Submissions are now open for Presentations at the 29th Homebirth Australia Conference.

Abstracts are welcome on any topic relevant to the conference theme. The deadline for abstract submission is 5pm Friday 24 May 2013.

Conference Theme
Own Birth – Home Birth, Informed decision making in homebirth.

Presentations
Presentations will be allocated a fifteen minute or thirty minute presentation time. Please put your preference in your abstract.

• Please limit abstracts to a maximum of 250 words

For more information or to send your abstract please contact Sonja at sonjamac@bigpond.com

Kirsten told us how most women are living in poverty and access to clean drinking water and nutritious food is a problem, further hampered by cultural beliefs about what foods women should consume when they are breastfeeding.

Women birth in very basic local clinics. Early discharge is the norm in most areas – there just isn’t the physical capacity in the clinics (which are primary health care run and staffed by midwives only) or the hospitals (which have basic medical assistance and medical staff) for women to stay for more than a day or two. When women return home, ‘Roasting’ is an active concern – the practice of keeping the woman and the baby very warm with blankets and sometimes by lighting a fire under their sleeping platform – resulting in dehydrated sleepy mothers and babies, poor breastfeeding as a result and sometimes burns.

Kirsten explained that the fund raising body for WHC, Life Options Asia, had funded a blue tuk tuk which enabled them to get staff from the clinics to the women in the villages, however one blue tuk tuk wasn’t enough and that to fund a second would cost $1000. Inspired by her presentation, recognising the strong need for the tuk tuk in Cambodia and confident in the solidarity of women I went home that night and did some sums: Approximately 100 women at the Homebirth conference, hmm that’s $10 each (2 and a half cups of coffee….)

Returning to the conference on sunday morning, heart in mouth, I talked my idea through with the organisers who encouraged me to speak to the delegates. Basically we had that opportunity to raise $1000 for the women of Cambodia in a day! At morning tea I held out my red beret, the notes started dropping in, how exciting. Then again at lunchtime more cash was deposited. By the beginning of the afternoon we had about two thirds of what we needed. With only about $350 to go, another announcement was made and people came running with the money. How wonderful to see the incredible generosity of so many women. In total we raised $1071.

Kirsten Small deposited the cash in the Life Options Australia account. And it was duly used to buy a blue tuk tuk.  With only the one blue tuk tuk previously it was sometimes requisitioned to make emergency transfers for women to hospital which prevented the midwives from making their village visits.  Kirsten has recently returned to Cambodia and reports that with “our” tuk tuk the WHC staff are able to continue their important work visiting the women in the villages. The program aims to ensure that all women have 3 visits from the team during the first 6 weeks after discharge. Mothers and babies are given a check up, and it is an opportunity to do education in the villages about appropriate postnatal care and contraception (called birth spacing in Cambodia).

WHC also employs a team of men who act as tuk tuk drivers – providing meaningful employment for more Cambodians. It’s quite a challenging job as the roads are poor – unsealed mostly and badly damaged during the wet season each year, with cows roaming free, and other rural traffic to compete with. There are generally no street names or numbers so finding where the women are is generally a process of stopping and asking at several houses for directions. Fortunately once you get to the right village everyone generally knows everyone else so they can tell you who has just had a baby and where to find them.

The accompanying photos were taken in Takeo city, in Takeo province in the south of Cambodia. There are a number of health centres that WHC works with and the tuk tuk is used wherever the WHC team is currently working. At present they are supporting Preyvihear clinic in Kampong Spue province and the Rominh Subreferral Hospital in Takeo province. The clinics change – as funding allows the work to be expanded and other places are left either because they now have the capacity to be self supporting or because corrupt practices are exposed and the decision is made to withdraw support until they sort them out.

A huge, warm thank you to you to all of you who so generously helped to manifest this tuk tuk which is now in action in the villages of Cambodia.

From Julia Gibson
http://www.bellyblissyoga.com.au
http://facebook.com/bellyblissyoga

Read more about the work of Women’s Health Cambodia here

Do you have nursing, midwifery, medical or doula skills?  Volunteer to work with Women’s Health Cambodia here

Australia’s mothers and babies 2010 is the 20th annual report on pregnancy and childbirth in Australia providing national information on women who gave birth and the characteristics and outcomes of their babies.

In 2010, 294,814 women gave birth to 299,563 babies in Australia. The average age of mothers has increased gradually, from 29.2 years in 2001 to 30.0 years in 2010. The caesarean section rate has shown an upward trend over the last 10 years, increasing from 25.4% nationally in 2001 to a peak of 31.6% in 2010.

There were 285,617 women who gave birth in hospitals (96.9%) in 2010. A further 6,367 women gave birth in birth centres (2.2%); this proportion was highest in South Australia (6.2%) and the Australian Capital Territory (5.5%). Planned homebirths and other births, such as those occurring unexpectedly before arrival in hospital or in other settings, accounted for the smallest proportion of women who gave birth (2,763 women, 0.9%) (Table 3.18).

In 2010, there were 1,345 women who gave birth at home, representing 0.5% of all women who gave birth. The highest proportions were in Victoria, Western Australia and the Northern Territory (0.8%) (Table 3.18). It is probable that not all homebirths are reported to the perinatal data collections.

In 2010, there were 2,206 fetal deaths reported to the NPDC, resulting in a fetal death rate of 7.4 per 1,000 births. There were 2,202 fetal deaths in hospitals and other facilities. There were 4 fetal deaths at home births in 2010. Of babies born at home 99.7% were live born (1350 babies) or a fetal death rate of 2.3 per 1,000 births.

The mean age of mothers who gave birth at home was 31.8 years (Table 3.49). The proportion of mothers younger than 20 was 1.0%, and the proportion aged 35 and over was 28.7%. The proportion of mothers who gave birth at home who identified as being of Aboriginal or Torres Strait Islander origin was 0.9%. Most women who gave birth at home were living in Major cities (69.5%) (Table 3.49).

Of mothers who gave birth at home, one-quarter had their first baby (25.2%), and 74.3% were multiparous. The predominant method of birth for 99.3% of women who gave birth at home was non-instrumental vaginal (Table 3.49).The presentation was vertex for 97.2% of women who gave birth at home.

Of babies born at home in 2010, 99.7% were liveborn. The mean birthweight of these liveborn babies was 3,604 grams (Table 3.49). The proportion of liveborn babies of low birthweight born at home was 2.1%, and the proportion of preterm babies born at home was 2.2%.

Source: Australia’s Mothers & Babies Report 2010 available online here – http://www.aihw.gov.au/publication-detail/?id=60129542376

Photo by Documenting Delight

Some Australian families have had to endure television crews filming through the windows of their homes, private photos published without consent, images of homebirth women, midwives and their families have been broadcast including identifying information such as where they live and sensitive health information. There has been appalling treatment by the media of families who have experienced a stillbirth at home and during coronial inquests. This has caused considerable distress to families already suffering grief at the loss of a child.

The Australian Communications and Media Authority (ACMA) has now taken action following a complaint made by a father in Adelaide following the birth of a healthy baby.

It was found by ACMA that Channel Nine Adelaide (NWS 9) has breached the privacy provisions of the Commercial Television Industry Code of Practice 2010 (the code) by identifying a family involved in a home birth. It is the first television broadcast to breach the privacy provisions of the code since the new privacy guidelines were introduced in December 2011.

The news story concerned a deregistered midwife continuing to practise but it broadcast sensitive personal information about a newborn baby. The 16 February 2012 broadcast also contained identifying and intrusive footage of the complainant and his family inside their home and surrounds. The television crews arrived at the house following a call to the ambulance – they then proceeded to film over a period of 2 days including walking down the driveway and filming through a kitchen window into the family’s home.

‘The concept of being protected against someone intruding on your private space is a key tenet of the privacy guidelines,’ said ACMA Chairman, Chris Chapman.

‘It is partly based on a person’s reasonable expectation that their activities would not be observed or overheard. In this case, footage in and around the complainant’s home was found to be an invasion of privacy,’ he said.

The ACMA also found that the licensee failed the additional code obligation to exercise special care before using sensitive personal information about a child.

NWS 9 has agreed to a tailored training program for relevant staff and to making a statement on its website providing a link to the ACMA’s investigation decision.

The footage was said to be intrusive and identified the complainant and his family inside their home and surrounds, which had been broadcast without the complainant’s knowledge or concern for their privacy.

Download the ACMA decision here [PDF]

Media:
ACMA media release 93/2012 – 4 December 2012

Mumbrella – Nine News found guilty of breaching family’s privacy by filming through window in midwife report

Crikey – Channel Nine slapped down for privacy breach – 4 December 2012

The Australian – Nine breached home-birth privacy – 5 December 2012

Writer and social commentator Catherine Deveny (@catherinedeveny), who hosted the conference says that “there is a crisis in Australian birthing. It is a medical, legal and ethical one. Women are being bullied, manipulated and lied to about their birthing options. It’s time for a rigorous discussion about the whole system. This is it.”

A webcast is available for purchase online ($50). Purchase now.

Keynote speakers Elizabeth Prochaska (UK human rights barrister) and Dr John Seymour (ANU Adjunct Professor of Law) led a complex and intriguing debate on the issues in childbirth about consent, regulation, insurance, rights and professional obligations.

Following the keynote speakers, panellists discussed the role of rights and regulations in maternity care and legal issues about birth with risk factors – coercion and choices.

The first panel looked at the role of regulation in supporting (or restricting) women’s choices and how regulators balance their role of protecting the public with respecting the rights of women and the choices that they make.

The second panel looked at birthing with risk factors with a particular focus on issues of consent and informed decision making across all birth settings.

How do we ensure that women are making genuinely informed decisions and how to we respect those decisions once made? Do women have an unfettered right to make decisions about their maternity care and where they give birth?

The film Freedom for Birth was screened with a special introduction from the filmakers, Toni Harman and Alex Wakeford.

Thank you to all the speakers, panellists and those who sent in questions for the panel both before the event and during the event on twitter using the event hashtag #birthlaw – the website for the event is www.childbirthandthelaw.org

The event was held at Riverside Theatres in Parramatta on 12 October 2012. The forum was hosted by Homebirth Australia, the Maternity Coalition and the Australian College of Midwives.

Media:

Midwives face legal uncertainty for home births
The Law Report – ABC Radio National (16 October 2012)

Leading human rights lawyer concerned about steep rise in caesarean births
The World Today – ABC Radio (11 October 2012)

Interview Elizabeth Prochaska – ABC Newcastle Mornings (11 October 2012) Listen now

Barrister to lead Childbirth Debate
Lawyers Weekly (10 October 2012)

Thank you to the panellists for contributing their valuable time and expertise to the discussion -

• Associate Professor Kristin Savell
• Professor Alec Welsh
• Rachel Reed
• Bashi Hazard
• Robyn Dempsey
• Elizabeth Prochaska
• Dr John Seymour
• Dr Andrew Bisits
• Associate Professor Hannah Dahlen
• Ann Catchlove
• Dr Rebecca Dunlop
Full details of panellists here.

Human rights abuses during childbirth will be highlighted in a powerful new documentary to be launched on 20th September 2012.

Described by the filmmakers as “the biggest event in the history of birth activism”, FREEDOM FOR BIRTH will be screened simultaneously in over 1,000 locations in over 50 countries in 17 different languages this Thursday 20th September 2012.

Featuring a Who’s Who of 40 international birth experts, academics, Human Rights lawyers, doctors and midwives, the film calls for a radical shake-up of the world’s maternity systems.

Made by British filmmaking couple Toni Harman and Alex Wakeford, Freedom for Birth tells the story of Hungarian midwife Agnes Gereb, imprisoned for supporting women during homebirths, and the subsequent successful European Court of Human Rights case that has major implications for childbirth around the world.

Filmmaker Toni Harman says, “the court ruling means that every birthing woman in Europe has the legal right to decide where and how she gives birth.”

The 1,000 Freedom For Birth premiere screenings will start at a breakfast screening in New Zealand and end in Hawaii. The day also includes screenings at the Cambridge Film Festival, Yale University, the Motherhood Museum in New York and at the Royal College of Midwives in London.

Cathy Warwick, Chief Executive of the Royal College of Midwives (RCM), says: “The making of this film, which the RCM is supporting, will go a long way to help make skilled maternity care a reality for those women who currently do not have access to it.”

Lesley Page, President of the RCM adds, “Too many women across the world are dying or suffering terribly because of a lack of skilled maternity care. This is unacceptable and I call on all Governments to give women the right and access to safe care in pregnancy and childbirth.”

Hermine Hayes-Klein, US lawyer and organiser of the the recent Human Rights In Childbirth conference at the Hague says, “Freedom For Birth holds the answer to changing the system. Birth will change when women realise they have a right to meaningful support for childbirth and claim that right. Birth will change when women stand up against the abuses that are currently suffered in such high numbers and say, No More.”

Filmmaker Alex Wakeford concludes, “With the release of Freedom For Birth, we hope millions of women become aware of their legal rights. With stories of forced caesarean sections and persecution of those providing woman-focused care, it doesn’t make for easy viewing but has the potential to spark a revolution in maternity care across the world. In fact, we are calling this the Mothers’ Revolution.”

To find a screening in Australia near you – visit http://www.oneworldbirth.net/freedom-screenings/ or check our facebook page here – http://www.facebook.com/homebirthaustralia

Elizabeth Prochaska UK human rights barrister featured in the film will be visiting Australia in October 2012 and is a keynote speaker at the Childbirth and the Law Forum – tickets available here. There will also be a Q and A with Toni and Alex Harman, Freedom for Birth Directors via video link in London at the Forum on October 12.

ENDS

Contact Information:

Toni Harman, Producer/Director, Freedom For Birth

Email: info@altofilms.com+44 (0) 1273 747837 / +44 (0) 7770 794233

Website: http://freedomforbirth.com

High resolution still images available on request.

Additional Notes

Additional information about Freedom For Birth can be found on the website:

http://freedomforbirth.com

1,000 screenings are happening on Thursday 20^th September, 2012 in the following countries: England, Wales, Scotland, Northern Ireland, Ireland, Germany, France, Denmark, Spain, Greece, Italy, Norway, the Netherlands, Sweden, Switzerland, Austria, Poland, Bulgaria, Croatia, Lithuania, Slovenia, Slovakia, Serbia, Belgium, Hungary, Israel, Palestine, Sweden, Malta, Finland, Iceland, Russia, USA, Canada, Mexico, Colombia, Brazil, Argentina, Chile, Uruguay, Panama, Australia, New Zealand, Malaysia, Philippines, China, South Africa, Kenya, UAE, Kuwait, Dubai and India.

The film has been translated into 17 different languages: English, Bulgarian, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Polish, Portuguese (Portugal), Portuguese (Brazilian), Russian, Slovak, Slovenian and Spanish.

The film has been selected for screening in the Cambridge Film Festival on 20^th September. http://www.cambridgefilmfestival.org.uk/

Toni Harman and Alex Wakeford are a filmmaking couple who have set up a cross-media global film project called One World Birth to provide educational videos featuring the world’s leading birth experts  http://oneworldbirth.net

Freedom For Birth is Harman and Wakeford’s third documentary film about birth. They were inspired to make the film following their own difficult birth four years ago when a cascade of interventions led to an emergency c-section.

Case studies of parents affected by human rights issues in childbirth are available on request.

Interviews are also available with the following international birth experts:

Ina May Gaskin, Midwife & Winner of the 2011 Right Livelihood Award (the alternative Nobel Prize)

Robbie Davis-Floyd PhD, Medical / Cultural Anthropologist, University of Texas

Professor Lesley Page, President, Royal College of Midwives

Review available online here:
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000352.pub2/abstract

“The right to respect for private life includes the right to choose the circumstances of birth” said the European Court of Human Rights in Ternovzsky versus Hungary in 2010. Health authorities should consider establishing home birth services; this is the conclusion in a Cochrane analysis of planned hospital birth versus planned homebirth that was published today.

The authors Ole Olsen and Jette A Clausen find “the previous conclusions about “no statistical difference” in perinatal mortality (Olsen 1997a; Olsen 1998) seem to have been strengthened, and the results showing significantly lower morbidity rates related to home birth have become more convincing.

The review notes:

Increasingly better observational studies suggest that planned hospital birth is not any safer than planned home birth assisted by an experienced midwife with collaborative medical back up, but may lead to more interventions and more complications. However, there is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. Only two very small randomised trials have been performed. Only one trial (involving 11 women) contributed data to the review. They did not allow conclusions to be drawn except that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice.

In summary it was found that:

Most pregnancies among healthy women are normal, and most births could take place without unnecessary medical intervention. However, it is not possible to predict with certainty that absolutely no complications will occur in the course of a birth. Thus, in many countries it is believed that the safest option for all women is to give birth at hospital. In a few countries it is believed that as long as the woman is followed during pregnancy and assisted by a midwife during birth, transfer between home and hospital, if needed, is uncomplicated. In these countries home birth is an integrated part of maternity care. It seems increasingly clear that impatience and easy access to many medical procedures at hospital may lead to increased levels of intervention which in turn may lead to new interventions and finally to unnecessary complications. In a planned home birth assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary these drawbacks are avoided while the benefit of access to medical intervention when needed is maintained. Increasingly better observational studies suggest that planned hospital birth is not any safer than planned home birth assisted by an experienced midwife with collaborative medical back up, but may lead to more interventions and more complications. However, there is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. Only two very small randomised trials have been performed. Only one trial (involving 11 women) contributed data to the review. They did not allow conclusions to be drawn except that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice.

Implications for practice
This review shows that there is no strong evidence to favour either planned hospital or planned home birth for selected, low-risk pregnant women. From an autonomy-based ethical perspective the only justification for practices that restrict a woman’s autonomy and her freedom of choice, would be clear evidence that these restrictive practices do more good than harm (Enkin 1995), as we stated in the previous version of this review (Olsen 1998).  A decade later, the European Court of Human Rights in Strasbourg handed down a judgment stating that “the right to respect for private life includes the right to choose the circumstances of birth”. Thus, no matter what the level of evidence is, European governments are not allowed to impose, e.g. “fines on midwives assisting at home births” as it “constitutes an interference in the exercise of the rights … of pregnant mothers” (Registrar 2010). On the other hand, the ethical concept of the fetus as a patient (Chervenak 1992) may lead some to state that “Obstetricians have an ethical obligation to disclose the increased risks of perinatal and neonatal mortality and morbidity from planned home birth in the context of American healthcare and should recommend against it” (Chervenak 2011) and that “In clinical practice it involves recommending … aggressive management (interventions such as fetal surveillance, tocolysis, Caesarean delivery)” (Chervenak 1992). In this ethical perspective recommendations about interventions are acceptable even when they are not supported by randomised controlled trial (RCT) data. The lack of strong evidence from RCTs and an autonomy-based ethical perspective lead to the conclusion that all countries should consider establishing home birth services with collaborative medical back up and offer low-risk pregnant women information about the available evidence and the possible choices.

Photo credit: Jane McCrae – http://www.janemccraephotography.com/

I have been trying to write your birth story for over two weeks now little Oliver Byron. I know I must not take too long for although I will never forget your birth I want to write down everything while it is so vivid and poignant in my mind. Your sisters are both asleep and I look at you curled up on my chest nuzzling into my neck -this is one of your favourite places. You are so settled and content…..so perfect your little fingers and toes, your cheeks which get chubbier each day. I look at your precious little face that I tried so hard to imagine for 9 months, I am so glad you are here and that I brought you into the world exactly how I wanted to. I wanted to give you a calm, gentle journey; as I know you were so comfortable and warm inside your little womb home. I wanted the first face you saw to be mine and your dad’s, the first touch to be my hands cradling you. I wanted you to enter into a place we call our home, surrounded by those who love and care for you, this was not a simple decision or plan we always had but we achieved it and I am so glad we did. I had originally been booked into a Birth Centre and although I attended my first few appointments there I knew I wanted desperately to have you at home.

I started researching every spare moment I had as to how I could be able to have a homebirth as I knew this was the right choice for me. I began contacting local midwives, attending the Brisbane Home Birth Queensland meetings.  I began to educate myself in the politics surrounding homebirth in Queensland. It upset me that the reasons making it difficult to have a homebirth was because QLD had no publicly funded homebirth system and the controversy regarding the prior and current restrictions placed on independent midwives and private homebirths and of course the financial implications of affording it. Hiring independent midwives for a homebirth was not as easy as I thought as there were not that many around where we lived and many of them already had full caseloads and all were above our budget; but I knew there had to be a way. I spent many late nights conspiring ways and means to be able to afford it, I shed many tears in the weeks leading up to finally finding our beautiful midwives. We contemplated having a free birth, or just hiring a doula. I knew I could do it but I wanted the support of midwives. I started making and selling heat bags, children’s skirts and tops to be able to save a little extra and worked out the most frugal budget we could survive on to pay for your homebirth, it was going to be a tough and tight few months but I knew it would be worth it; thankfully your Dad supported my decision.  I showed him research and evidence supporting home birth and explained why this was so important to me and for us as a family. To have his support behind me was awesome. We would never remember the take out dinners we missed out on or a holiday we could have had but we would always remember your birth-I kept this thought in my head. I was so happy once the decision was made and Teresa and Hazel were my midwives, this decision was made when I was 24 weeks pregnant, now I could relax, thankfully they were happy to organise a payment plan for us. The one on one care with Teresa was precious and how it should be. Being able to have visits in my home, that were never rushed and in a place where I felt the most relaxed and comfortable was wonderful. To sit and chat over a cup of tea in the privacy and comfort of my own home, where your sisters were happy while getting my checks done was a new experience and one I loved especially in last few weeks when I was so big. I had a beautiful mother blessing a couple of weeks before you were born; it was a lovely afternoon of women, support, connection and love.

My due date came and went and 6 days later, in the early hours of the morning on the 26th of July you let me know you were ready to meet us. I awoke to a surge, I am sure I was waking to go to the toilet anyway as it was so mild that I am sure I could have slept through it. I was excited. So excited I had been waiting for some sort of sign that you were on your way out to meet us. I went to the toilet and had a small show, yes I thought to myself another good sign. Everyone was asleep it was 2.30am in the morning I thought about waking your Dad, but decided against as 1) he would need his sleep for what was soon to come and 2) he had been begging me excitedly to let him put the birth pool up every day for the last 2 weeks – so I certainly did not want him to start doing that now. I made myself a cup of honey and chamomile tea, it was freezing so I wrapped my dressing gown around myself and found my woolly socks which I only just managed to put on myself as your home was just about at its growth limits. I sat on my fit-ball, and read some more of Jenny Blythes’ Down to Earth Birth Book. I had a couple more surges but their mild nature assured me you were not in a hurry.  I was so excited and started to visualise your birth but knew I should get some rest as I would surely need it soon. I was woken in the morning by your beautiful sisters and not long after felt another gentle surge, I was happy they had not disappeared.

I told your Dad, he was excited, I wanted him to know that it could still mean I could labour into tomorrow. Your Dad had already started his leave from work so it was nice having him home already. I had a chiropractor – Webster technique adjustment booked in for 9am on the other side of town and tossed up whether I should still go and decided I would like to be aligned the best I can before birth anyway so we all got ready and headed off to that. My chiropractor was amazing, the pinching muscle spasm pain in my bottom went away after seeing her and I felt good. I was still having surges not really interested in timing them but about 10-12mins apart.  We took your sisters to the park and I remember it felt good to be out but knowing you were working your way down to meet us. I had a midwife appointment in the afternoon and phoned Teresa to say we would come to her as we were out and about as she had been coming to me for the last few weeks.

It was great to see Teresa, she checked bubs position – he was engaged for the first time- YAY- still a little LOP but neither of us were concerned, your heart rate and my blood pressure were all fine, we chatted and hugged and knew we would be seeing each other pretty soon. We went back home to relax and get ready. I had told your Nanny to come as she had to travel from the Sunshine Coast and had let your aunty and my friend/photographer Georgia both know that I was in early labour and left it that I would let them know shortly when to come.  At around 4 in the afternoon the surges were getting a little closer together and occasionally forcing me to stop to breathe through them but still manageable.

Dinner, baths and organising was all happening in our house – it was nice having your Dad and Nanny there just helping and allowing me to wander around when I needed to. I was excited and relaxed. I loved the feeling of knowing that I was not going anywhere that this is where you were going to be born. I felt safe and comfortable, your sisters were happy especially Scarlet who really knew what was about to happen. We promised to wake her up as we put her to bed for the night. The surges were getting closer together and increasing in intensity. Your Dad suggested I ring Teresa after I had four surges in sixteen minutes; I had rung her an hour before just to chat and let her know how things were going but they had stepped up quite a bit during that time. Teresa said she was coming straight away, I let Georgia know and she was also on her way. I felt more relaxed now I knew they were coming. I tried to put your sister Willow to sleep but lying down during a surge was too uncomfortable, I really wanted to be walking or standing or rocking, so I gave up. Your Dad took Willow for a walk in the pram to hopefully get her to sleep- I was thankful. Georgia arrived followed by Teresa then Hazel. It was just after half past seven my surges were now requiring me to stop and breathe through them.  I chatted with everyone between them, Georgia lighted my candles, I set the iPod up and pressed play on the playlist I had prepared. My birthing space looked beautiful – I had hung a quilted wall hanging I had made at a ‘sew birth workshop’ and prayer flags made by the women at my mother blessings, drawings by Scarlet and Willow were also on the wall. Photos of our family surrounded me. Your Dad had started setting up the birth pool before he took Willow for a walk. Teresa and Hazel took up where he had left off with the birth pool and began filling it. It was so nice to have your Nanny here and she was so helpful with your sisters. Your Dad came back which was good because I was beginning to feel like I wanted him with me. Willow was still not asleep, she knew something was going to happen I am sure. Nanny took Willow down the end of the house to go lie down and watch Baby Einstein. Your Dad and I retreated to our bedroom, I leaned into him and we rocked back and forth almost like a gentle dance. I felt so safe and supported in his strong arms; I felt happy and peaceful, when we came out Teresa asked to listen to you and took my pulse, I moved to my fit-ball after this. I was now in a place of surrender and openness and I was enjoying it knowing I was getting closer and closer to meeting you. I had my eyes shut and focused on my breathing; my pelvis wanted to be rocked and make circular motions. I did this. Your Dad was right there with me putting pressure and rubbing on my lower back just when I needed him to, we worked together. Teresa checked in with me in between a surge to see how I was going, I remember saying I felt I was doing well but I knew I had not hit transition yet. I knew you were not far away, you were making your journey down. I was half aware that the birth pool was still being filled but was unaware we had run out of hot water quite early in the piece so did not realise Teresa and Hazel were boiling four pots and microwaving water all at once and pouring it in as fast as they could, running back and forth trying to get the birth pool filled up in time.

I leant over the couch and rocked from side to side as your Dad placed heat packs on my lower back.  Georgia took over holding the heat packs on at one point when he had to attend to Willow. Your Dad was back, I was glad to have him by my side again. I wanted to kneel now I found a spot in front of the couch near the pool, leaning over the couch I buried my face in a cushion it felt good – another surge came longer and more intense, this was transition, the great intensity of each surge came and went the pressure on my sacrum increased.  Your Dad continued to place pressure and make circular motions during each surge.  I wanted my dress and my cardigan off now. I buried my face in the cushion again and allowed myself to release the deep primal sounds which came so naturally and felt so good. I was focused; I trusted my body, I knew it was working just as it should. I felt strong and confident. The sounds I made were deep and low and in control, I was doing this, I had surrendered and my body had taken over, I felt like I was in a good place and my mind focused, all the mental preparation I had done were paying off.

I had another surge in which I called out to Teresa – I told her you were coming,  my pelvis and my body were opening, I felt this – Teresa was sitting beside me already, I had no idea she was right there, quietly and gently supporting me and allowing your Dad to do this also. She told me the pool was now ready if I wanted to get in. I did want to but my legs were shaky, your head felt so far down that it made it hard to move. Your Dad and Teresa helped me to my feet and I was just able to get my legs over and collapsed into the pool. It felt good I remember thinking. I again resumed my position of kneeling and leaning over this time over the edge of the birth pool. I grabbed hold of the side of the pool with my fingers as the next surge came. Your Dad stroked my back and hair and I welcomed another surge. Teresa asked me kindly to listen to you, I nodded. I put my hand down to feel your head coming as I could feel you were so close to being here. It felt all squishy and fluidly as I touched what I thought to be your head – it was not hard as I had expected, in this intense moment I kind of realised you were in your waters. I gripped the side of the pool and welcomed another surge- it felt a little strange, almost like you were moving in and out a little; as my body was working hard to bring you down. The next surge brought your head out, and then the rest of you quickly followed, with barely a break in between. You were born in your caul, you swam out between my legs. It was 10.09pm, your Dad watched and told me how amazing it was to watch you come into the water in your caul and watch it float off your face, “Almost like a veil lifting” he said.  Teresa encouraged me and coaxed me in my still shocked state to reach down and pick you up as I stated I wanted to do this (Your Dad was about to dive in if I didn’t). I looked down and for what seemed like much longer than it really was I saw your gorgeous face looking up at me, eyes open, arms moving slowly. The moment you and I shared staring at each other will always be imprinted firmly in my memory and the overwhelming feeling of love and pure joy as I reached down and brought you up out of the water, into air and into my arms where you took your first breath. I looked at your Dad, his eyes fixated on you and moved to meet mine, they were eyes filled with happiness, his face beaming with joy; the love exchanged overflowing between us all. “I caught you” I exclaimed “and you are perfect”.  Teresa was right there and supported me with you so I could sit back against the edge of the pool comfortably and encouraged me to give you a rub on the back, leaning you forward a little and she congratulated me.

You were perfect, we had done it together, “you are perfect and so beautiful I told you” again. I sat back into the loving arms of your Dad.  Your aunty, Amy, had woken Scarlet and brought her straight in to meet her little brother and Nanny came in with Willow to meet you. We were all there, your birth was beautiful and to just sit there and relax taking you in surrounded by family and your midwives as we relaxed and got to know each other and recovered in the pool was just beautiful. Your Dad cuddled me and kissed me and held your hand and asked me if I thought you were Oliver Byron, I agreed. We sat there in awe of you and your journey.  I looked up at Georgia and smiled, she was kneeling in the corner, she smiled back at me, our eyes exchanging words we didn’t need to say.

Scarlet fell back asleep in her Aunties arms, Nanny took Willow back to bed after meeting you and I decided I wanted to get out of the pool as I was getting cold. Your cord was still attached as I had not yet birthed the Placenta. I was helped out of the pool still holding you and sat down onto cushions leaning against the couch next to the pool. We were wrapped in towels and I continued to cuddle you on my chest. You snuffled and made gorgeous sounds, I couldn’t take my eyes off you, you attached to the breast for a short period, a few times. I birthed the placenta fifty six minutes after you were born and we placed it in a bowl next to us to allow it to fully finish transferring all the amazing nutrients and blood from it to you. Eventually after another hour your Dad cut the cord. Teresa weighed you – 8lbs you were, we dressed you and wrapped you up warmly. Then your Dad held you while Teresa helped me have a wash and get cleaned up and into some clean and warm pyjamas – it felt nice. I put Willow to sleep as she had still not gone to sleep, intent on waiting for me. Georgia made me the best hot chocolate and vegemite toast which I devoured. Your Nanny gave you a cuddle and Teresa and Hazel together with your Dad started emptying the birth pool and cleaning up. I hopped into bed with you and it was just how it was meant to be.
We gave you that journey that entrance into the world, into my arms, into our hearts and our family and you gave us so much more. You gave me a sense of empowerment, a feeling like I could do anything; your birth allowed your Dad and I to work together uninterrupted to support you into this world. The intensity of childbirth is not one you can explain but to be able to birth how and where you feel most comfortable, being present and surrendering to your body while being supported is truly the most amazing empowering experience I have ever had. Being a mother to now three beautiful children is unquestionably the most rewarding gift I have been given.

I really want to thank: You – Mr Oliver Byron for your amazing birth and for being my son, I love you so much. Your Dad, my amazing husband who has always trusted and supported me in everything I choose to do, who is an awesome Dad and is by far the best labour support I could ever need – I love you. Your gorgeous sisters; Scarlet and Willow-who are a constant delight and keep me on my toes teaching me so much about myself and life. My beautiful mother, your Nanny who brought me into the world and of whom I love dearly.  My lovely, gentle sister, your aunty Amy who was a constant moral and emotional support throughout my pregnancy in achieving my homebirth.  Georgia my dear friend, thank you for being the truly special friend you are, who knows more about me than most and now has seen everything  – she gave us the beautiful gift of capturing your birth into the world, I love you. Also all my beautiful friends and family who also supported me and our family and continue to do so, I love you all so much (you know who you are). Our life would not be the same without you all. I feel truly blessed to have such a lovely network of friends and family. Lastly but not at all least – I want to thank Teresa and Hazel, my beautiful midwives who supported me and cared for me through my pregnancy. Thank you for always listening and for helping me achieve the birth I wanted, I cannot thank you enough.

Love Heidi

Who decides how and where a baby is born? Who bears the risks of childbirth? What legal rights do women have to choose how they give birth? These are just a few of the issues that will be discussed at the upcoming Childbirth and Law Forum on Friday 12 October 2012 at Riverside Theatre, Parramatta.

The Childbirth and Law Forum will begin at 2pm with presentations from  two speakers who will discuss the legal issues facing childbirth today in Australia.

- Elizabeth Prochaska, a human rights barrister from Matrix Chambers in London, is a regular adviser to women and health professionals on the area of women’s rights in childbirth in the UK and Europe. Most recently Elizabeth was involved in the Human Rights in Childbirth event in Hague.

- Dr John Seymour, BA, LL.B, PH.D (Auckland), Dip Crim (Cantab), currently an Adjunct Professor in the ANU College of Law. Before joining the Faculty he acted as the Commissioner in Charge of the Australian Law Reform Commission’s inquiry into child welfare law in the A.C.T.

“Human rights law has a very valuable role to play in improving maternity services around the world, both by promoting women’s autonomy and dignity and protecting midwives’ right to practice their profession autonomously” said Elizabeth Prochaska.

Following the keynote speakers, panellists of women, doctors, midwives, lawyers and ethicists will discuss the role regulation has in protecting the woman, unborn baby and health professional. Panel 1 will discuss the Regulations and Rights in supporting and restricting women’s choices, and Panel 2 will discuss Birth with Risk Factors such a breech, twins or previous caesarean.

“Regulating a childbearing woman’s body has serious ramifications and undoes hard won battles our feminist forbears fought for and the unintended consequences should give us cause for sober reflection. Where do we stop once we start and who controls what is acceptable behaviour and what is not and who has the ‘rights’ and who does not and what is risky and what is not?” said Hannah Dahlen, Associate Professor of Midwifery University of Western Sydney.

“This forum will explore the legal context of the choices that women make in all settings during pregnancy and childbirth. In bringing together a diverse group of women, clinicians, lawyers and regulators we hope to tackle some of the difficult issues in this area and explore ways to make woman-centred care a reality for all Australian women,” said Ann Catchlove, solicitor and Maternity Coalition National President.

“Australian women and midwives who care for them are increasingly having to interact with the legal system during pregnancy and childbirth and are facing marginalisation and discrimination. Some women are even being refused medical care from other health professionals due to their choice to birth at home,” Michelle Meares, Homebirth Australia.

Following the speakers and panels, the new film ‘Freedom for Birth’ will be screened and there will be a Q & A with the directors in London, Alex and Toni Harman. When pregnant with her second child recently, Anna Ternovzsky took her country to the European Court of Human Rights and won a landmark case that has implications for childbirth around the world.

Tickets are $80 for students and $130 for adults. A webcast option is available. The event is hosted by Homebirth Australia, the Maternity Coalition – Australia’s maternity consumer organisation and the Australian College of Midwives. Attached is the official flyer for The Childbirth and Law Forum.

Contact: Jo Scard, 0457 725 953 or jo@joscardagency.com or Michelle Meares 0439 645 372 www.childbirthandthelaw.org

Homebirth Australia congratulates Federal, State and Territory Health Ministers for ensuring midwives can continue to provide care to Australian women for birth at home.

Australian Health Ministers met in Sydney today for a meeting of the Standing Council on Health (SCoH) and agreed to extend the professional indemnity insurance exemption for privately practising midwives and agreed to vary the determination on collaborative arrangements required of midwives.

Midwives across Australia have found it virtually impossible to obtain collaborative agreements with individual doctors as required under the current legislation.

Some midwives had approached more than 40 doctors and obstetricians and all had refused citing advice from their insurance company or the AMA. This requirement for Collaborative Arrangements had resulted in fractured care for women and impacted on the safety of homebirth in Australia.

“The safety of Australian women and babies must come first in maternity care reforms. Ensuring the workforce of private midwives across Australia can continue to function efficiently and effectively is one of the most important things that can be done to ensure the safety of homebirth in Australia”, said Homebirth Australia spokesperson, Michelle Meares.

“We congratulate the Health Ministers on fixing this problem that midwives have been reporting since 2010 when the Determination was passed.”

“The extension of the exemption for indemnity insurance for private midwives for homebirth is a positive move as it allows the best possible system to be put in place that will not have the unintended outcome of denying some Australian women and babies access to professional midwifery care at home,” Ms Meares said.

‘Whenever Australian women give birth at home, they must have professional midwives available to care for them and their babies, and any policy or legislation put in place must be scrutinised to ensure that it will not have the unsafe consequence of leaving women abandoned without access to midwives.”

“The Australian Medical Association has expressed outrage at this move claiming it will allow midwives to practise independently. Yet this is what women who choose homebirth want. Women choose homebirth with an independent midwife so they can be guaranteed care by the midwife of their choice and make their own decisions about the care in collaboration with their chosen care provider during pregnancy and birth,” Ms Meares said.

“Women need respectful collaborative maternity care – they must have access to the whole spectrum of maternity care professionals according to their unique needs and the decision about who to involve in her care must remain with the woman and her family.”

Contact: Michelle Meares 0439 645 372

Collaboration was the focus of the National Guidance on Collaborative Maternity Care
 commissioned by the Department of Health and Ageing and released in 2010 from the National Health and Medical Research Council (NHMRC). In it’s discussion of collaboration this document states:

A woman decides who she involves in this decision-making process,
 be it a health professional, partner, doula, her extended family, friends or community, and should be free to consider their advice without being pressured, coerced, induced or forced into care that is not what she desires (McLean and Petersen 1996). Women have the right to decline care or advice if they choose, or to withdraw consent at any time.
Therefore, if a woman declines care or advice based on the information provided, her choice must be respected (UNESCO 2005). Importantly, women should not be ‘abandoned’ because of their choice (FPA Health and Read 2006, Faunce 2008; NHMRC consultations 2009).