This year I was reprimanded by the medical disciplinary board for the way I was involved in a (intended) homebirth of twins.
Did this mean I am no longer to assist in high-risk homebirths?
No, it does not.
And yes, I am still willing to attend so-called 'high-risk' homebirths, if that is the best way to go for the women involved.
Now - I won't be telling you today about how the Ternovszky holding was incorporated in my defense, because I did not use it.
Neither did I bring my lawyer here - I hadn't any.
I have learned a lot in the three years this case was going on - and I will use my five minutes to tell you about one thing I learned.
What I learned is:
We tend to make things very difficult, but actually it is not that hard.
And of course, I am aware of the complexity of things, and often overwhelmed by it.
The question should not be:
"Does a woman, under any circumstance, have the right to give birth at home?"
The question should be:
"Who will assist her?"
Because in a civilized country a woman, any woman, who wants a home birth in spite of the medical advise to be hospitalized, should not have to exercise her rights alone.
The bottom line is that we must never be allowed to use manipulation, coercion or force to push women towards 'sensible choices'. That would have nothing to do with civilization, either.
There will always be homebirth.
Let's make it a safe option.
Let's ask ourselves the questions:
"Who has the expertise?"
"What 'area of expertise' is essential?"
If you look at what is possible and what is not possible in homebirth, we see that it's a fact that there is much more improvising and much less monitoring possible, compared to hospital birth.
But this is not a problem - it is supposed to be that way!
So if this brings a caregiver out of her (or his) comfortzone, is she (or he) competent, then? I really doubt it.
For the time being I would suggest that midwives with a lot of homebirth experience are the experts here.
As for the birth itself - I think it's the expertise of the birthing woman we need to trust.
And yes, we can lack experience, but that's also not a problem -
if it's experience we lack, we must learn.
We have to set the standards high for ourselves.
- We need to be able to participate in the whole healthcare system as freely as with 'low-risk' births.
We must not settle for less.
We need to fight for this.
- We need to be able to trust that the mere act of assisting women at home can never be a reason to be prosecuted.
But most of all:
- We need to be willing to be held accountable for the things we do, just like any other caregiver.
We need to be transparant, open, about what we do.
Firstly, and most importantly we need to be honest with ourselves.
I think it's time to be clear about this and stop making things so complicated.
Only in a climate of transparency, trust can develop.
To all midwives present here today I would like to say:
Please reject the role of victim.
Do not let yourselves be marginalized.
Let's find better answers.
There will always be women who give birth at home,
and we will support them.
It's as simple as that.