Commentary

Here’s an open letter to Jill Hennessey MP, Martin Fletcher of AHPRA & the Health complaints commissioner, Karen Cusack

Here’s an open letter to Jill Hennessey MP, Martin Fletcher of AHPRA & the Health complaints commissioner, Karen Cusack

The Australian Health Practitioner Regulation Agency has Suspended one of the countries small number of Privately Practicing Midwives Martina Gorner.

Martina Gorner of Ten Moons Homebirth Services is currently being investigated by AHPRA who has yet to contact the family involved in the recent surprise twin homebirth that took social media by storm. With only a very small number of privately practicing midwives who attend homebirths in Australia and a fraction of those in Victoria, many have expressed their concern over what maternity choices will be left, given the currant climate of highly medicalised hospital birth settings.

Professor of Midwifery Hannah Dahlen and her team have research showing that freebirth rates are climbing because they cannot access or afford midwives. While AHPRA has maintain that their reason for suspending Martina was to “protect the public”, many have expressed their confusion as to why they have suspended and effectively taken away one of the few privately practicing midwife options of Melbourne.

With an overcrowded hospital maternity system in which medical intervention is at an alarming all time high, Professor Hannah Dahlen says “women are refugees of maternity care.”

With 1 in 3 women experiencing birth trauma and frequent complaints about private midwives made by hospital staff, the public have shown their concern over what options women will have in the near future if this birth culture continues. Victorian stats on birthing outcomes are monitored and published every year by the Victorian Perinatal Data Collection Unit (VPCU). When you compare these to those of Martina Gorner, it becomes concerning that this is not the focus of investigations.

Members of the public are appalled by AHPRAs action, suspending Martina while investigating her for the home born surprise twins. Especially with an unknown time frame for the investigation.

The surprise twin mother herself freshly postpartum joined the rally outside AHPRA on the day of Martina’s suspension in support of her. Brooke has been openly and publicly grateful to Martina during this whole ordeal.

With no ultrasounds (dating or otherwise), Martina had no reason to abandon her client during labour before the birth of the undiagnosed twins. There was no certainty she was exactly 35 weeks pregnant. In fact if the mum measured slightly ahead (an unknown fact to public) then even more reason to assume they were a little further.

Being born at 35 weeks, the twin baby boys were taken to hospital for care where Martina Gorner was reported by staff.

A tweet criticising Martina Gorner was brought to Jill Hennessey’s attention, who has said she will “ask the Health Complaints Commissioner to investigate.”

On the day of Martina’s AHPRA hearing, supporters crowded outside showing their concern, but were devastated by the result, especially given she has a number of pregnant clients due to give birth.  These mother’s have expressed their distress.

When you look at the Victorian Hospital outcomes that have recently been published and the mere number of births that Victorian Hospitals are servicing / accommodating, it becomes not only concerning that these are not the focus of investigation, but clear as to why women are choosing midwife supported homebirth, among many other reasons.

Instead of looking at improving maternity care, our Health Minister perpetuated criticism of the safe homebirth of undiagnosed twins, that in other countries (such as the UK, US and NZ) is completely normal and not illegal for midwives to attend, as they are in Australia.   The homebirth rate in Australia currently is less than 0.5% and the c section rate is above 33%!

The issue with the complaints regarding Martina Gorner, revered Melbourne Midwife among the home birthing community, is that she is being defamed for supporting mother’s choices, albeit not to have interventions or screening (without medical indications) during pregnancy, birth and postpartum.

Accused of being negligent for having clients refuse vitamin k, anti d and ultrasound which all carry their own risks…Martina Gorner has supported many women who choose to opt out of otherwise routinely pushed procedures.

In the case of the safe twin homebirth, the mother made a choice to decline a procedure (vitamin K and ultrasounds) and Martina her Midwife did not coerce her into receiving them. The midwife continued to provide care as it is expected that any ethical, respectful midwife would, in mother centred care.

In response to the controversial birth one woman raised:

‘But what happens if a homebirth midwife attempts to require her client to have a particular unwanted test (eg an ultrasound) as a precondition for care. If the woman feels that that hospital care and now homebirth midwifery care are unsafe for her, what care will she get? Answer: none. In these circumstances, women tend to “freebirth”.

A midwife tweeted “I’ve been m/w at a number of home births & hospital births in this should read…. ‘Home birth midwife ensures a woman & both her babies are safe despite arriving unexpectedly, she does not administer any drugs without consent”

What is deeply concerning here is the bullying and a birth culture that sorely needs change. We are in a “labour bypass era” as renowned Birth educator and Author of “Birth with Confidence”, Rhea Dempsey calls it.

Another Midwife said: “I loved Martina. I wanted to be a midwife just like her. The way she helps unpack the emotional stuff in pregnancy is like no other.”… I want to one day be an independent midwife (like Martina), but you need to have been working in all areas of midwifery for a minimum of 5 years”

Mothers addressed defamatory comments by sharing: “The case you are referring to when she was banned (from a certain hospital) … was mine. The only reason why she was banned is not because she did the wrong thing, it was because I refused ANY intervention and they did not like it and pointed the finger at her.”

“You have no clue about the details yet you are very fast making judgment. They didn’t know they were premies as the mum didn’t know her dates. As they obviously didn’t know it was twins she was measuring bigger and further along than she in fact was. The reason why they called the ambulance and went to the hospital is because once they were born they realised they were premies. How would she have known this would get her into trouble as they didn’t know it was twins ?”

… “Now as an expecting mum with Martina I don’t feel like it’s her fault whatsoever that we are left without our chosen care provider. I don’t think that the twins mums choice has left us without our beloved midwives. AHPRA has. This patriarchal over medicalised childbirth system has. They have never even mentioned us the expecting mums left for some about to give birth without any midwife and support- how is that about negligence ?”

Certified Homebirth Nurse Midwife in the US said  “this has happened to me a couple of times over the past 25 years. I primarily serve the Amish and Old Order Mennonites. They usually decline ultrasound unless their is a good reason.”

Doula College founder and Author said “How wonderful to have this marvellous birth story. Very clever and most considerate of this baby to have remained hidden. Consider all the fuss and unnecessary anxiety that would have been projected on to the mother and her team had the ‘facts’ been known…”The level of cortisol creating ‘care’ that most pregnancies endure needs a serious review. Although possibly well intended by inappropriately trained staff, many routine procedures contribute to the obstetric violence that occurs for mothers and babies.”

Another surprise twin mother said  “I had twins. They were ‘diagnosed ‘ at 37.5 weeks. I saw two gp’s trained in obstetrics, three midwives with over 45 years combined experience, and the Obstetrician I mentioned above, none of them picked up that I had twins. My twins measured 36cm at 36 weeks. Every previous measurement was always spot on for a singleton.”

Women want to know why aren’t we looking at why women aren’t birthing in hospitals?

One women said “Our society is over medicalised and natural events are being made into medical procedures when 9/10 times it is completely unnecessary.” and another commented “Prosecuting a midwife when she didn’t even know the mum was having twins is not going to benefit the health & safety of future mums & babies, it is going to harm it. Mums are going to be less inclined to seek medical care if they see they cannot trust medical staff.”

Expecting client of the homebirth service said “As if we’re not actually allowed to decline ultrasounds, and as if midwives are expected to bully us into compliance if we do. I had 4 babies, no ultrasounds… It (Vitamin k) has risks and benefits, like anything else, and the right to decline it should not be penalised. My 4 children had no ultrasounds, no Vitamin K, were born at home, and have no vaccinations. Since they had gentle births with no force or instruments, I declined Vitamin K. The question is: may we apply our own risk assessment, or may it be imposed upon us by a third party of superior power? My children are fine.

They are free from so many of the common modern ills that are so normalized now. Of the hundreds of births I’ve attended in which parents have declined Vitamin K, there haven’t been any poor outcomes (note: I personally do recommend Vit K if there’s been any trauma during the birth. …

There’s a place for judicious use obstetric technology and medications. Just as there’s a place for judicious declining of that technology. You can recommend it, you can educate – you can’t enforce it. You can’t say, induction is safer, Vit K is safer. You can only say, in my considered opinion, I believe it’s safer. You only have to read the actual Vit K insert to conclude, well we’re only getting this if there’s a clear need. But all the variables (for any choice around childbirth) are rarely presented to parents.”

Here is the change petition of over 37,000 signatures; you can sign to support Martina Gorner.
https://www.change.org/p/australian-mothers-have-the-right-

If you would like to further help support Martina, please send your concerns directly to:

Martin Fletcher at AHPRA martin.fletcher@ahpra.gov.au,
Jill Hennessey MP minister.health@health.vic.gov.au and
The Health Complaints Commissioner Karen Cusack hcc@hcc.vic.gov.au,
as well as any media outlets including 9 News who have featured the story
contact@9news.com.au

There is also a Go Fund Me set up to help Martina’s appeal linked here:

“Martina’s AHPRA Hearing cost her approximately $35,000, so she can’t appeal without our support.

If everyone who signed Martina’s Change.org petition gave just a couple of dollars, Martina would be able to push back. For herself, for her clients, and for all Australian families who may choose intervention-free homebirth in the future.”

https://www.gofundme.com/help-martina-midwife-push-back…

By Leah Jade-Women’s Therapist & Author

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