The Review of Maternity Services commissioned by the Commonwealth Department of Health and Ageing will surely be released soon.
The aim of the Review was to:
canvass a wide range of issues relevant to maternity services, including antenatal services, birthing options, postnatal services up to six weeks after birth, and peer and social support for women in the perinatal period; ensure that all interested parties have an opportunity to participate; and inform the development of a National Maternity Services Plan.
Many people from around the country participated in the canvassing process. This included written submissions from individuals and organisations, as well as ‘roundtable’ discussions.
The website says that the Department has received a large number of submissions and is working to publish them progressively on the public website. The first batch of 473 submissions has been already published. It is understood that more than 900 submissions were received. This is an extraordinary number and goes to show how much interest there is in the issue. This should be encouraging for all who are interested in ensuring that women and babies have access to and receive the very best maternity service.
As the release date approaches, it seems likely that groups and individuals will start to get anxious and the posturing will start (indeed it already has).
From sitting collaboratively around roundtables discussing issues respectfully and using evidence to inform the debate, I fear that the release of the Report (regardless of the recommendations) could mean that we retreat to our former positions where the turf wars will begin again.
We must all restrain from this response.
It is time to take a big deep breath and develop new and more constructive ways of working together. We must keep women and babies at the centre of the discussion, not our various professional perspectives.
We (particularly doctors and midwives) must take this opportunity to rethink maternity services in this country — rethink how we can work together — rethink what we can do together to ensure the maternity services are safe, and feel safe. A knee-jerk separatist turf war is unhelpful for women, midwives, obstetricians and the health system.
Developing safe, high quality and sustainable maternity services means working together.
It does not seem such an extraordinary thing to ask for, but it does mean that we (midwives, obstetricians and GPs) need to find a middle ground. We will all need to make concessions and compromises as we move forward, and women need to be involved in the decision-making at every level. Some decisions will be hard and other decisions will be easy and be embraced with enthusiasm.
Here is the challenge — surely we can do it?
As a male who recently qualified for the title of Gramps, I wish that midwives had a trade union as powerful as that of MBBS recipients.
Caroline your plea for peace is dependent on reaching a middle ground?
Midwives and women have their backs so firmly up against the wall already that a call for further concessions and compromise seems absurd – there is no-where for them to go!
The medicalisation of pregnancy and childbirth in Australia has been so effective that all birth is now deemed to be normal only in retrospect. How can we move forward when the dominant medical ideology is based on the premise that every pregnant woman is a ticking time bomb.
Women and midwives have not created these “turf wars” by pushing for birthing autonomy – but it would seem that obstetrics may have something to lose – control! Not a good position for bargaining really. The power is very firmly maintained by our obstetric colleagues.
What we need is a paradigm shift towards the reality that all low risk birth is normal until proven otherwise and that midwives have the requisite qualifications and skill to attend birth, and refer appropriately when necessary. It’s about recognition of specialist skills. Specialist obstetricians, specialist midwives. There is a mountain of evidence to support midwifery led models of care and yet midwifery units and family birth centres close down! Why? At this point, we are rapidly loosing expertise in both disciplines. If we do not find a way to change our model of care then I fear we are looking at a future where ‘deliveries’ are made by obstetric surgeons and obstetric nurses and vaginal birth, like undiagnosed breech birth, will become a curiosity.