My girlfriend is a midwife. On July 1, 2010, new legislation (called the “National Registration and Accreditation Scheme”) comes into force, affecting all health professionals, including midwives. One of the provisions of this legislation is that to register as a midwife, you need to show that you have insurance that indemnifies your practice. Without registering as a midwife, you cannot practice as one.
OK, so what? It’s a little illiberal to force people to have liability insurance, but it’s hardly an unusual step. The problem is that insurance to indemnify midwives who practice individually is simply not available. One of the reasons is that the statute of limitations on legal action is extremely long, since the baby’s right to sue doesn’t even begin until 18 years after birth. It may also simply be too risky to indemnify individual midwives of uncertain ability, given the massive payouts that are likely to result from negligence. In any case, liability insurance for individual midwives cannot be bought for love nor money.
If midwives can’t practice individually, that has a number of consequences. Obviously it restricts the ability of midwives to practice as they please. It also reduces a woman’s chance of having the same midwife throughout pregnancy and thereby developing a personal relationship before the birth. But most importantly, it makes it essentially impossible for women to choose home birth in practice. Obviously hospitals don’t send out midwives to carry out home birth – women have to come to the hospital for that. And since midwives can only be indemnified when attached to hospitals or other large health practices, that means there are no midwives available to assist in a home birth. Anyone a woman recruits to help with a home birth will be acting as a midwife while unregistered, which attracts a $30,000 fine. (Bizarrely, the woman giving birth also gets fined for “enticing” the midwife to practice).
It’s a regressive step towards a monopoly health services system – where people don’t get to choose how medical care is provided, even for something as personal as birth.