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Thursday, 14 November 1985
Page: 2141

Senator WALTERS(11.48) —I agree with the Minister. Therefore, I ask: Does he believe the Government would authorise such payment to midwives and therefore encourage home deliveries in the absence of these statistice? Would it not be better for the statistics to be available before any decision was taken in the area? As I said, I understand the Minister's difficulties. Would it not be responsible of the Government at least to defer any encouragement of home deliveries? I have some figures and the Minister may be aware of them because he would possibly know that Tasmania, at least, makes some attempt to compile statistics through Professor Correy's efforts, because he is very interested in the area, particularly in trying to get some statistics. In 1983-I stress that these are only the reported cases-there were 34 home deliveries in Tasmania and there were six perinatal deaths. The figures indicate that there were nine perinatal deaths-that is deaths occurring after 28 or more weeks of pregnancy-for every 1,000 deliveries in Tasmanian hospitals. I calculate that six prenatal deaths out of 34 home deliveries amounts to between 170 and 180 deaths out of 1,000. Those are the only figures that I can get in the whole of Australia.

Senator Peter Baume —Where was that?

Senator WALTERS —Tasmania. Professor Correy has gone to a lot of trouble--

Senator Grimes —Well--

Senator WALTERS —No doubt the Minister would acknowledge that Australia-wide he has figures--

Senator Grimes —I do not think Joe would like the way you are using his figures.

Senator WALTERS —I think the Minister would find that he would agree with the way I am approaching this matter. However, as these are the only figures that we have in Australia I would like to refer to some United States figures because I think it is important that we find out what are the Government's feelings in this area. In Iowa in 1975-I am sorry that the figures are so old; I cannot get any later figures-there were 18.4 perinatal deaths per thousand hospital deliveries and 63.6 perinatal deaths per thousand home deliveries. In Kansas City between 1972 and 1976 there were 22.3 perinatal deaths per thousand hospital deliveries and 95.3 per thousand perinatal deaths in home deliveries.

I am stressing what I believe to be the dangers of home deliveries, and I am sure that the Minister would agree with me in that respect. In the event of home confinements not being a passing fad, will the Government conduct an appropriate cost-benefit analysis in terms of the need for flying squad services and additional hospital intervention costs, given the high transfer rates, before making a decision? I think the home birth statistics indicate that there is a 12.18 per cent hospital transfer component in regard to home deliveries. Even if one does not accept these figures, the transfer rate is still very high.

I would be very grateful if the Minister could find out as much detail as he can. Evidence has been taken from the Royal Australian College of Obstetricians and Gynaecologists and from the Australian home birth groups. I am very concerned that the outcome of the committee of review be fully understood by the Government and that prior to any agreement that home birth deliveries be accepted by Medicare for Medicare benefits purposes, statistics should be made available so that women can be made aware of the tremendous problems that they will face if they decide to have their deliveries at home.