Expectant mothers are having planned home births cancelled within weeks of their due dates, with Victoria’s ambulance crisis putting intense strain on the state’s maternity services.
Victoria has just two publicly funded home-birth programs at Sunshine and Casey hospitals – both of which are now temporarily suspended. Assisted home births require ambulances to be available in case of any complications during the procedure.
Guardian Australia understands pressures in the state’s ambulance services have contributed to the pause in both programs.
It means women currently wanting access to assisted home births must turn to private midwives that cost about $5,000.
The opposition health spokesperson, Georgie Crozier, a former midwife, said home births were another service that had declined due to the state’s ambulance crisis.
“There’s been a lack of planning and preparation and now Victoria’s health system is in crisis and it’s impacting on women’s choice to have home births,” Crozier said.
Depleted staffing levels in the state’s triple-zero service has left it plagued by lengthy call-wait times, with the state coroner investigating reports of people dying while waiting for calls to be picked up. The Andrews government last week announced it would pour an additional $115.6m into the emergency services sector to fund 120 new call-takers.
Kelly Langford, co-founder of private practice Midwives and Mothers Australia, has seen an influx of women wanting to book home births because they have experienced last-minute cancellations in the public system.
Langford said hospital home births require “an ambulance to, theoretically, be on standby”.
“If there’s more strain on the health service then it has an impact,” she said.
Melbourne mother Jane Gould-Dowen, 30, had planned to have her second child through Sunshine hospital’s home birth program last month, as she felt it offered her the most “safe, secure and supported” environment.
She was advised in early January – at 33 weeks – that her birth would be unable to go ahead through the scheme, which was paused in October, a month after she had booked the home birth. She was later advised that the midwifery group practice program – which offers continuity of care for expectant mothers – was also being stopped and that she would need to be moved to the Mercy hospital as she was in their catchment area.
“That month of January, with everything cancelled, was so stressful,” Gould-Dowen said. “I was crying so much and it was such a hard thing.
“It’s such a really huge mental shift to have to have undertaken and do that. It’s massive and it’s not something that you want to have to be dealing with towards the end of your pregnancy when you’re trying to slow down.”
Gould-Dowen said being plunged back into the “general maternity system” with no continuity of care meant she opted for an unassisted home birth.
“I just felt really backed into a corner, in that I was like, I don’t, I don’t know what to do,” she said.
First-time mother Ruby, 27, gave birth to her son two weeks ago at Sunshine hospital. Despite also booking into the hospital’s home birth programs, she was 34 weeks pregnant when it was confirmed it would be unable to go ahead as planned.
“It was quite upsetting,” she said. “I remember I looked at the bag I’d packed for the hospital and I just cried … I felt so out of control. A birth is a really important time in a woman’s life and in a baby’s life. And to be, you know, to not have a say in how that goes … was really sad.”
A Victorian government spokesperson said “every effort is being made to resume home birth services as soon as it’s safe to do so”.
A spokesperson for Monash Health – which includes Casey hospital – said it had temporarily suspended its home birth program to “ensure the safety of all pregnant women and their babies in our care”.
“We highly value our home birth program and look forward to resuming the service when it is safe to do so.”
Wendy Watson, divisional director of women’s and children’s services at Western Health – which oversees Sunshine hospital – said its home birth program was paused due to “Covid-related pressures on the healthcare system.”
About 0.3% of births in Australia took place at home in 2019, according to the Australia Institute of Health and Welfare.
But Victoria’s public home-birthing programs saw a rise in demand during the pandemic, with some expectant mothers worried about potential exposure to Covid at a hospital and support person restrictions.
In 2013, Victoria’s last birthing centre – designed to provide a home-like environment for women with low-risk pregnancies and take pressure off the state’s hospitals – was closed.
In July last year, the Andrews government announced a $13.2m investment to ease pressures on the state’s maternity services, after reports of understaffed maternity wards and women giving birth in emergency rooms and corridors. But the six-month funding has now run out.
The Greens’ deputy leader and emergency services spokesperson, Ellen Sandell, urged the government to undertake a “comprehensive review” of the state’s public maternity care system to determine how to better care for people during pregnancy.
“We need to invest a lot more in good maternity care, including 1:1 midwifery care and small family birth centres, to take the pressure off hospitals and give people more supportive care in pregnancy and birth,” she said.
“If Victoria hadn’t closed our family birth centres, and had invested a lot more in 1:1 midwifery care early on … women might not be facing these distressing situations now.”
