Woman as Fodder: Australia's Obstetric Monopoly
Guest post by Julie Bell
It is outrageous and undemocratic that the Australian government has paved the way for obstetricians to rort the system and have handed obstetrics a monopoly over maternity care, while pushing through legislation against intense opposition from parents and midwives, to provide obstetricians with legal right of veto over the midwifery profession, and while depriving independent midwives of insurance and Medicare coverage.
This means that women cannot access the midwifery model of care, cannot access homebirth or independent birth centre care, but are forced to have a corporate-model-style ‘McBirth’ in massive abattoir-like profit-driven institutions which are high-tech, risk-averse, and offer fragmented care instead of continuity of care with a midwife a woman chooses herself. It eliminates midwifery as an autonomous profession, ends a check & balance system between midwifery and obstetrics, and renders midwives to be nothing more than subservient obstetric nurses within a totally medicalised, techno-phile system.
In the hospitals here, I often hear the obstetricians refer to themselves as “doctors” and to the midwives as “nurses”. It sets up an institutionalised hierarchy that does nothing for normal birth, normal breastfeeding and the ability of well women to choose gentle birth options. This is leading to higher rates of birth trauma, lower rates of breastfeeding and sets women’s rights in Australia back 50 years. Women deserve a choice, and this legislation has taken that essential human right from women, disempowered midwifery and given obstetricians unchecked power that will facilitate further corruption.
Obstetrics is a billion-dollar industry and women are merely being used as fodder for this industry, as smaller birth units offering more personalised care to local women are being shut down across the country, despite storms of protest from local parents, who then have to contemplate driving for hours in labour to large centre institutions. (Road-side births are becoming more common as a result. It’s safe to make women drive for hours in labour to a more profitable institution and give birth in the back seat … but a planned homebirth with expert midwives skilled in facilitating normal birth is ‘unsafe’???) Having seen the ‘big boys’ in the USA successfully marginalise midiwifery birth, medicalize normal physiological birth, create a ‘labor-bypass’ culture, and drive homebirth underground, the obstetricians of Australia want the same.
An obstetric monopoly is not right or healthy for any society. However, when a billion-dollar industry is as stake, what is optimal for women and babies becomes secondary to matters of greed, power, profit, litigation issues and what the insurance companies (owned by doctors) dictate.
What women and babies choose want and need in order to thrive becomes merely a game of words. What we want, what we need, is CHOICE - and it is clear that up to 80% of women would actively choose midwifery care if that choice was available, as it is in New Zealand. This is a choice that must be made available to women in remote areas and to indigenous women, who are currently inhumanely evacuated hundreds of miles from their country, their people and their vital spiritual and social support networks, to give birth alone in a ‘white man’s’ institution … and they wonder why there are complications and non-compliance.
Obstetrics is a billion-dollar industry, fuelling the profits of insurance companies, pharmaceutical companies and obstetricians … but we don’t have the money to insure midwives, fund homebirth or provides culturally-sensitive and appropriate care for the most disadvantaged women in Australia? What a con. The check for allowing an obstetric monopoly to snuff out the womanly arts of midwifery and normal birth & breastfeeding has not yet been presented. The voice of women, mothers and midwives, is not being heard. Big business and a greedy, corporate style approach to delivering maternity care has a lot to answer for. Midwifery must be an autonomous profession, and supported as a check to, and alternative to, the excesses of the obstetric model of care. All maternity care must be woman-centered and woman-led, and women themselves must have the final say in what is ‘safe’ for themselves and their babies. Until women have such self-determination in their own care and well-being and that of our babies, and until midwifery is on equal footing with the medical/obstetric juggernaut, we will continue to see rising rates of intervention, financial corruption & waste, post-natal trauma, lowering rates of breastfeeding, and the art of natural birth and mothering will continue its demise.
When there is ‘blood on the carpet’: when a woman gives birth under her own power, with birth attendants she has chosen herself, in a place of privacy, trust and peace… a lot of ‘fat cats’ don’t get paid.
And that is the bottom line in the obstetric-midwifery turf war. It is not about ‘safety’. It is about control - and greed.
Added to post as follow-up per the author’s request:
Maternity Coalition Australia:
Homebirth: Midwife Mutiny in South Australia:
“But can I still have a homebirth? Aren’t they making it illegal?”: