RANZCOG and the ACM have called for national laws to align with South Australia’s model.
In the wake of several recent deaths linked to freebirthing, two leading peak bodies have jointly called on health ministers across the country to enact national legislation restricting the management of labour and birth to registered health professionals.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian College of Midwives warned that the absence of skilled clinical support during freebirths has led to preventable harm and loss of life.
Freebirth – the intentional choice to give birth without a registered midwife or doctor – differs from planned homebirths attended by qualified providers.
RANZCOG and the ACM have urging national, state and territory governments to replicate South Australia’s Health Practitioner Regulation National Law (South Australia) (Restricted Birthing Practices) Amendment Act 2013.
This legislation limits labour and birth management, including all three stages of labour and the delivery of the placenta, to registered midwives, medical practitioners, or supervised students.
The South Australian legislation defines “restricted birthing practice” as, an act that involves undertaking the care of a woman by managing the three stages (or any part of those stages) of labour or childbirth or of managing the third stage (the placenta) … only a registered midwife or medical practitioner (or a student under supervision) may perform such a practice.
Adopting this legislative model across jurisdictions would advance the safety of birthing women and people and their babies, enhance professional accountability, and clarify the roles and responsibilities of obstetric and midwifery practitioners, the peak bodies said in a joint statement.
“While choice and model of care are important, such choice must operate within frameworks that ensure safety, quality and accountability. This proposed legislation would affirm that principle,” said RANZCOG president Dr Nisha Khot.
They said the move would strengthen maternal and newborn safety, support professional practice, and contribute to equitable birthing care across Australia.
The alliance said they stood “ready to work in partnership with governments, health services and those with lived experience to assist in implementing and operationalising such legislation”.
“ACM respects individual women’s right to autonomy in birth,” said ACM president Dr Zoe Bradfield.
Related
“Harmonising national legislation as proposed, will ensure all women can have confidence in the transparency, safety and accountability of care during birth, in the same way, all across Australia.”
Dr Heather Waterfall, an O&G in regional South Australia, and chair of the RANZCOG South Australia & Northern Territory Committee said women and babies deserved safe, evidence-based care.
“By enshrining in law the requirement that birthing services be provided by registered professionals working to defined standards, we have elevated system-wide practice,” she said.
Specifically, RANZCOG and ACM are asking health ministers to:
- Introduce and pass legislation which expressly restricts labour- and birth-management (including the three stages of labour, birth of the baby, and the third stage) to appropriately trained, registered practitioners (i.e. obstetricians/gynaecologists, GP obstetricians, and/or midwives);
- Ensure that unlicensed or unregulated persons are prohibited by law from undertaking the management of labour and birth as defined in the legislation;
- Harmonise regulatory frameworks across all states and territories to ensure women receive the same protections regardless of where they give birth in Australia; and
- Promote transparency, accountability and safety in birthing services.
While the joint statement did not specifically identify any recent cases in which women and/or babies have died while freebirthing, it did refer to “the wake of several recent tragedies linked to freebirth”.
