Australian College of Midwives backs Qld funding for home births as Health Minister Shannon Fentiman reveals timeline for Toowoomba
With Queensland’s first publicly-funded home births due within months, the midwifery sector has backed a rollout in Toowoomba and the Darling Downs. Here’s when we could see it.
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Public funding for home births in Toowoomba and Darling Downs is likely still years away from being delivered, according to the state’s health minister.
Shannon Fentiman was one of the keynote speakers at Friday’s Australian College of Midwives (ACM) state conference in Toowoomba, where she vowed to continue listening to the industry as it grapples with key pressures like labour shortages and burnout.
It comes as the ACM revealed its desire to see all women in Australia have access to the “gold standard” continuity of care model, where a mother or birthing parent sees the same midwife for the entire pregnancy.
Currently less than one quarter of women across the nation have access to that model, with home birthing considered a part of that solution.
“We know that nationally, only 24 per cent of women can access these models of care, so we’re working in each state and territory to increase the access of care to women,” ACM chief midwife Alison Weatherstone said.
Ms Fentiman said she was excited to see the first babies born at home through the public sector on the Sunshine Coast in July, but downplayed any move too fast-track it across the state.
“I’m looking forward to seeing that evaluation and expanding it to places across Toowoomba,” she told the media.
“Women have told me time and time again, they want three things – they want continuity of care, they want choice and they want it close to home.
“I’m a big fan of making sure we have a publicly funded home birthing service, and I’m confident we will see that service expand (over several years).”
Toowoomba midwife backs home birth rollout
A local midwife says she’d love to see the Queensland Government’s public funding of home births expanded to the Darling Downs.
Toowoomba Hospital registered midwife Letisha Dawson, who also works privately with women who want to give birth away from hospital, said home births were still rare in Queensland due to the cost and demands it placed on the current workforce.
“The midwife I work with takes on about 50 women a year at home, so the home birth rate Queensland is quite low, but we turn women away because there is just not enough midwives to facilitate home births,” she said.
“It’s costly, it’s about $6500 to do a home birth and of course families have to come up with the money.
“The visits are claimable on Medicare but the homebirth itself is not claimable and you need to have two midwives at home to cover everything.”
Ms Dawson, who also works with Griffith University student midwives as a practice lecturer, said home birthing had been shown to be as safe as hospital deliveries.
“There’s also the perception of homebirth — there’s this big push that home birthing is unsafe, but the literature has shown for years that it is as safe, if not safer than hospital births,” she said.
“The only restriction is you have to meet very strict criteria to be able to get into it and birth at home — you can’t go overdue for example.
“It’s a great start and to see it rolled out everywhere would be amazing, because it cements the fact that we believe homebirthing is safe.”
The conference came just days before International Day of the Midwife on Sunday, which celebrated the role of the profession around the world.
Ms Dawson said each of the more than 300 births she’d been involved in were special.
“It’s really selfish, because we get that oxytocin high at the end as well — it’s watching mothers and families actually become families.
“At the end of it, it doesn’t matter what (delivery) it is, they have this baby in their arms and we get that feeling of worth, that we’ve really helped them.
“Even if they were the eighth child of that couple, they’re still a different parent at the end of that journey.”
Ms Dawson said it was important mothers felt like they were in control, even during potential serious complications.
“There was a woman who was fully dilated, did it all at home and tried hard to push her baby out for a few hours but she was transferred to hospital and ended up with a caesarean section, which was sad for her,” she said.
“But she was so happy in the end because she had all of her choices met along the way, that no stone was left unturned and regardless of the outcome, she was in control.
“She felt honoured and heard and listened to, and that’s what we want.”
Strong results in Western Queensland model
Health Minister Shannon Fentiman also used her speech at the conference to spruik the government’s $16m investment in midwifery group practice models to rural and regional areas, using a “hub-and-spoke” concept to help birthing specialists cover large territories.
Darling Downs Health’s western cluster midwifery unit manager Kate Fay, whose team is centred at Dalby but covers vast parts of the Toowoomba and Western Downs regions, said the vast majority of women were getting access to continuity of care under the model that the funding covered.
“We’ve got a fairly large catchment and everyone who hooks in with our service gets a known midwife,” she said.
“They have a midwifery group practice and even those women that are higher-risk, they have their own known midwife so they can have access to a continuity model.
“I had a team meeting with one of our groups just this week, and in one small team, for the month they had nine births and all but one mother birthed with their primary midwife and the one that didn’t was unwell, so otherwise it would’ve been 100 per cent.”
Queensland’s first chief midwife officer, who is based in Toowoomba, says the region is leading the way in delivering a number of innovative services to expectant families.
Liz Wilkes, who was recently appointed to the new position earlier this year, said the Garden City was chosen to host the ACM conference due to its ability to overcome obstacles and respond to industry pressures.
“As the chief midwife officer, we’re basically focused on expanding the options for women to access midwifery continuity of care,” she said.
“We’re looking at workforce initiatives to get people into midwifery, to retain them and make sure they’ve got a good work environment.
“The Darling Downs will have a midwifery model available in every single one of its clusters, so the Darling Downs does really well when you look at it in comparison, and that’s why the conference has been held here.
“Kate’s model in Dalby is a really good example of how rural maternity services work well with a ‘hub-and-spoke’ model.”
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