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  5. Thread on the C-section Forum got me thinking.........

Thread on the C-section Forum got me thinking......... Rss

Posted by: Kandied Heart
Forgive my ignorance do some women get funded home births? or is that just rural women?
Vbacs are scary territory- but if all else is well, what is the likelyhood? (Ive heard someone birth at home fine- so i don't quiet understand?!?)

From what I understand some women go through a community midwifery program and that is just like going to a public hossy as in no charge. Problem is that you have to "qualify" ie, not go into labour b4 37wks, not go over 40+10, not have high bp, gd, overweight yada yada yada....The only other option if you don't want to be tied to those constraints is to hire a private or independant middy or freebirth with no assistance.
Yep, in some states there is publically funded homebirth for healthy low risk women (which is about 80% of the pregnant population!). Apparently the Maternity Services review believes that the Commonwealth will not fund this kind of program as too few women choose homebirth - of course they do, it is so expensive right now, imagine if every birthing women was provided the option of free homebirth in Australia! Anyway, what kind of argument is that - oh well lets not fund heart transplants as so few people need them....
oh, and yes VBAC is very common at home as a previous c/s is generally not viewed as a 'high risk' birth based on current worldwide evidence based research. It becomes risky with the introduction of other interventions which is why VBACs are common and more sucessful at home (you are less likely to require these other interventions/restrictions at home).
A vbac would put you out of any public funded homebirth program tho wouldn't it melissa? I thought vbac'ers would have to go indi/private?
yep bb. a vbac would be considered high risk making vbacers uneligable for community midwife programs.
Only WA and NT have Community Midwifery Programme which allows free homebirth. But VBAC and other things are deff not allowed. They consider you "high risk" for this pfffft.... the chance of uterine rupture is exactly the same as a first time mother being induced! I desperately wanted to home birth due to opposition I have encountered within public and private system here to wanting a VBAC but my health fund wont cover a homebirth nor will a private midwife attend to me because they can't get insurance in case something goes wrong. Where are my choices here people? So now I have a GP obstetrician freaking out about caring for me in labour as he is worried about the size of the baby. He is trying to refer me to an OBGYN which I am refusing. Now I am getting daily phone calls and threats about monitoring and breaking my waters and booking in for a c/s - when do I get my say and have my wishes respected? No wonder I am not going into labour with all the pressure they re putting me under. How can you CHOOSE to have a c/s and have it fully funded and paid for in a public hospital at tax payers expense but not have a choice to birth at home or have a hospital VBAC on your terms?! Very frustrating and one sided IMO.
If the government provided public funded homebirth then how they chose to set this up would depend on whether VBAC would be provided as an option. If women are truly at the centre of the system then each woman would be considered individually rather than 'risk categorised' which would mean that publically funded homebirth would need to be midwifery led not become an extension of hospital which is obstetric and risk led model. We can only hope!!
Can i just ask why you have to get out of the water to birth the baby? (just really interested)! I had my 2nd DD in the birth pool (labour and delivery including placenta).. i would go nuts if i had to get out to birth so im wondering... smile

Wow...started out slow and is ticking over nicely now. LOL

I told DP the other night that we couldn't move to Aussie for this reason alone. LOL

It's great to see so many of you "thinking out loud"; alot of this stuff stays in my head because there's not really anyone I can discuss it with IRL. Plus the system here in NZ is so very different that it's hard to "compare" I suppose.

I guess the other interesting thing I take from this is there is no consistency from state to state and even hospital to hospital. I mean I can understand why "rural" hospitals might have different policies to the big city ones but why can't all the "city" ones adopt the same policies re" VBACs in particular? I mean I prefer to look at "risk" in a positive for example there is a 99% chance that a c-section scar will NOT rupture than there is a 1% chance that it will.

In a similar vein, I stumbled across this in our local media the other day so feel free to comment as it kind of relates to the whole "choice" and "risk" issues. This might be an interesting read as well...I feel like it's "starting" here too, this implication that midwives are deficient in some way and that they are somehow not highlighting potential issues when it comes to giving birth;particularly at home.

Both those stories are very sad, especially that the life of a child has been taken away.

However, from what I read and maybe I missed the point but I thought that both stories seemed to be about mismanagement. To me these are just "one off" stories that may and probably will cloud the judgement of those who are looking into home births. The media love these kinds of stories...full of emotion and finger pointing.

With the first story, I dont think we've been given all the information. I dont think a professional midwife who had been given the care and conduct of a patient would willingly go on "holiday" and not provide adequate back up (another midwife) for her patient. In Brisbane I'm told that you're allowed to go to 42 weeks before they start intervening. Who knows if this woman at 42 weeks say didnt start showing signs of early labour.....that just progressed another week before fully going into labour at 43 weeks. I dont reckon a mum who was 40+ weeks wouldnt be in contact with her midwife (or backup) on an almost daily basis. I think a tragedy has occured but not necessarily through negligence on the midwifes part.

The second story just seems completely mismanaged on the part of the parents. True a baby can turn breech while in labour but the fact that it only occured to "everyone" at the last and most vital moment that the hospital was an hour away is just absured ! I thought these were things both the parents and midwives would be looking into in case of complications....again I doubt we've been given the full story and will probably never know as the media gloss over certain facts and dwell on the ones that will sell their news papers.

And all this from a pro-hospital gal !!! lol Christina, maybe you've converted

Actually, I'm just pro-choice... smile

[Edited on 11/03/2009]
SA also has a homebirth option through 2 of the big public hospitals.
Two tinkerbelles - whereabouts are you? Have you been to the homebirth Australia website or joyous birth. You may find an independent midwife that attends vbacs there.
All the best!
I have been to both those websites - they are really good. I also get on Birthrites alot. I am in Perth... if I really wanted to get a midwife I could probabky do it at a push but we couldn't afford it. We have private health which is what we are relying on for when bubba is born and our health fund wont cover a private midwife or a homebirth unfortunately.

PMSL...I am so glad you saw basically what I saw there with the limited information we are given; but you've hit the nail on the head. It is inflammatory enough just to give those in the "right" the ammunition they need against those who are "wrong" i.e. anyone who doesn't except the belief that birth is inherently dangerous and thus needs managing. We are after all working with an ESTIMATED delivery date (EDD), it's not an exact science and I know for a fact that when my midwife went out of service for a month she did a handover to another midwife, in conjunction with her and I wasn't left "hanging"; but will also admit that the care we received was top of the line and would like to think if someone dropped the ball that those are the exceptions not the rule.

In the breach story, fair enough, the midwife should have known that the "local" hospital didn't have a maternity service...but then again so should have the parents to be! I mean even though we knew there was no way in hell we were going to the hospital unless it was a life and death emergency we still did the hospital tour; we asked the pertinent question of how long we thought it would take to get there if need be because that was a major part of our decision in the first place. Deciding to birth a baby at home is not about putting on blinders and assuming it will all be alright, because though it might you still need to be aware of the "what if I need a transfer and how long will it take for me to get the help that is needed?" Not doing that IMO is irresponsible, not the fact that they chose to have the baby at home.

Right, those are some more mindless ramblings from me........feel free to discuss amongst yourselves. LOL

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