Childbirth 'over medicalised'

WA's top child health researcher has stirred up the childbirth debate, claiming it is over-medicalised and saying she does not believe there is evidence that homebirth is riskier than a hospital delivery, provided it is a low-risk pregnancy.

Telethon Institute of Child Health Research director Fiona Stanley said she was strongly supportive of the use of midwives and that too many women were having caesareans, which could lead to complications for the mother and baby.

Professor Stanley said her own grandchildren had been delivered by midwives without medical intervention, and obstetricians needed to relinquish low-risk deliveries to midwives and trust there would be good outcomes.

Her comments came as pregnant women cared for by experienced midwives won the right to claim Medicare rebates from this week, as part of the Federal Government's health workforce reforms.

"I'm strongly supportive of the increasing role that midwives are playing by preparing women for birth, by helping them plan for a spontaneous, normal delivery that will be better for mother and child," Professor Stanley said.

"We published a study about a few years ago which showed a dramatic increase in caesareans, and that the majority of the increase was unrelated to medical risk, so it was either obstetricians wanting to deliver that way or it was the mothers demanding it."

Professor Stanley said there were anecdotal claims that homebirth was dangerous but she had not seen the evidence.

"If people say homebirth is dangerous, show us the data, because the data we have shows they're not if the right things are in place," she said.

Retired Perth obstetrician Ralph Hickling, who has just published a book, Childbirth today: too many caesars, not enough joy?", echoed the call for wider use of midwives.

Dr Hickling said the management of childbirth had been taken over by consumerism and there was a push towards an almost 100 per cent caesarean rate.

"In recent times Australia could claim having the highest caesarean rate in the world and I think WA could claim the highest in the country, and there's no way the obstetric discipline can justify a caesarean rate of 35 per cent or more," he said. "Pregnancy is being treated as a disease and childbirth is seen as an operation to cure the disease."

Community Midwifery WA manager Pip Brennan said that under the program women with low-risk pregnancies were reviewed by an obstetrician and monitored by midwives during their pregnancy and labour.

"Typically women have very positive experiences," she said.

First-time mother Emily Gillett, 26, gave birth to her son Hugo at home three weeks ago, under the care of a community midwife.

She and husband Brian, 32, chose waterbirth for a natural birth without medical intervention.

"I was in labour for quite a while but it was a wonderful experience being in my own home," she said. "Soon after the birth I was having a cooked breakfast in bed and it was so relaxed."