Baby Bonus gone

The federal treasurer's announcement in the Budget 2013 that there is to be no Baby Bonus from early 2014 is, in my opinion, a sad legacy of the present government, and an equally lamentable commentary on the opposition's lack of support for those who need it most. 

It sometimes takes a cartoon to speak truthfully about political situations.  Thanks, Australian.

Mothers who stay at home with their young children, particularly in the pre-school years; mothers who do not benefit from paid parental leave because they do not have employment out of the home; families who live on one income - these are the ones who will miss the baby bonus most.  And, as it happens, many in this sub-group of modern Australian communities are the ones who also value wellness and protection of health in pregnancy, birth, and nurture of their babies - and who employ a midwife privately.  Many mothers have 'afforded' homebirth, knowing that they will be entitled to the baby bonus.  So, in that sense, I must declare that my interest in the baby bonus is, in part, linked to my need to earn a living as a midwife.

I don't have time thismorning to write any more, but will get to it as soon as I can, and add to this post.  Any comments from readers will be appreciated, either in the comments section here, or by email.

later...
Responses received in 4 our so hours since I wrote include:

Cancelling the baby bonus demonstrates ...

"undervaluing of the role of a parent"

Yes, the current social pressure to have children of all ages cared for by specially designated child care businesses does ignore the very real intuitive and personal roles of parents in caring for, guiding, and teaching their own children.

"full time parenting is not recognised as gainful or important.  ... the role of a stay at home mum has been labelled 'for the chronically unambitious'."

Outrageous!

"I think this really will have an impact of breastfeeding and extended breastfeeding rates."

No doubt!

...

Then, there are those who have seen what they consider to be abuse of the government's over-generous middle class welfare, new parents who have boasted of purchasing the flat screen TV, state of the art coffee machine, new sofa or a trip to Bali.

or, as a midwife notes, 

"the women in [low socio-economic area/suburb] who come back and have a new baby each year, and can't wait to get the Centrelink forms filled out so that they can get their payments."

Yes, any social welfare scheme can be abused.  We Australians have many supports provided by government at the time when our babies are being born and nurtured, including family tax benefit, parenting payment, as well as the child care benefit and child care rebate for children in approved care facilities.  For more detail, click here.

A quick review of media around the scrapping of the baby bonus informs me that there will be an end to the current baby boom, that teenage pregnancies will be discouraged, and that families will no longer have 'one for the country', as proposed by Peter Costello in 2004.  The consensus amongst thinking people seems to be that the baby bonus is better relegated to the wastebin of bad economic management.

Here's a story.  Once upon a time ...

There were two men in a certain city.  One was very rich, and he had properties and flocks and herds and many possessions.  The other was very poor, and lived near the rich man.  He owned just one ewe lamb, which the poor man had bought.  The poor man and his family loved that lamb, and it ate their food, and drank from the same cup, and slept in the poor man's arms.  Now one day a traveler arrived at the rich man's house, and he invited the traveler to stay for dinner.  The rich man did not take a lamb from his own flock, but in stead took the lamb from the poor man, killed it and had it prepared for his meal.

[This story is based on the one in 2 Samuel 12.]

I see the cancellation of the Baby Bonus as the rich man taking from those who are weakest and least able to defend their own interests in the political arena.

When (then Treasurer) Peter Costello introduced the Baby Bonus reform legislation in 2002, he stated that:

"The Baby Bonus recognises that one of the hardest times for families, financially, follows the birth of a first child. A family could lose one of its two incomes for a period of time as the mother, or father, gives up or reduces paid employment to care for the child." [click here for more]

The need for support when one parent gives up or reduces paid employment to care for a child is an ongoing need.  By all means, the provision of the baby bonus should be refined and managed in a way that minimises abuse.  In the current financial situation, I believe it would have been prudent for the opposition to hold to the long-term support of this program, rather than supporting the government's plan to use the ewe lamb owned by the poor man to feed the rich man's guest.

physical midwifery

Today I am pondering the physical demands of my sort of midwifery, at the primary maternity care end of the professional spectrum.  This means that I, the midwife am committed to being with woman, regardless of time or place. 

It means that I accept phone calls at any hour, and that I am prepared to get in my car and go to a woman who calls me. 
It means that I lug my equipment - the case with supplies; the oxygen cylinder; the bag and mask; the baby scales ... up flights or stairs, or wherever they need to be. 
It means that I have no idea when I will be home again; that I have to organise my private life so that my absences are manageable within my family. 
It means that I need strategies for driving home safely after a long night on the job, so that I don't fall asleep at the wheel.
It means that when my ageing body complains, with aches and pains in shoulder, or foot, or wherever, I am prepared to carefully consider my capacity to continue in my profession.

But, you might say, it's the birthing woman who is physical.  She's the only one who can give birth.  She's the only one who can breastfeed and nurture and love that baby as mother.

Yes.  Birthing is the essence of phyiscality.

When I studied midwifery we were taught about the 3 'p's:

• the passage (birth canal)
• the power (contractions of uterus and mother's expulsive efforts)
• the passenger (the baby)

Then someone added another 'p': the psyche - the mother's emotional and psychological acceptance of birthing, including the impact of fear and anxiety (adrenaline and other fight-or-flight hormones) on the process.


You might think that being a midwife is a matter of sitting on your hands, or better still, knitting. 

When I was working as a midwife in a hospital the physical demands of my job included traversing long corridors to check on the women in my care, or to answer the 'buzzer'.  It included manual lifting of women from theatre trolleys to beds, or positioning women who couldn't move themselves.  It included leaning across the bed to assist babies with breastfeeding, or to extract minute amounts of liquid gold colostrum from breasts of new mothers.

Today my office is in my home, and I spend much of my time here.  I am glad I don't have the physical demands of mainstream hospital midwifery to deal with.  I'm glad I don't need to work night shifts, although some of the best times for being with woman in hospital are in the wee hours. 

I'm glad I have strength sufficient for the task.

A joey in the pouch

Baby Lucinda in the pouch

Baby wearing is a great idea.  Babies like it, mummies like it, and even other significant adults in baby's world enjoy carrying the little bundle.  There are many wonderful designs of slings and ties available.  You can join social networking groups that compare notes about baby wearing. 

Baby Amelie in the bilum - a string  bag from Papua New Guinea - not too sure if it's a good idea

Baby Mizz on Noel's back

even Granny can do it!

Making the bed

I drove through crisp Autumn air, under blue sky, to visit the mother and her baby boy who was just 24 hours old.

Within minutes of laying eyes on them, and without touching either, I was satisfied that all was as it should be.  With early morning light filtering onto the bed, I noticed that the baby was sleeping quietly in his mother's arms; that his skin was a healthy pink; that his mother had a confident, oxytocin-induced smile.  A few questions confirmed my assessment: mother's blood loss was minimal; she was eating and drinking well; passing urine without difficulty; she had slept a little, and her baby was eagerly taking the breast.

It's difficult to describe the deep thankfulness that I feel as I witness the normality of birth.  Much of the preparation and discussion prior to the birth focus on what would happen if complications or difficulties arise in labour, or if the baby's condition at birth is not good.  The equipment and supplies I bring to the birth require skill and competence in assessment, resuscitation, and midwifery management of sometimes unpredictable, rare events.

Although the assessment was made with the confidence that comes from years of professional learning, at this postnatal visit I did not need to take any professional action.  I asked the mother if she had had breakfast yet, would she like a cup of tea?  Yes.  So the midwifery student went to the kitchen to prepare it.  We reflected on the exhaustion a mother feels after even an 'uneventful' spontaneous birth.  We laughed at the though that the father is often more spent!  We pondered the help given by the warm water in the birth pool; that the softness of the pool's inflated sides gave the mother a lovely soft surface upon which to drape her upper body in the most demanding part of the labour.  We chatted about the responses of the baby's brother and sister, building up a set of unique and very personal memories of this unique and very personal event.

I had noticed a small splatter of blood on the bed sheet.  "Would you like us to make the bed for you, with clean sheets?" I asked.

And while mother ate her toast and drank the hot herbal brew, we changed the sheets.

Making beds happens each morning in hospital, and it's not something that I would write about in a midwifery context.  Yet as we went away from this beautiful homeborn baby and his beautiful mother, I thought that making the bed was the main professional act that we had accomplished in that visit.

Informed decision making

As I take a few moments to reflect on the past couple of weeks, I am trying to pull together the issues in the world of maternity, and highlight anything that needs critical comment from yours truly. 

no explanation required!

The AMA's new Position Statement on Maternal Decision-Making is worth focusing on for a few moments.  My initial comments are at the MidwivesVictoria blog.

The topic of  'decision-making' in situations of known risk - particularly breech and twin births - is being discussed constantly by mothers, via social media.  One group, linked to BBANZ, that I belong to, often has messages from women who are torn between options that appear to be poles apart - the elective caesarean, or the unpredictable, un-knowable journey of spontaneous natural birth.  Another option comes up from time to time, especially for women who have financial reserves + private health insurance and can access a private maternity hospital and a sympathetic obstetrician (that's a big IF), that the doctor sets out the 'rules'.

"OK, here's the plan.  You come to hospital as soon as your labour starts and ..."

These few obstetricians, well known for pushing boundaries, set down what they believe is the safest course of action in the given situation.  They (understandably) want good outcomes, as do the women in their care.   They are able to achieve good outcomes if they recognise the time when it is best to depart from the spontaneous natural process, and take decisive action without delay.  This may mean delivering a baby with forceps or ventouse, or moving to the operating theatre for caesarean surgery.  The women understand the rules, as they have been discussed, and are expected to submit to them.

In many cases, this is an acceptable, and successful exchange.  Yet it is medical dominance, with a touch of class, Melbourne style. 

When the doctor enunciates the plan, and receives a compliant nod from the woman, there is a big exchange of trust.  There is not likely to be any subsequent *informed* decision-making by the woman, because she has entered a 'plan' with her doctor.

This phenomenon disturbs me as much as any other form of medical dominance, whether it is carried out in a private arrangement, or in the less refined tactics that we often experience in public hospitals.  The woman's ability to bear and nurture her child is a basic ability that requires huge respect.  I would like to suggest that the AMA position on maternal decision-making is not worth the paper it is written on, unless the protection of the woman's own natural processes in childbearing, including spontaneous onset of labour, giving birth, and breastfeeding, are held in high priority, and not by-passed without a valid reason.

Welcoming the newest member of the family

Thanks to Bec and Al for this picture

In the past few weeks, in writing this blog, I have delved into personal memories and thoughts, preparing for and anticipating a particular birth.   I expect this fact has been clear to many of my readers; many being women with whom I have shared that deep and wonderous journey.  Although I usually write in an impersonal way of 'the woman' and 'the midwife', so much of my knowledge of midwifery is inextricably linked to my own experiences in childbearing and mothering - intensely personal.  In many ways, I am the woman; I am the midwife; I am even the child.

Tonight as I sit at my computer, thinking of how I can express the wonder that is welling up in my heart, I hear the brief small cry of the wee one in another room of our home.  I know she will soon be transported back into that milky dream world, her little body being nourished by the abundant supply that is freely given.

I treasure the memory of the first view of her beautiful face, and the ecstatic glow on her mother's face, as we three - mother, child, and midwife - three generations of a family - shared in the moment of birth.  I look at her, and wonder what her life will bring.  I practice using her name.  This is a new name; a new person who I will treasure and pray for, for the rest of my days.  I look at her features; the colour of her hair, the exquisite tone of her skin, the wonderfully made body.  I observe the deep bond that is apparent in her mother, her father, and her 'big' brother; instinctive and intentional behaviours that protect the new child within a family unit.  I have so much to be thankful for.

Yet even as I am awash in the joy and newness of new birth, I know there are times when even our best is insufficient.  Times when a baby cries with tummy ache, or when a mother is overwhelmed with tiredness.  Times when the needs of other children must be attended to.  Times when we seek medical expertise for health problems that can sap us of energy.  Times when our best is simply not good enough.


An abiding lesson that I have learnt from my contact over the years with newly born babies; my own children, the children of my friends and clients, and my grand-children, is the picture of the baby's craving for mother's milk.  This analogy was drawn by Peter: "Like newborn infants, long for the pure, spiritual milk, so that by it you may grow."  (1Peter 2:2) 

In the same way as the newborn infant craves her mother's milk, and cannot be satisfied without it, the skill of the midwife is to work in harmony with this primal natural process.

strength

Following on from the previous post about submission to the spontaneous natural processes of birth, it may appear that I am fence-sitting to now write about strength.

Yet in normal childbirth, strength is the other side of the submission/surrender coin.  There is probably no more emotionally challenging, physically demanding event that ordinary women face in life than the act of giving birth and nurturing a baby.

Readers who are mothers may recall the evenings, just prior to the births of your babies, when you have doubted your strength for the task ahead.  When you have gone to bed hoping the baby doesn't need to be born tonight: "I just don't have the strength!"

(Your midwife might also experience that!)  

Or, in labour, when you experience that overwhelming feeling of weariness.  "How will I have the energy to keep going?"

(Your midwife might recognise that as progress, moving into an altered state of consciousness, when your thinking mind is suppressed, and the more instinctive, hormonally driven activities of your body can be freed up.)


Readers who know the ancient Biblical stories may remember Gideon, who was told by an angel that he had been chosen by God for the (rather daunting) task, to "deliver Israel from the hand of Midian" (Judges 6:14).  Gideon argued that he was not suited for the task, that he came from the weakest clan in Israel, that his family were inconsequential, that he was the least significant person in his family ... .  In response to Gideon's obfuscation, God's angel said "Go in this might of yours and deliver Israel."  The power to achieve was there, even though Gideon continued to duck and dodge and try to avoid the job.

The strength to give birth is a deep inner strength that resides in a woman.  Not in her logical, calculating mind.  Not in her organised, planned day.  But it's within her body, wonderfully made.  And that strength can only be realised when we (the woman and the midwife) submit to the natural physiological processes, and refrain from interrupting these processes without a valid reason.