Maternity care: a human rights issue?

Abstract

All women need the ability to access midwifery-led care at the primary or first level of care, enabling them to have control over, and decide freely and responsibly about, their reproductive health. In establishing women’s control of their own reproductive health, there is likely to be a reduction in reliance on unnecessary interventions in birth. The choices of maternity care provided in Australia are at present discriminatory. On the pretence of fundinglimitations, community based midwifery-led models of care are not widely available. Such options are limited to so called ‘alternative birthing’ arrangements for a limited number of women, mainly in low socio-economic groups or ‘at risk’ groups such as teenagers and Aboriginal women. Whilst the increased mortality and morbidity rates, and poor social circumstances, of women in these groups clearly demonstrate their need for better care, these women may be further marginalised by being identified as needing special attention. Furthermore, we argue that a strategic reallocation of present funding from mainstream medicalised care would enable all women to access midwifery-led models of care, which are not only generally more cost effective than standard care but importantly offer them the option of choosing one-to-one midwifery (Maternity Coalition 2002). Until Australian governments stop limiting the real maternity care choices available to women, and make a political commitment to provide care based on consumer needs, rather than health professionals’ preferences, Australian women will not be able to exercise their fundamental human right to decide freely on matters related to their reproductive health, for these decisions are currently strongly constrained by what governments are prepared or encouraged to provide.