, Randwick. It is hoped that home births will soon be available through Camden and Belmont Hospitals to extend theircurrent caseload midwifery services.

Although a welcome development, the Policy Directive does not help independent midwives, as it does not address their lack of professional indemnity insurance. As the Directive states, midwives offering home birth will have to be employed by or have been granted visiting rights at the AHS. This means that independent midwives are still excluded as they had their visiting rights at hospitals withdrawn when their indemnity insurance was withdrawn some years ago. This is a critical issue that still needs urgent resolution. Until a means is found to resolve the insurance issue, independent midwives will be reluctant to offer their services and women will be denied access to their care. This situation is discriminatory both for pregnant women and also independent midwives.

The Policy Directive is a good start. How many Area Health Services will heed this policy and set up a service for homebirths? That will be the final proof that home birth is on the map.

Posted by andrea at July 07, 2006 01:06 AM