Archive for the ‘AMA’ Category

In May 2009 the Government announced long-awaited reforms to Australia’s maternity care system, to give women better “choice and access” in their maternity care:
- Medicare rebates for women receiving care from expert midwives
- A solution to midwives’ professional indemnity insurance problems
- Boosted funding for rural maternity services
- $120.5 million new funding
These reforms promised to greatly improve women’s control, choices, continuity of care and access to community-based care, in the most significant reform yet to the Medicare system.

The peak body for midwives says some women are being refused a drug called Syntocinon, which prevents haemorrhaging after birth.

The college says it is aware of a cluster of cases in the Blue Mountains, west of Sydney, and accuses doctors of trying to make “political statements”.

DOCTORS, fearing they will be sued, are refusing to prescribe drugs or order tests for women who want to give birth at home, and this is forcing mothers to give birth in hospitals or putting lives at risk, midwives say.

Well, the discussion didn’t stop there. I am writing a piece for the Crikey bulletin on related issues, some of which are also aired in the current issue of the BMJ (extract available here, but the full article costs).

Below are three sets of comments that helped inform the BMJ and Crikey articles. Firstly an email comment from Drs Steven Woloshin and Lisa Schwartz from the Center for Medicine and the Media at the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire. They are international leaders in efforts to improve media coverage of health and medicine.

If you’ve been half awake in recent days, you might have heard of a new study showing that “babies are seven times more likely to die during home births”.

It’s worth having a close look at what the study actually found (the full article is available here in the Medical Journal of Australia), and also considering some of the broader context that has been sadly lacking from most of the coverage I’ve seen and heard.

Further to the posts below on the homebirth study, the AMA has sought right of reply.

Dr Andrew Pesce, for those who haven’t been following the story thus far, is the president of the AMA (which opposes homebirth), an obestetrician and gynaecologist, one of the reviewers of the new study, and also the author of the MJA editorial on the study.

Article from the Medical Journal of Australia written by Dr Andrew Pesce, President of the AMA (which is to opposed homebirth)

One of the problems is that the planned home birth group includes women who planned homebirth at booking but then developed risk factors and had their babies in hospital. There are probably only two women whose babies died who started labour at home planning a homebirth and one of these was a twin pregnancy (high risk). The others had all transferred before the onset of labour. The authors admit they ‘could not differentiate all planned homebirths according to whether transfer to hospital had occurred before or during labour.’ So for low risk women who start labour at home the risk is very low - 1 death in 16 years.

For babies born at home the news is even more encouraging. There were only 2.5 deaths per 1,000 actual homebirths making homebirth at 328% safer for babies than birth in hospital.

For a long time now we have heard the rumours of a new home birth study that Dr Pesce had hidden under his hat, waiting to release it at the perfect moment. Reportedly it showed a baby had seven times more chance of dying at a homebirth but a close inspection of the research reveals these claims as false.

IPSWICH homebirth supporters have slammed a report by the Australia Medical Association (AMA) that labelled home birthing dangerous.

The AMA published a study in the Medical Journal of Australia which stated homebirths lead to a sevenfold increase in babies’ deaths during labour.