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House of Assembly - Fifty-Second Parliament, First Session (52-1)
2011-10-18 Daily Xml
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HOME BIRTHING

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for Mental Health and Substance Abuse, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (15:26): I seek leave to make another ministerial statement.

Leave granted.

The Hon. J.D. HILL: Today I tabled in this house the Health Practitioner Regulation National Law Amendment (Midwife Insurance Exemption) Regulation 2011. On 26 September this year, the Australian Health Workforce Ministerial Council made a regulation under national law to extend for a further 12 months the professional indemnity insurance exemption for privately practising midwives attending home births. This exemption will only apply to registered midwives. Registration requires midwives to comply with standards, codes or guidelines issued by the Nursing and Midwifery Board of Australia. Failure to do so, may result in disciplinary action against the practitioner. Health ministers were of the view that this form of regulation would protect the public in the absence of a national consistent approach to the regulation of unregistered health practitioners.

Home birthing is a legitimate practice when undertaken with the right safeguards. Since 2007, SA Health has provided publicly funded home birthing services for women who are deemed low risk in line with the Nursing and Midwifery Board of Australia's standards. I recently met the home birthing unit at the Women's and Children's Hospital, and I can assure members that they are a fantastic, dedicated and professional team. Women whose pregnancies are deemed to be high risk, often because they have previously delivered by caesarean section, are expecting multiple births, whose baby is in the breach position when labour starts, or are precluded by existing medical or health conditions, are not eligible for publicly supported home births.

I am extremely concerned that these women are, perhaps, turning to unregistered practitioners who present as birthing assistants or doulas. Prospective mothers, their partners, families and friends need to be fully aware of the potential risk involved with this approach. The Deputy Coroner recently held an inquest into two separate cases of babies birthed at home under the care of Ms Barrett following pregnancies that would not meet the SA Health guidelines for homebirths.

Following an appeal by Ms Barrett to the Supreme Court and the High Court of Australia, it was held that the State Coroner had jurisdiction to hold an inquest. The inquest concluded on 30 September and the Coroner's finding is pending. I am advised that Ms Barrett surrendered her registration as a midwife in January this year. I am also advised that, since that time, Ms Barrett has been practising as a doula. Doulas are unregulated and provide assistance and support to women during birth. This is distinct from the role of a midwife who is a qualified practitioner who has successfully completed the prescribed courses of study in midwifery, and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery.

Members may have heard media reports over the weekend that Ms Barrett was associated with another incident on 7 October involving the home birthing of twins, one of whom subsequently and tragically died. The Women's and Children's Health Network has notified the State Coroner of this case.

I have been further briefed on yet another incident involving Ms Barrett. On 12 October 2011, another doula presented to the Lyell McEwin Hospital with a woman who was in established labour. A live infant birth was assisted by medical staff. Against medical advice, the infant was taken home by the mother. The mother subsequently returned for medical treatment for the infant, accompanied by Ms Barrett.

I am advised that Ms Barrett is also at the centre of a coronial investigation underway in Western Australia regarding the death of a twin during a home delivery in July of this year. I have asked the chief executive of SA Health to write to the Health and Community Services Complaints Commissioner to request an investigation into the involvement of Ms Barrett in relation to the two 2011 incidents.

Having regard to the recent appeal from the decision of the Deputy Coroner and the subsequent decision of the Supreme Court upholding his decision, I am sufficiently concerned about this matter to have discussed it with the Attorney-General, who has indicated to me that he will raise this matter with the Director of Public Prosecutions to see whether the facts as known suggest the commission of any offence.

The South Australian government supports the rights of women to access safe, planned home births for women assessed as low risk. Planned home births conducted under the public system are attended to by at least two qualified practitioners, one of whom must be a registered midwife and have available, at short notice, the services of obstetricians and other hospital resources should the care required become more complex.

Women planning a birth at home should make an informed decision and ensure that they have qualified clinicians providing care. Mothers should be aware that all births carry an inherent risk and that despite choosing a home birth she may need to transfer to a health facility if complications arise.

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