MCA joins forces with other advocacy orgs on insurance for homebirth

Message from Homebirth Australia:

Thank you for your patience since our last update. We have been busy working behind the scenes analysing the data from our recent survey and working on our strategy for the next steps in this campaign.Once again, we would like to extend our heartfelt thanks to the almost 6000 people who completed our survey last month. We have completed the first stage of the data analysis and are working hard to have it completed in time for the consultation submission deadline of the 12th of August. Our gratitude also goes out to our friends at Homebirth NSW, Homebirth QLD, Homebirth Victoria, Better Births Illawarra, Maternity Choices Australia, Hygieia Health, Strength to Progress and the teams at Born at Home Film and Birth Time for their contributions and support on this campaign. 

Today, Homebirth Australia received an invitation from the Federal Government to make a submission to the consultation on expanding eligibility under the Midwife Professional Indemnity Scheme for low-risk homebirths.

The consultation document states: 

The Department of Health and Aged Care is seeking stakeholder input from organisations that represent midwives, obstetricians, general practitioners, consumers, and advocacy organisations on the proposed criteria for low-risk homebirth for the purposes of professional indemnity insurance for privately practicing midwives.

It is proposed that homebirth intrapartum care insurance product be introduced into the MPIS when the current exemption for PPMs expires on 30 June 2025, with the following criteria for suitability:

• Singleton pregnancy (not multiple e.g., twins)

• Head is down (cephalic presentation)

• Pregnancy term is between 37 and 42 weeks

• Midwife has a documented plan for safe and timely transfer to a hospital with maternity services

• Midwife has documented no concerns that make homebirth unsafe for the midwife, woman or baby.

• Where the woman has Category B conditions as listed in the ACM National Midwifery Guidelines for Consultation and Referral, evidence the midwife has consulted with other qualified, competent health care providers with the knowledge and skills to make decisions about the woman's care to determine if homebirth is safe and appropriate

• Where the woman has Category C conditions as listed in the ACM National Midwifery Guidelines for Consultation and Referral, evidence the midwife has referred and transferred primary responsibility of care to another qualified health service provider or professional who can determine if homebirth is safe and appropriate

• Comply with the Nursing and Midwifery Board of Australia Safety and Quality Guidelines for privately practicing midwives. 

Notably, the criteria listed above is similar to how PPMs attending homebirth practice now, but there is no mention above of what happens if a woman declines referral (as is her right) and whether there is protection for a PPM to continue providing care to women who want to birth at home outside the guidelines.

We also have concerns about the suggestion that another 'qualified health service provider or professional' holds the final say as to whether homebirth is safe or appropriate. In fact, there is no mention of women's right to choose mentioned at all.

And frankly, we find the suggestion that midwives and women are not skilled, knowledgeable or competent enough to make decisions about whether homebirth is a safe and appropriate option insulting and dismissive. There are a lot of unknowns at the moment, but whatever the final policy wording is will need to be more specific than this consultation document if we are to avoid deliberate misrepresentation like we've seen in the past with the collaborative arrangements guidelines.

Next Steps

Once we have made our submission to the government consultation, we will share it with you, our community, and let you know what you can do next to support our campaign.

In the meantime, we are writing to MPs and arranging meetings to gain support for our cause and continue to meet with our political advisors and strategy team to work on future actions.

We have invested a lot of time and resources into this campaign, so if you would like to support us financially it would be greatly appreciated. You can make a donation of any amount below, or join as a member of Homebirth Australia for as little as $20 a year.