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Legislative Assembly for the ACT: 2001 Week 8 Hansard (8 August) . . Page.. 2546 ..

MS TUCKER (continuing):

Doctors are specialists in caring for women's complicated pregnancies, yet they are the lead carers of most pregnant women within state maternity systems and for all in the private health system. Health departments have been slow to implement the recommendations of the World Health Organisation, the NHMRC and the state ministerial inquiries into childbirth services that called for more use of midwives within the maternity services in the 1990s. Similar recommendations from the Senate inquiry into childbirth services are only recently being recognised.

Midwives are specialists in caring for normal pregnancies, keeping in mind that normal pregnant women make up about 85 per cent of the total child-bearing population. The ratio of midwifery-led care to obstetric-led care needs to change. With a caesarean rate of 20 per cent in the ACT, without any other intervention, normal healthy pregnant women are having unnecessary interventions that are placing undue strain on the health budget.

Many concessions have been made in recent months to obstetric models of care, with pregnant women being encouraged to give birth in private hospitals and promises being to reduce the gap in rebates for doctors' fees. At the same time, the basic option of continuity of carer from a known midwife, the model that is strongly supported by research evidence, is being withdrawn. This is absolutely unacceptable. It defies best practice standards, removes the midwife's livelihood, is not in the interests of the consumer and is causing great distress to women who have chosen to give birth in the care of a midwife.

In supporting this motion, members will demonstrate that they believe in the right of women to choose who cares for them during this very important time and that this territory values the most appropriate and cost-effective maternity care.

MR MOORE (Minister for Health, Housing and Community Services) (11.51): Next year, when I am not a member of this Assembly and when some others here are not members of this Assembly, I would recommend to former members that when they wish to lobby they do as I will do and go to Ms Tucker and put their case. The big advantage of going to Ms Tucker and putting their case, provided you bring enough information, is that you will know that she will put just your side. She will not worry about the other side. Your side will be put so clearly and concisely that you will not have to worry. That is what I will be doing, Ms Tucker. You will probably see me quite regularly when I think it is important to lobby on something.

The aim of Ms Tucker's motion appears to be to ensure that the option of home birth is available to women and families in Canberra. I think that is something we would all agree with. We would all hope that that would continue. It is a good aim. The objective is shared by the government, but we go much further than Ms Tucker. We also have to ensure that the choice is an informed one. We have to ensure that there are no unsafe practices. We have to ensure that there is adequate skills-based backup available in the hospital when emergencies occur and that the availability of safe home birth does not put other more mainstream birthing services at risk.

What we have here is a simplistic intervention by Ms Tucker, an intervention that will not guarantee the critical aspects of care for women and families in Canberra. To rectify this, I have circulated a very minor amendment to Ms Tucker's motion. I move:

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