Birthing at Home: A Podcast
Hosted by Elsie @birthingathome_a.doula and co-creator of @homebirthvictoria ||
Sharing incredible birth stories from births at home around Australia and the world. Also sharing partner and midwife stories. Using the power of story telling, this podcast will hopefully empower, inspire, and motivate.
Birthing at Home: A Podcast
Chatting homebirth history in Australia & the future of homebirth with Jo Hunter from Birth Time
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- Birth Time https://www.birthtime.world/
- Learn more about Jo here: https://midwifejo.com.au/
- Learn about Waminda https://waminda.org.au/
- Homebirth Australia https://www.homebirthaustralia.org/
Connect with me, Elsie, the host :)
www.birthingathome.com.au
@birthingathome_apodcast
@birthingathome_a.doula
Hi everyone, welcome to Birthing at Home, a podcast. I'm Elsie, your host. I'm a home birth mom of two little boys. I'm a mental health nurse, the co -creator of Home Birth Victoria, and I'm a Melbourne based doler. If you want to learn more about me, the podcast, or my work, check out www.birthingathome .com .au. And before we begin today, I would like to acknowledge the Wurundjeri people who are the traditional custodians of the land I'm recording on in Nam, Melbourne, Australia. I would also like to acknowledge the Aboriginal and Torres Strait Islander people have been birthing at home on country for tens of thousands of years prior to the British invasion and acknowledge that sovereignty has never been ceded. In this month's Midwife Story episode, I chat with Joe Hunter, who many of you may know from being one of the creators of Birth Time. And if you haven't seen it, it's essentially mandatory for anyone planning to give birth. She's also a home birth midwife, former doula and former convener for Home Birth Australia, just to name a couple of things that she's done. I invited Jo to come on and chat with me to give some context around home birth in Australia in the past 30 or so years. Also given that three of her four children were born at home in the late nineties and early two thousands and to also talk about the current issues affecting home birth in Australia right now. The issue around public indemnity insurance for private midwives, including home birth, attending midwives is evolving as the weeks go by. So make sure to follow home birth Australia and join their newsletter for the most up to date information. hope you love this episode as much as I do. Joe to birthing at home a podcast. Thank you. It's awesome being here. Thank you for joining me. So to listeners, Joe is going to be. the midwife story of one month we in July. And she has so amazingly agreed to give us a bit of history about home birth in Australia. But before we get started, Joe, are you able to give a bit of background about who you are, where you live currently, where you're from? know that you, did you come from the UK? Originally, very originally. Yeah. I that on your website. and yeah, just a bit of a background to who you are. Yeah, sure. I'm Jo and I live in Sydney. I'm a home birth midwife and I've been a home birth midwife for 16 years now. I was born in England and we were, we were 10 pound palms. So we came over on the boat when we, when I was three, so I was, I don't remember it. so my family originally from England grew up in the Western suburbs of Sydney. And then I went back when I was 17 and lived there, I was just about 18 and lived there for three years, traveled and then lived there for three years. And I worked over there as a mother craft nurse. So I used to basically move into families homes for the first six weeks after they had their baby and with their newborns. was cool. I loved it. I really loved it. And it was a great way of, you immersing myself in the London culture and having to get a free accommodation and being paid for it. that was very good. And then came back to Australia and I worked in early childhood for a while. And then I had my first baby in 1996 and she was first, am I just giving you a bio or am I just going to go? Yeah, just go, go for it. Go for it. I was just thinking 1996, that's the same year that I was born. That's funny. Yeah. So I hadn't heard of home birth before. I didn't know it was a thing. And my sister -in actually had a home birth with my nephew in 1992. Wow. And she raved about how amazing it was. you know, so that was the first time I'd ever heard of it. And so she kind of broke the seal in our family of having a home. So I didn't have to deal with that one. Yeah, yeah, yeah. Amazing. I mean, I didn't really, everyone was pretty supportive of it. I think probably coming from the UK, it's, particularly back then, it wasn't an uncommon thing. And I know my dad was born at home in the UK. Wow. Yeah. So it wasn't, it wasn't seen as a taboo thing within my family, but certainly within the wider community, it was seen as a bit of bizarre thing to do. So I got pregnant with my first baby in 96 and I birthed her in a birth center in Sydney. I chose that really because we had no money. So I couldn't really afford a home birth. I would have loved to have had one. So it was still quite expensive back then as well. mean, I it was about, I can't remember exactly, but I know it was around about two grand. 28 years, mean, amount of money. Yeah, yeah, yeah. Yeah. We're in a different time right now. Absolutely. Yeah. So yeah, we, I birthed her in the birth center and I had a lovely, I arrived at like seven centimeters dilated. I had a lovely water birth. and then things went pear shaped. So I wanted to have a physiological third stage and the midwife, I guess, thought that that meant just don't give Sinto. so she pulled on the cord. and pulled the cord off and left the placenta inside me. And I ended up hemorrhaging, losing 1500 mil and ended up in theater taking the placenta out and then a blood transfusion. it was, it was a very unnecessary situation. my gosh. Yeah. So, so then I felt pregnant with my next baby and that was in 1998 and I was then considered high because I'd had a patient in hemorrhage and I wasn't allowed to go back to the birth center. So frustrating. Yeah, even though what had happened to me was a result of, know, your, yeah, exactly, management. So, so I went, I'm all, okay, we just need to get the money. I'm going to have a home birth this time. I employed a beautiful midwife, Maggie, and she ended up being my midwife for all three of my babies. Wow. And just had really straightforward home births, 1998, 1999 and 2001. three girls and a boy and they were, know, quick, easy, no bleeding, placentas born, physiologically, absolutely no problems. The last one was like an hour from beginning to end. The third one, the midwife didn't get there. He was born before she arrived. my gosh. Yeah. So it was... At the time, it was seen as a very fringe dwelling activity. Yeah. There was no publicly funded home birth and there was actually no continuity of midwifery care in any setting apart from home birth. Yeah. So you couldn't go to the hospital and get on an MGP or anything like that. There wasn't anything like it. It was really fragmented care. Yeah. And it was the only way that you could get your own midwife. Yeah. I feel like somebody told me the other day that even in Victoria where I am that there's still only like three hospitals or something that have MGP programs, which seems like, you know, it's 2024. Like, seems so bizarre. We have such good research on continuity of care. know. That's ridiculous actually. Yeah. It's ridiculous. yeah, I mean, yeah. So I feel like all of the good things that have happened in the system. since that time have all come from the home birth model of care. So, midwifery care, know, water birth, children being present at births, know, physiological third stage, all of the things that's all, it's all really originated from home birth, which is really physiological birth. yeah. And so, you know, in the nineties, when you're having these home births and I guess finding perhaps home birth community was there much home birth community in your area at that time or what was that like? Yeah, there was. was well, the first the first time I had was in Sydney and then I moved to the Blue Mountains and had two more and there was a really strong home birth community in the Blue Mountains still is. It's a really very strong community up there. And I got very involved. I was the coordinator of Home Birth Access Sydney, which is now known as Home Birth New South Wales. And I stood, I took various roles in that organization. I started as the treasurer for God's sake. mean, I had no idea about money, then I started. Ended up like making the magazine and then ended up being the coordinator. And then, that was between 99 and 2005. And then from 2005 to 2010, I became the convener of Home Birth Australia. And I worked. Justine Keynes was the president of Maternity Coalition. She was a fierce consumer activist who sadly died a couple of years ago, but she and I worked very closely together. yeah, was mad time, wild time. And in that time, what happened with the midwifery, well, okay, go back a bit. Then I became a doler.-huh. And a childbirth. So after you've had the three, the four babies? No, it was during. I became a doula when I had the third baby. Yeah. Okay. Cool. Yeah. So, and worked as a doula. My mom was around, so she was amazing. She used to come and just look after the kids if I was called out, you know. Yeah. And I worked, I did that, but I worked mainly with the home birth midwife in the Blue Mountains. In fact, she employed me to come to births with her. amazing. So wasn't the women that paid me, it was the midwife. Yeah, yeah, yeah. And I learned more from her, you know, doing that in the years that I did that for. It was about eight years I did that for than I did in any lecture theatre. know, it was a, yeah, absolutely. And so I did that and then also ran childbirth classes. So, yeah, we used to come to my home and I worked with another woman, Natalie, and we used to do that together. And then from there, back then, if you wanted to become a midwife, you had to do nursing first. And you just did like a tacked on year at the end of it of midwifery. And they changed the law. The reason why they didn't have a separate midwifery degree was because nurses and midwives were registered under the same board. was like the nursing and midwifery board. So they had to change the law so that midwifery was a separate profession to nursing so that they could then create a bachelor of midwifery degree. Yeah, wow. Yeah. So the first I was in the second cohort of the Bachelor of Midwifery at UTS in Sydney, which was I think it was the first university in Australia to do the Bachelor of Midwifery. I didn't want to do nursing. was like, I'm not I would never have done it actually if I had to do nursing first, because I just felt like it's not who I am. it is a very different profession. So 100%. Yeah. But it was an interesting thing doing it because, know, we were so it was such an early course that, you know, when we didn't do anatomy and physiology or pathophysiology that was related to midwifery, we were bunched in with the nurses. Yeah. Because they didn't have a separate course for it. So we were like learning about prostrates, prostates and like, know, testicles. my God. Yeah. Anyway, it's changed a lot since then. Yeah. my goodness. That's really cool though, because Beth, who I chatted to last month, or the month before. She was also part of like one of these very first cohorts of bachelor of midwifery students. I think she said in 2001, 2002, something maybe like that. But yeah, I hadn't like thought about how, how much it would have evolved over, you know, 20, 24 years. It's changed. mean, it's it's what about it's 19 years for Yeah, Since I started. yeah, it's changed a lot, thank God. Yeah. Even the clinical placement, they just didn't know what to do with us because with midwifery clinical placements prior to that, they were nurses first. So they did all the nursing things, whereas we didn't. We started and we were like, we didn't know how to do blood pressures. Yeah, blood pressure. Any of that stuff. So when we went on to clinical placement, were like, no, no, We weren't really You guys are useless. We weren't really like - my gosh. Because when I was a student midwife, like that was like one of the main things that you'd be sent to go do the blood pressures. you know, the vital signs, like that was your bread and butter. If you didn't know how to do that, you were pretty useless to them. my gosh. And do you remember like, cause right now, obviously, there's a lot of talk around the professional indemnity insurance and the lack of it and whatever else like Medicare, Home Birth, that kind of stuff. know, back 20 years ago when you were having your home births and in that community, what, please, please tell me there were some different issues or were they The exact same issues or? They were very different. mean, things have things have got a lot better in some ways. Yeah. Okay. In ways they've better in other ways. They've got a lot worse. Yeah. And I think, yeah. So there was no Medicare. Yeah. They will endorse midwives. Wow. know, a midwife was a midwife. You could just go and work as a home birth midwife if that's what you wanted to do. There were no midwifery guidelines. The ACM didn't have the first. guidelines were written in 2004. So prior to that, they weren't any. And midwives, there was insurance, it was, you didn't have to have it. Yeah, you didn't have to have it. Some midwives chose to have it, others chose not to. So then like the woman that was my midwife, midwives just used to attend anything. Like they would go to breaches and twins and whatever women wanted, they would do. So I mean, obviously within their, comfort zone and within their scope of what they've experienced. But the more experienced midwives would attend whatever went down. Because there weren't any guidelines, right? So the guidelines have been written and the guidelines were really written, yes, to guide our practice and they are only a guide, they're not rules. So there is very clear pathways for women that choose care outside of them. But they were written really to help midwives both collaborate when it was necessary because that was a real issue back then. Like back in the late 90s and early 2000s, know, midwives were just getting reported left, right and center, but you don't even have step foot in a hospital. And you were reported because you, know, for whatever reason, there was a real lack of understanding of the way that home birth midwifery worked. collaboration was a really like, yeah, there was the odd obstetrician that was happy sort of work with the home birth midwives, but mostly not. it was a, you know, being a home birth midwife was also a very, you know, fringe dwelling activity back then. I wasn't one, you know, my midwife was, and of course I was involved in the movement, so I knew a lot of them. And so, yeah, there was no, there was, we lobbied hard for Medicare actually. And in some ways it's been a good thing, in other ways it hasn't. Yeah, that's what I've heard too. Yeah. Yeah. So I was at the helm of Home Birth Australia when we were doing a lot of the lobbying around, you know, making it more affordable for women by trying to get Medicare. going back to what happened with the insurance was that in 2010, they created national registration. So prior to 2010, You, it was state based registration. So if I wanted to go and work in Queensland, I would have to re -register as a midwife in Queensland. So they created this national registration, but with it came the need to have professional and indemnity insurance in order to register as a practitioner. By then there wasn't any for home birth midwives. And it wasn't because there wasn't, there had been a big claim. It was because at the time there was only about 180 of us around Australia. And what the insurance companies were saying, well, there's not going to be enough money if there is a claim. There's only 180 people doing it. It's not a financially viable thing for us to do as an insurance company. So no, we're not offering it. So what that meant when national registration came through was would meant that we couldn't register as midwives because we didn't have insurance. So we organized this smother of all rallies in Canberra. Yeah, I've heard about this. Yeah. 3000 people showed up. Wow. The airlines went into meltdown because all these babies were coming on that they didn't, you at the time you didn't have to say that you had a baby because they were, it wasn't a seat. would sit on your Yeah. Yeah. Wow. my gosh. Yeah. But they were only allowed to have a certain amount on a flight. They were like, we're not allowed to have this many babies. Anyway, that happened. And it was amazing. And Nicola Roxton. who was the health minister at the time gave us a three year exemption from needing to have professional indemnity insurance. And with that came a bunch of rules and hoops to jump through, which is called the safety and quality guidelines for privately practicing midwives, which we have to follow in order to be eligible for the exemption. my gosh, so you gotta Also, I'd never even thought about that being eligible for the exemption. I just thought everyone would like that was just a broad thing. my gosh. So we had to do, well, the two midwife rule came in prior to that. We could go to home births on our own. Yeah. The there's lots, there's lots of things that we had to do 10 more CPD points than anybody else. Yeah. Yeah. We had to do the pharmacology course and become endorsed and get an endorsement. and keep up with our, yeah, do a yearly emergency skills, then drills, maternal infant recess. I mean, a lot of that hasn't been a bad thing actually. I'm not complaining about that, but yeah, it's, it's, there's been a lot of hoops. So we had an audit. had to, every single home birth midwife was audited. Our notes was, had to be sent through. across Australia, like in no other profession has that ever been done. my gosh. Can you imagine like if they audited the doctors, you wouldn't even be able to read those handwritten notes. And then the notes that I've seen as a nurse from doctors are so brief, so nondescript. Like that would, yeah, that would never happen. Total double standards there. Absolutely. Yeah. Wow. So yeah, that's what happened in 2010. that's so every three years, they've revisited the fact that we don't have insurance and they've just continued to give us an exemption every three years because they can't find couldn't find a solution. So now now what they've done is the government a few months, a few weeks ago said that they found a product. There's been no consultation with anybody as of yet. Even the College of Midwives has been no. consultation. And we don't know what it means. Nobody knows. There's nothing written. All we know is it's for low risk women. We don't know whether that what low risk means. Got no idea. Yeah. We don't know what it would mean for women who are outside. What is considered low risk, whether they would still be able to access a home birth and whether we'd have an exemption for that. But there's just, we actually don't know where things are Yeah. And it's, the home birth community are reeling about it because it's not only the women, but the midwives as well. mean, 60 % of my caseload would be considered higher risk if you looked at it from the guidelines perspective. Yeah. I hate the word, but yeah, high needs is a better way of saying it. Yeah, yeah, yeah. And so, yeah, and what's it going to mean? Is it going to be violating human rights? Because at the moment, We've got the guidelines. So there's category A, which is considered low risk. Category B is, you know, have a chat with another health professional about the situation and category C is refer on to an obstetrician. And that would be, that would be like placenta previa where the placenta is over the cervix. That absolutely has to be a cesarean. There's no other way, two ways about it. know, category B, if women fall into category B and some of those things would be, there's so IVF. Yeah, think macrosomnia. Yeah, there's so many. Fits in there. know, previous third degree tear. Anything. Yeah. Two fat, two young. Yeah. Yeah, pretty much. Yeah. But there's a pathway for us to follow. So if women choose care, that if they fall into category B and they want to have a home birth, there's a pathway that's called a record of understanding that we fill out with the woman. It's back covering for the midwife, but it's also to ensure that you're sharing research and evidence -based information with the woman so that she can make an informed decision about which way she wants to go. And at the end of the day, it is her decision. And what we don't have in Australia is a duty of care to the woman. So we can, in those guidelines, we can just discontinue care if we want to. We can just say, no, you have 39 weeks and I don't want to support you anymore. Sorry. On your way. know, is bullshit. That shouldn't be something that we can do. In England, they've got a duty of care. They have to continue to look after the woman or they have to find someone to step in who will. Yeah. Yeah. I think I've read something about that in the UK about Yeah. Women refusing to go into hospital. And then I've seen people say, they'll send a midwife. Like they have to like a midwife has to go or something. and I just thought, my gosh, if you did that here, like no one's coming for you. It's like, no one's going to help you. No, it's so bad. They'll send the ambulance, but, that's about it. there'll be coercion and all the things that come with that, know, police probably. Yeah, probably. Yeah. Yeah. Yeah. I don't believe that would actually be the Yeah, yeah, yeah, absolutely. Well, I, I spoke to another midwife, Bibi, who shared her free birth twin story, a few months ago. And I was telling like, a friend who's a social worker and, his joke was like, it needs to call CPS, like child protection. was like, my gosh, no, that's not why I told you the story. Like, Yeah, I guess I think that that is, you know, like for health professionals, say, so a paramedic, it's mandatory reporting that it is. Yeah, you're required to do that. Yeah, that's madness. I think that there definitely is a misunderstanding about. what midwives do and what home birth midwives do and our home birth midwives, you know this. fringe group that, you know, isn't very educated, but you know, you've just said like, you know, you have to do, do you say 10 more, CPD, hours? and usually it's, I think I have to do 20 as a nurse. Is it usually 20? It's usually 30, but we have to do 40. Do you have to do 40? Yeah. I hope mine is 20. And, And like the extra because you have to do extra study to get your endorsement for the pharmacology. Yeah. Pharmacology to give medication also to request pathology as well as that. Referrals for ultrasounds and pathology. Yeah. Scripps for drugs. Yeah. To get a Medicare provider number so that women can get some rebate for antinatal and postnatal care. Yeah. There's no rebate for the birth part of the care. Just pausing here to thank the July sponsor. Bimby and Roy. They describe their products as versatile intimates that adapt to your everyday. But they are also the unofficial outfit of labor and birth for women across Australia. Was anyone else counting their appearance in the Born at Home film? In my first labor and birth, I unexpectedly found myself completely naked, which is fine. But when planning my labor and birth for Frankie, I knew Bimby and Roy would be my outfit. They are perfect for the sweat and water that labor so often involves. And because of their ability to dry quickly, you can wear them comfortably no matter where you are laboring. You can check out all of their beautiful designs yourself at bimbyandroy .com .au. Enjoy. Yeah. One of the things that is the talk on the street is that with this insurance coming, potentially there might be, because it's now there'll be insurance, potentially there might be a Medicare rebate for the birth. I don't know. Who knows? It seems a big risk to take. But it's also that thing of, mean, one, we're allowing an insurance company to dictate midwifery practice and to dictate when women can birth at home. also, also once the government becomes involved, there's going to be rules attached to it. They just are. Yeah. You know, it's the way of the world. You know, I mean, my preference would be, just have an exemption. Let's just have a forever exemption. A forever exemption. Yeah. Maybe we can propose that. I don't know how much it would go through. Do you feel like, I guess from my perspective, you know, this is the first sort of major home birth related controversy. Or like, you know, that is happening, but like compared to your experience historically, does this feel different? Does it feel the same as like previous fights? Like, feels the same. mean, it feels the same. Yeah. It just feels like we're just banging our head against a brick wall, you know? Yeah. Yeah. But I, but I do, I am confident that it's going to be okay. Yeah. Strangely so. Yeah. Yeah, well, women have been birthing at home for literally forever before all of this existed. exactly. It's not going to stop women. just, it's not going to stop women. mean, it, would suck for women who, you know, free birth is a valid choice for women. And if that's what they really want to do because they want a free birth, then that's fabulous. If they're forced into it, when they actually really do want to have midwifery care, that's really not okay. That's an issue because they feel it's safer for them then to step back into the hospital system or to step into it to start with. Then that's not an okay reason to be choosing it. Lots of women do want to have a midwife. There are a lot of women who do want to have midwifery care. We know that it does create the home birth model of care planned, attended home birth. It has the best outcomes in everything and any other model of care. So let's look to the evidence when making decisions around what is acceptable for an insurance company to ensure, because we know that, you know, VBAC women do better at home. Yeah. We know that there's higher rates of vaginal birth after cesarean and higher rates of satisfaction and babies do better, you know, so. Yeah. Yeah. It's still quite unknown and not really understood. the way in which women choose home birth and the way in which home birth midwives work. hope, you know, hope birth time's done a little bit to educate people on that. That was kind of the plan. Yeah, yeah. I think it has. think it has. Like, yeah, gosh, when I watched it, I was just like, whoa, like this could be something. And now that this is happening, I feel like it's even further. motivation to share birth time and like it's so beautifully spelt out in the documentary that like, how can you argue with it? Like, you can't, you can't. When you've got academics, when you've got academics, when you've got research and when you've got women and birthing people and families, all saying it, that it's, You can't deny it. Yeah. Yeah. So yeah, I think what really needs to happen is Home Birth Australia needs to be the, they are the key stakeholder. Yeah. It's literally called Home Birth Australia. And they do represent home birthing women, but also home birth midwives. Yeah. Yeah. Yeah. So much work behind the scenes. mean, they've done this survey that, you know, 5 ,900 people filled it. Yeah. You can't deny that the information in that either. So, yeah, I look, I'm feeling quietly confident that it's going to be OK, but it's not it's not going to be without a fight. Yeah. And I think like really vigilant and just. Yeah. Yeah. Making sure that we're at the table. Absolutely. If Homebird Australia is not at the table, then Mother of All Rally's 2 is coming at you. Me too. Yeah, yeah, yeah, yeah. Absolutely. I haven't asked anybody this before, like a midwife, but so you have the safety and quality. Do you call them guidelines or safety and quality guidelines? For practicing midwives. For privately practicing midwives. So for like. Women out there having twins or breach or, you know, what might fall under like higher risk categories. If the woman or the birthing person feels informed enough to make that decision that they want to have a baby at home, no matter if they're bummed down, if there's two of them or whatever, what is sort of stopping or influencing the midwife, a private practicing midwife in Australia from supporting somebody through that? Quality and safety guidelines say that it should be a, like home birth should be a, I can't remember the exact terminology, but it's something along the lines of without risk factors in that pregnancy, singleton and catholic, which is one baby and head down. We do have the guidelines, they're not rules. So if a woman chose I mean, one, she'd have to find someone that would be prepared to support her. Yeah, 100%. Yeah. Yeah. It's not going to be that easy in this climate. No. And two, and if she did, she would then need to be fully aware of the fact that her midwife could be reported. Yeah. Yeah. So and that's like at the end of the day, that's like the midwife's, well, generally livelihood. Like that's. I do think that that's probably the biggest contributing factor to midwives choosing not to attend breach and twins at home. It's not because they don't believe women should have that choice. It's not because they don't believe it's a safe choice. Yeah. But they're scared of losing their registration. Yeah. That's what it's about. Yeah. Yeah. I think I have seen discussion about this on, you know, social media. And there's sort of being a misunderstanding sometimes where the woman or family say, but like, we wouldn't report, like we're happy with like whatever outcome, we just want this journey, but it's not even about the family because anyone can report the midwife. if it became an issue where you had to transfer to hospital, yeah, absolutely report would happen. There's no two ways about it. would be 100%, especially twins. there would be a report put in and we know, I mean, look at the midwives who have been deregistered. They're all midwives who have supported twins, pretty much twins at home. Yeah. Yeah. So, you know, for midwives that are thinking about doing that or, you know, choosing to support breaches and twins, it's really, I'd get your documentation really up to scratch, you know, and really follow the guidelines with it, you know, that record of understanding so that women can fill it in. Also, like, I mean, most time birth midwives wouldn't have had experience with what, know, particularly, mean, we've all had experience with breaches, but with twins, it's a whole different ball game when you've got two babies and two placentas and, you know, if you haven't actually done a twins birth anyway, in any setting, you're probably not the safest practitioner to be supporting it either. So, And that's pretty sad because that's just like a product of like the culture that we've created. we've de -skilled everyone. So now even obstetricians aren't even like confident to do half these things that they should be. Or originally, you know, would have been a midwives role. We need a Dr. Stu here. Yeah, we do need a Dr. Stu. An obstetrician who'd be prepared to attend those with midwives. So the midwives could get their skills up, but also so that you've somebody that's had a lot of experience with it. Yeah. Yeah. Yeah. Cause even like, you know, breach without borders does amazing work in reteaching breach and whatnot. But, you know, realistically, how often do you, do you like just generally like rhetorically as a private midwife come across breach in a home birth setting to be able to sort of practice these skills so you can have this certificate or whatever I presume they give. But like in Australia, like if you're engaging in scans and you know, the medical system, anti -natally and they pick up breach, they're going to have a lot of questions. And so it's going to be hard to fight that off. mean, most women don't, you know, they choose to home birth. don't have all the scans to be honest. Yeah. Yeah. they have any, but yeah, usually they'll have one. Yeah. It'd be the morphology and you know, the breaches that I've attended have been, okay. You're pushing and look, there's a toothpaste, meconium coming out. Yeah. Yeah. Yeah. Whoopsie daisy. There's a breach, know, so there's been a few of those. Yeah. But so it's important to know what to do and to have the skills to do Yeah. I think that, yeah, like hopes for the future hopes for the future. and being a home birth midwife. is that what you still mostly do at the moment? Because I think is there birth time number two? Is that no? No. but you've got the podcast. We've got the podcast. Yeah. And you know, we might do a little bit of filming of other things. We're thinking about, well, we're going to be doing some stuff with Werminda. I don't know what it's going to be yet or what it will turn into, but yeah, we'll follow the story a bit because we've got so much footage of when they were really starting to first set that up and we went down there for this magical weekend where we were speaking to all the women and they told us their stories. Like we couldn't put all of that in the film because it's a film of its own actually. Yeah, you got So we've got heaps of footage and heaps of amazing things. we would like to, yeah, and they've kind of, we've talked to them about. you know, following the story a bit, but we're just going to film it and see what happens. I don't know. We might not turn into anything, but that's going to be one thing. And then we've got the podcast, yeah, the birth time podcast, which I'm loving doing actually. It's yeah. Yeah. You enjoying doing yours? Yeah. It's just nice to like chat to people, you know. I suppose I started the podcast and Home Birth Victoria because I didn't really like know any other home birth. Families, parents, moms, kids, like, you know, I knew Home Birth Australia existed. I knew about Home Birth New South Wales, Home Birth Queensland. But in my own sort of circle, like I didn't know anyone. So it's been really amazing to chat to women and partners and midwives, like all over Australia and like sometimes internationally as well and just You know, I spoke to actually an Australian, but she lives in Canada the other weekend about her experience with home birth. I just like, it's just, yeah. And I, guess that's what brings me hope as well. Like you say, like all of these issues, like it's not going to change. Like people are still going to be able to have a home birth. It's just complicating if the midwife. you know, has rule more rules to follow about being in attendance. But people will still be able to have a home birth, but it might not be midwife attended. Yeah. Yeah. And yeah, big ques, lots and lots of question marks. And you know, it's not OK. You know, no, it's not OK. We know that. Yeah, anyway, yeah, yeah. Well, I'm keen for a rally. I mean, I hope it doesn't come to that, but I am keen for a rally and Yeah, I get the sense. Yeah, like everyone that I speak to, you know, has chosen Home Birth for a particular reason, you know, and in often, I think I counted the other day that basically 50 % of my episodes are moms that have come to home birth after subsequent subsequent hospital births, whether they've been, they're not always traumatic. They might have been fine. They might've been very quick births in hospital and that's why they've chosen home birth. There's a variety of reasons why, you know, women choose home birth. But it's not, you know, I feel that, You know, when somebody becomes pregnant, like the obvious thing is like, we'll go to hospital and this is what we'll do. But it's very intentional when somebody chooses home birth, don't just use usually you don't just accidentally end up having a home birth, you know, like this. It's not a cheap thing to do. Yeah. It's not a cheap thing. Yeah. And then accessing a midwife. mean, like I'm, I'm booked out till the end of March next year. Yep. I mean, I've got three women booked in who are three weeks pregnant. Yeah, it's ridiculous. It's absolutely ridiculous. There's just not enough midwives working in this day. And, you know, I'm turning women away every month. Yeah, wow. yeah. And for the rules around home birth with a private midwife to try and be the same as the rules around a hospital run home birth program is not going to work. No. it's not going to work. mean, the sort of women that choose to home birth through a hospital program are women that they're the kind of women that are okay to birth in a birth center. You know, they they they should understand from the beginning that they could be denied access to that at any point they could develop something that means that they can no longer birth there. know, we all get phone calls from women at 36 weeks saying I've been kicked off the home birth program. And we're like, well, sorry, but Yeah. Yeah. So it's, it's not going to work. I mean, women choose to birth outside the system for a reason. yeah, rules can't be the same as the system. Otherwise we may as well not be bothering. Yeah, absolutely. When I've created the map for home birth, like privately practicing, practicing registered midwives in Victoria, when I've like put it on a map, there are so many just spots where there's no, like if you, and you know, there's people living out there and if they wanted to have a home birth and you, see it like, if you're, yeah, between, I dunno, like probably Bendigo, Ballarat, I think there's like one or two midwives in like Shepperton, but like any, any further than that, like it's just, yeah. I think they, it's called like a midwifery desert, like there's just no, there's no private midwives in that area. and it's really sad. And I imagine it must be very stressful to want to intentionally choose to have a home birth with, you know, a midwife, which I think is everyone's right. and then just simply not be able to like access one, like that must be hard to overcome because yeah, that, I mean, all of these little hubs have hospitals. I mean, I've had women come from remote New South Wales and get an Airbnb close to where I live to have a home away from home birth. Because it would, I mean, even out in some of those really remote places, they do have to relocate anyway to be near a hospital. Yeah. give birth. they've, they will, well, you know, I want to have a home birth. I'm going to, I mean, gosh, it's a lot. Yeah. It's a lot to do. Yeah. To bring, I had one woman who I was living in the blue mountains at the time and she, came from Koba and she, her other three children, her budgie, a dog, a cat partner, obviously. And they rented an Airbnb for a month. two weeks before they would, she was her due date and two weeks after. Yeah. the guinea pigs, they brought their whole family in. Wow. You know. my gosh. Wow. I think I saw, because we're hopefully going to be having five publicly funded home birth programs in, well, let's be honest, it's basically Melbourne. You can't really say it's Victoria because they're all based in Melbourne. But, you know, Melbourne is also a big place when you look at the, you geography, you know, they all have, except for the Royal Women's, they're all probably going to have like a 30 minute cutoff, like radius that women's has 20 minutes. And, you know, it's been very distressing for a lot of people, because if you meet the criteria and what denies you that opportunity is like simply where you live. It's been suggested on like Airbnb or like, you know, temporary accommodation, but you have to, like, it has to be your registered address. Like the hospital says, no, no, you can't cheat the system like that. and that just, yeah, mean, it's just very frustrating. that have used a family member's address that's within that area and then, I've moved to here. Yeah. Yeah, surprise. Yeah, that's very convenient. But yeah, like lots and lots of question marks, Yeah, I guess there's just a lot of a lot of questions and no answers. I think at the moment, it's sort of like Chinese whispers, like I think social media feeds that as well. There's a lot of that. It's you know, we don't know. mean, everyone's saying you can't have you won't be able to have a home birth. But we don't know that. We don't know if that's true or not. And obviously, anyone can have a home birth. But with a midwife, it's There's nothing we don't know. Yeah. There's, but we need to make sure we're at the table so that when these decisions are being made, they're being made in a way that is going to not violate people's human rights. Yeah. Yeah. Well, it's been really lovely to speak to you and get some like history and chat about midwifery and home birth and are you going to be at the home birth Australia? conference, do you go to that? Yeah, I'm speaking at it actually. you're speaking? me too. are you? Yeah, yeah, yeah. Excellent. Well, meet that's great. Yeah, meet you in person there. Did you have anything that you wanted to say that you haven't said or anything like that? I think we were going to just do one little bit about the challenges of either being or becoming a home birth midwife. Yeah, please. Yeah, yeah, yeah. I think probably the biggest challenge is this need to have the 5 ,000 hours. or three equivalent to three years full-time practice before you can even think about becoming a home birth midwife. mean, from my perspective, a midwife is a midwife. When I went straight out into private practice from my degree, I was in a fortunate position of having worked for 10 years or eight years with a home birth midwife. So I did feel very comfortable and confident, but I just wish there was some way you know, midwives could come out of university and come and work maybe as a second midwife for a year or two with an established experienced home birth midwife and then be able to just set up, put the shingle out and set up private practice. Cause I feel like if it became an affordable thing and there was a lot more midwives doing it, imagine how amazing it would be if it was like in New Zealand and we just had houses dotted around all the suburbs that were. you know, where the midwives congregated and then you could either birth there or go, they'd come to your home. Yeah. Like it's not hard. Yeah. And we've got like, yeah, role models like New Zealand that we can look to and be like, look at what they're doing. I mean, they're, the actual system's good, but their midwives aren't paid enough. There's the burnout, burnout, where they've got to do like 10 births a month to even, to even make a living. the burnout rate is very high for, midwives in New Zealand, but if they got paid better. Cause it is, it's a lot, you know, it's a lot on your life. Like, you know, 24 seven on call. there's, yeah, it is. It's a beautiful lot, but it's a lot. Yeah. I, like as a student midwife, I was on call, for my follow through women, but obviously that was quite a few years ago now, but, Like I'm doing my doula training with Rhea Dempsey. and I went to my first birth with that the other day. and from 38 weeks and she went, she was first baby. She gave birth at 42 plus three or four. And so on call for over four weeks, like every night I was like making sure is my phone like. Like, I'm sure you get used to that. was a lot of like flashbacks to a student midwife life. but yeah, you gotta be mindful. yeah. have I got enough fuel in the car? Like she lives 30 minutes away. Am I going to make it there? If I haven't fueled up, is my phone charged? Have I got a charger? you know, these like rookie things, but like it is like there's extra thing You know, you can't go too far. And you could be in the middle of doing anything, know? Yeah. Literally. I've been in the middle of painting a fence and had to just quickly put the paint away and go. Dinner with the family or Christmas day. I've had to twice on Christmas day. I've been called to the slum. Yeah. You know, so you do need to like your family needs to be pretty on board. Yeah. Yeah. And that can be tough for them sometimes, you know, be children, know, I missed some things, you My oldest daughter was school captain and I missed her, you know, the badge thing, know, the... yeah, yeah, yeah....because I was at a birth. So, you know, other people's families become... before yours really, instantly, you know, when a woman's in labor, it is what it is. you know, thankfully my kids have been beautifully understanding about it they've always been used to it. But I reckon it'd be pretty tough. Yeah. Yeah. The times would be hard to deal with. Yeah. The next time that I left the house, my four year old Murphy, who was like, are you going to another baby or is she having another baby? I think, no, love that name. and Frankie both born at home, both over four and a half kilos. Yeah. So that's what I'm passionate about. think, yeah, macrosomnia or whatever. so how have you say it is in category B. So it would be, I would have to, if, if that was the, you know, criteria, I'd have to get someone to sign off to say that I can, I was allowed to do it or something. So that's where my motivation comes from. Like, cause there was nothing else, right? Like there was, mean, big babies that wasn't saying wrong with me. I bel I firmly believe that like, just have big babies. So absolutely. I mean, I was, I'm the same and I I would have been risked out for previous postpartum hemorrhage. Yeah. Over 42 weeks. went over 42 weeks with one of them being over four and a half kilos was enough. Yeah. You know, like there's so many things and I just had these amazing, beautiful straightforward. Yeah. And most people do. Yeah. Actually, when you just leave it alone, it works. Yeah. Amazing. Like how are we even here? Like birth works for tens and tens I don't know, hundreds of thousands of years of evolution of homo sapiens, like we're here. yeah, amazing chat to chat with you, Jo. And yeah, I'll meet you in person. I keep getting confused, but it's November, right? The conference in November? Yeah. Yeah. Thank you so much. you. Loved it.