The Pregnant Woman's Homebirth Bill of Rights and Responsibilities

There will always be an element of risk in birth whatever the choice of birthplace. However, safety in childbirth is intrinsically related to the mother's emotional, psychological and physical well-being during labour. This, in turn, is influenced by the choices which are made during pregnancy, choices which should enable a woman to give birth at ease with her environment, her attendants and herself.

No professional, however well-meaning, will have to live with the consequence of the outcome of labour and birth as long or as intimately as the consumers to whom they offer their services. The choice of birth professional is possibly the most important choice a woman will make during her pregnancy. There is no place for paternalism in the practice of obstetrics although at some stage of labour the decision may be made to place the management in the hands of the professional. However, domiciliary obstetrics is the 'art of invisibility' and without complications a woman gives birth herself, supported and aided by her midwife.

This most important choice of birth professional should be made after long and careful evaluation of the practitioners available. It is especially helpful to talk to as many clients as possible and get a clear picture of the mode of practice. Every woman gives birth in her own individual style and will feel easier if her practitioner's style suits her own. Some homebirth midwives collect statistics of the incidence of complications which occur within their practice, such as caesarean sections, episiotomies and tears for on-going review of their own work.

Expertise in decision making is based on a firm grasp of the possible options, their consequences and their relative risks. This is only possible within the context of a mutually trusting and warm relationship. The complexities of birth and death call for hard logic, love, courage, deep conviction and intuition.

Childbirth thus becomes a shared adventure between parents and p[professionals. The rights and responsibilities of all concerned should be thoroughly discussed and scrupulously observed. In this way, the self-esteem and autonomy of women, whether as birth-giver or midwife, will be enhanced whatever the physical outcome of the birth.

The arduous and often unrecognised role of the homebirth midwife has become politicised because of the support midwives give women in their efforts to regain autonomy in birthing. She and her family often suffer considerable personal and economic hardship as she may work outside the mainstream of obstetrics due to lack of peer support. With the widespread misconceptions about the safety of homebirth, her professional status is in jeopardy if anything goes wrong. However skilled she may be, deregistration and loss of a career is a constant insecurity in the face of social hostility to her chosen mode of practice.

Homebirth Australia has produced this Bill in the hope that it will protect and be of help to the parents, babies and midwives who make homebirth possible in this country.

Jan Pilgrim

Also see our submission made to the current Human Rights Consultation [pdf: 0.9Mb]