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Tuesday, 8 September 2009
Page: 8941


Mr JOHN COBB (6:38 PM) —In speaking to the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and related bills, I must say that, as somebody who has seven daughters and 15 grandchildren—and two more on the way—I think I have some knowledge, if not of having children then at least of dealing with those who do. I have been approached by midwives and mothers, some who are both and some who are one or the other. While I have to confess that, being a nervous father and grandfather, I would always prefer my children and their children who have children to do so with everything around them, I totally accept that a woman has a right to have a child in her own home with a registered and fully trained midwife. My only concern would be that they totally accept the advice of that midwife and, if there are likely to be any complications, that they do it within call of doctors or hospitals within a reasonable distance.

Most people, be they doctors or midwives, say to me that you really should be no more than three-quarters of an hour or so from more extensive help, should it be required. That seems to me pretty reasonable, because quite obviously an experienced and trained midwife will know reasonably early if there are likely to be any complications. During the course of a pregnancy, if it is likely to have any complications, I would hope nobody would go into labour outside of ready access to a doctor, hospital and everything that goes with them.

Having the far west of New South Wales as part of my electorate and having lived in the western division of New South Wales virtually my whole life, I know the tyranny of distance is quite a frightening thing. There are times when mothers and fathers are damned glad to have medical help of any kind. I think that is the main thing. I implore and plead that nobody has a child or allows themselves to be in a position where they have to give birth without medical help, be it a midwife or anything else. In particular, I would never be in favour of a mother putting herself in a position where she has to be out in the outback or anywhere else. I know these things happen—sometimes through misadventure. I will talk about some of those in a minute. But I believe that within the confines of which I speak a registered and trained midwife, having taken all due precautions to ensure that, everything being equal, there should not be undue complications, a woman should have the right to have a child in her own home with the assistance of that midwife and within a reasonable distance of further aid. I do not think any midwife—none that I have spoken to, anyway—has suggested for one second that they should be longer than the time period I mentioned away from further help should the unexpected arise. I am sure no mother would want to be.

I very much support the right of midwives to practise and mothers to make that decision with all of those safety valves in place, but I have to take this opportunity to talk about the current situation. The debate about midwives being able to continue to assist in homebirths brings up the Third World situation facing women in quite a lot of my electorate—certainly in the western part of my electorate, where they cannot have babies at their local hospital because there is no maternity service. Cobar, for example, is a town of 6,000 people. I believe that in this day and age in a town of 6,000 people in our country, let alone in New South Wales, you have a right to feel safe. I do not mean that things cannot go wrong; they can always go wrong, even if you are in Prince of Wales Hospital or whatever. I believe that in a place of that size you have a right to feel you are safe and you can have a child.

But women in Cobar have to wait until the last minute and call an ambulance to help with the delivery of their child, because they know that if they have not already gone they are not going to make it to Dubbo—which is the only serious medical centre there. There is nothing between Broken Hill and Dubbo, which is a distance of 800 kilometres. Cobar itself is 460 kilometres from Broken Hill and about 300 from Dubbo. Despite that being such a big centre and despite it being that far from the other cities, they do not want you to have children in Cobar. Those who decide to make the 300-kilometre trip to Dubbo do not always get there in time, and that is pretty understandable. More than one baby has been born on the side of the road.

A couple made it only as far as the Nevertire pub, which is about an hour or so from Dubbo, and it is just fortunate that the proprietor of that hotel happened to be married to a wonderful Irish nurse. I do not know if people actually thought, ‘I wonder if I can make it to Nevertire instead of Dubbo,’ but this has happened. And, as I said, when you have to leave a town of 6,000 people and rush to Dubbo 300 kilometres away, it is not good enough. Unfortunately, I believe that the Irish nurse who is married to my good friend who used to have the Nevertire Pub is no longer there, so I hope nobody thinks it is still an option.

In places like Nyngan, Trangie, Narromine, Warren and Brewarrina there is also no service for the delivery of babies. Even though they have a magnificent maternity section that is attached to the hospital in Condobolin, you are not allowed to have babies there either, you have to go to Parkes. There is nowhere in between Parkes and Broken Hill to have a baby, and that is a damn long way. There is no hospital between Wilcannia and Dubbo, a distance of over 500 kilometres, that would take a pregnant woman. There is a maternity unit at Broken Hill but it is the bare minimum. They do not have services to look after premature births and there is no guarantee that you will have a doctor. Broken Hill is a town of around 23,000 to 25,000 people. Bourke has a part-time service, which is lovely if your baby comes during the allocated hours, but it is not a good idea to have your baby out of hours.

Homebirthing is not an appropriate option for all women, but it is also far from appropriate for women to be forced to deliver their baby on the side of the road because the medical services are not available in a town, especially a town of up to 6,000 people. There are a couple of points here. Firstly, what is Kevin Rudd doing about this serious problem? He promised to fix the health system in August and November 2007, when he was the prospective Prime Minister. He promised he would fix it. He said, ‘The buck stops with me.’ He was going to have it fixed by June. But of which year? Was it 2010, 2011, 2012 or 2013? No, it was June 2009, two or three months ago. Secondly, if the government wants to change the status quo with regard to midwives helping in homebirths, they must provide appropriate medical services for pregnant women in rural areas. Midwives are incredibly well-trained people. Before we had RNs, we had nursing sisters. I remember that they used to be triple-certificate nurses, and midwifery was one of the certificates that they used to do.

As the previous speaker, the member for Canning, the colleague of my Western Australian friend here the member for Kalgoorlie, said just a minute ago, more often than not it is the nurse who delivers the children, even in a hospital. No-one can question the competency of our medical profession and particularly those who are trained as midwives. I do not have a problem with the desire of women within reasonable distance of help to have their children at home with the attention of one of those registered and very competent people. But I do have a problem with the fact that we have all these hospitals in western New South Wales with no provision for women to have their babies in their hometown. In New South Wales you are not allowed to have a child west of Parkes, you are not allowed to have a child west of Dubbo. If they can, they will not even leave you in Parkes or Forbes; they will push you on to Orange, which is the only place in central western and western New South Wales with a proper medical service.