To the Editor: The aim of the study by Kennare and colleagues1 was to establish data on home and hospital birth outcomes for the period 1991–2006, before the Policy for Planned Birth at Home in South Australia was introduced in 2007.2 One significant shortcoming of the study was the lack of data regarding the type of birth attendant, the degree of cooperation with the local hospital and the quality of transfer arrangements. Currently, there are virtually no home birth policies in Australia governing women’s access to qualified midwives with hospital visiting rights that enable appropriate transfer. Women who intend to have a home birth are forced to rely on the charity of midwives who provide care without professional indemnity insurance. Failing this, women are known to give birth without a midwife.
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- 1. Kennare RM, Keirse MJNC, Tucker GR, Chan AC. Planned home and hospital births in South Australia, 1991–2006: differences in outcomes. Med J Aust 2010; 192: 76-80. <MJA full text>
- 2. Department of Health, South Australia. Policy for planned birth at home in South Australia. Adelaide: Government of South Australia, 2007. http://www.health.sa.gov.au/PPG/Default. aspx?tabid=189 (accessed May 2010).
- 3. Bastian H, Keirse MJNC, Lancaster PAL. Perinatal death associated with planned home birth in Australia: population based study. BMJ 1998; 317: 384-388.
- 4. de Jonge A, van der Goes BY, Ravelli ACJ, et al. Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births. BJOG 2009; 116: 1177-1184.
- 5. Janssen P, Saxell M, Page LA, et al. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ 2009; 181: 377-383.
- 6. Dahlen H, Homer C. More critique of the homebirth study and its reporting by the media. Croakey 2010; 20 Jan. http://blogs.crikey.com.au/croakey/2010/01/20/more-critique-of-the-homebirth-study-and-its-reporting-by-the-media/ (accessed Apr 2010).
Hannah Dahlen is the Vice President of the Australian College of Midwives. Caroline Homer is an active member of the Australian College of Midwives and was on the Review Team for the Review of Homebirths in Western Australia (2007–2008), funded by the WA Department of Health.