Reports this week of the death during childbirth of the baby of a leading home birth advocate at her inner-western Sydney home come just as the Government is considering a review of maternity services.
The review, while advocating an increased role for midwives in co-operative settings with doctors, rejected Government funding for home births when it was released in February. This was despite the fact that more than half its submissions came from a minority of home birth advocates, who have besieged the Health Minister, Nicola Roxon, ever since.
The most ardent of lobby groups is Joyous Birth, whose convener, Janet Fraser, 40, tragically lost her baby after several days of labour at her Croydon Park home, which ended on March 27, when an ambulance was called. The NSW Coroner's Office yesterday confirmed it had received a report of the baby's death.
The last thing anyone wants to do is compound the grief of Fraser and her family, so we will spare readers further details. But as one of the most extreme proponents of home births, Joyous Birth has been influential in persuading pregnant women to shun medical intervention in childbirth. It describes as "birth rape" doctor intervention that saves the lives of mothers and babies, and has made Australia one of the safest countries in the world for childbirth.
Its website is popular, boasting 30,000 visitors each month and claiming to have doubled its membership to 1000 last year. So it is important to dispel the myth it promotes: that home birth is safe, medical intervention dangerous and obstetricians evil incarnate.
As a Wodonga obstetrician, Dr Pieter Mourik, says, the natural birth lobby "has been advocating dangerous practices and I believe the media has a responsibility to publish these cases when a totally avoidable baby death occurs … so gullible, pregnant women are not persuaded to follow these risky practices".
Dr Andrew Pesce, Westmead Hospital's clinical director of women's health, says he knows of four home births in the past eight months in western Sydney in which the baby has died, along with a further four home births in which the baby has suffered possible brain damage from oxygen deprivation; preventable tragedies if prompt medical care had been available.
Despite the disasters, Joyous Birth continues to promote 2009 as "Birth Trauma Awareness" year, urging members to write graffiti on hospital walls: "Birth rape on demand, a surgeon's right to choose"; "Did your rapist wear a mask and gown? Mine did"; "Episiotomy is genital mutilation"; "Fingers, forceps, hands, ventouse, baby - which one belongs in a vagina?"; "My body, my birth, my choice".
The website features a fantastic account of an emergency caesarean by a woman calling herself Sungaikecil:
"There is a man at the end of my bed. He is big. He is overbearing. He has soft hands. His eyes are strange … He tells me to lay [sic] back … He tells me to open my legs. I don't want to … He uses his arm to spread them. I fight him. He fights back. I am scared … He enters me. With his hand. With his fist … Where's my mum …
"There are sharp things inside me. There are people's hands inside me … My stomach is cut. One swift cut. The man is cutting me. He is scarring me. He laughs. He does not look at me. He admires his cut. The slit he made. He has wounded me."
Honestly. At the end of this deathless prose, she says she is "handed a baby". Hello? wasn't that the point?
Even if few women (2.5 per cent) are convinced by such propaganda to opt for a home birth, the anti-hospital message is pervasive, making women fear and reject basic medical help, as Ellen discovered, when she gave birth last year to her first child at Orange Base Hospital
"I'm still traumatised by the experience, and not just because it was horribly painful. Mostly, I'm furious," she wrote to me last month.
"It was virtually impossible to find anything written which was not informed by the ideologies of the powerful, anti-medical intervention natural birth lobby … [They] made my first experience of birth more painful than it needed to be …
"Two good things happened during the 18 ½ hours of trying to give birth to my son. The first was the male anaesthetist giving me an epidural, the second was the male obstetrician delivering my son with a vacuum …
"It did not take me an inordinately long time to recover because I had medical interventions. I just felt great about having a healthy baby. The only thing that was hard to recover from was that nobody had just told me the truth about birth - that it's agonising, that it's not that important in the great scheme of being a mother."
Women seduced by the "empowering" idea that only a woman knows how to deliver her child forget, as Pesce said yesterday, that "100 years ago one in 10 women died from complications of childbirth, and [one in 10] babies".
Pesce, also the president of the National Association of Specialist Obstetricians and Gynaecologists, was at pains yesterday to point out he knew about Fraser's tragedy two weeks ago but did not mention it. It was only when the story became public that he revealed seven other home birth disasters he has encountered since July.
The cases are mainly from the Blue Mountains area, and two stillbirths occurred at the hands of "doulas" - women paid to help women give birth, often former midwives. In one case last September, Pesce says the woman had been warned of the risk of a previous caesarean scar rupturing but had been offered a trial labour at Nepean Hospital. She delivered a stillborn boy at home three days later.
"The trouble is we take safety for granted now and are arguing about quality issues, like maternal satisfaction, which is important. But I'm sorry, as a clinician, survival is the most important thing." Amen to that.
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Source: Sydney Morning Herald
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