Tasmania looks at allowing public hospital midwives help with homebirths

For Aleysha Chapman, the arrival of her child was shadowed by a feeling of being unheard and having her birthing experience diminished. She expressed that the focus on the baby’s health often overshadows the mother’s well-being, stating, “A lot of people automatically say, ‘Oh, at least your baby’s healthy at the end of it’, but there’s also a whole other human being there that also matters.” She emphasized, “And it matters how you feel after your birth.”

Limited Birthing Options in Tasmania

When planning for her second child, Chapman desired a home birth supported by a midwife, believing it “would have been very healing.” However, she encountered obstacles: private midwives were fully booked, Tasmania’s public health system does not offer home birthing services, and a temporary move interstate proved financially unfeasible. She ultimately delivered in a hospital, experiencing a better outcome the second time, but still feels women deserve more choices.

Chapman’s experience highlights a broader issue: hospital births aren’t ideal for all women, and the lack of alternatives is leading some to consider “freebirthing” – giving birth without a medical professional present. This practice has raised concerns among health professionals, with recent deaths linked to unassisted births.

The Debate Over Birthing Options

Finding a solution to improve the birthing experience is proving contentious. One potential path is the implementation of a public homebirth service in Tasmania. A draft consultation paper from the state government references a Victorian review of planned homebirths for low-risk pregnancies. This review found higher rates of unassisted vaginal births, lower rates of instrumental or caesarean births and postpartum hemorrhage, and no difference in severe perineal trauma, stillbirth, neonatal death, or neonatal intensive care unit admissions.

The proposed Tasmanian model would limit eligibility to women who have had fewer than five births, are carrying a single baby, are between 37 and 42 weeks of gestation, and live within a 30-minute ambulance ride of a hospital.

Jaimee Smith, a private midwife in Tasmania, currently supports women choosing home births. She reports turning away over 100 women annually due to capacity, and expressed concern about those who may then attempt freebirthing. She emphasizes the importance of relationship-based care and allowing a woman’s body to progress naturally with support.

Differing Perspectives on Safety

The Australian College of Midwives advocates for a public homebirth model, arguing This proves both responsible and evidence-based. Katie Kingshott, interim Tasmanian chair, believes it’s “time for us to trust women and to trust midwives” and avoid pushing women towards potentially riskier freebirthing scenarios. She advocates for a collaborative approach to determining suitability for home birth, rather than strict exclusions.

However, the Australian Medical Association maintains that hospitals remain the safest place to give birth, emphasizing the need for rapid intervention in emergencies. Michael Lumsden-Steel, Tasmanian branch president, stated, “I can’t stress this enough: when there’s a medical emergency that involves a mother and a baby, you have two lives at risk,” and “In 2025, we don’t want to see preventable deaths occurring.” He suggests focusing on improving the hospital experience for mothers and promoting quality education during pregnancy.

Dr. Lumsden-Steel also proposed birthing centres – currently only privately available in Launceston – as a potential compromise, offering a less hospital-like environment while maintaining access to specialist care.

Next Steps

The Tasmanian Department of Health is currently assessing submissions to its draft consultation and will collaborate with stakeholders to develop a service model. A public homebirth service could be implemented in Tasmania, potentially increasing birthing options for low-risk pregnancies. It is also possible that the focus will remain on improving the hospital birthing experience, with an emphasis on trauma-informed care and patient education. Further discussion and collaboration between healthcare professionals and expectant mothers will likely be necessary to determine the best path forward.

Frequently Asked Questions

What is “freebirthing”?

According to the source, “freebirthing” is giving birth without a medical professional present, and has been associated with recent deaths and alarmed health professionals.

What does the Victorian government review of homebirths suggest?

The source states that the Victorian review found higher rates of unassisted vaginal birth, lower rates of instrumental or caesarean birth and postpartum hemorrhage, and no difference in severe perineal trauma, stillbirth, neonatal death, or neonatal intensive care unit admissions.

What are the proposed eligibility criteria for the Tasmanian home birth model?

The proposed model would limit eligibility to women who have had fewer than five births, are carrying a single baby, are between 37 and 42 weeks of gestation, and live within a 30-minute ambulance ride of a hospital.

What factors might influence a woman’s decision about where to give birth?