title: Not addressing the root cause: An analysis of submissions made to the South Australian Government on a Proposal to Protect Midwifery Practice.
abstract: BACKGROUND
  Reports of unregulated birth workers attending birth at home, with no registered midwife in attendance (freebirth), have become more frequent in Australia in recent years. A Coronial Inquiry (2012) into the deaths of three babies born at home in South Australia resulted in a call for legislation to restrict the practice of midwifery to registered midwives. A Proposal to Protect Midwifery Practice in South Australia was issued as a consultation paper in January 2013.
  
  
  OBJECTIVE
  To report the views of those making a submission to the Proposal to Protect Midwifery Practice in South Australia.
  
  
  METHODS
  Thirty submissions to the South Australian Government were downloaded, read and thematically analysed.
  
  
  RESULTS
  Twenty-five (81%) submissions supported the legislation, 5 (16%) opposed it and 2 (6%) were neither for nor against. Support for the proposed legislation was strong, however the underlying root causes that have led to the rise of UBWs attending homebirth in Australia were not addressed. Recommendations called for all stakeholders to work with women to develop a better framework of care that respected and met their needs and choices whilst safeguarding maternal and neonatal health.
  
  
  CONCLUSIONS
  The Proposal to Protect Midwifery Practice may promote greater protection of midwifery practice however, Private Indemnity Insurance (PII), collaborative agreements and power struggles associated with the medical domination of childbirth continue to marginalise homebirth and prevent women from accessing the care they want and need. These unresolved issues represent the root causes for UBWs attending homebirth; hence the proposal is only a partial solution.
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: elizabeth.rigg@acu.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rigg
authors.affiliation: School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: v.schmied@uws.edu.au.
authors.forename: Virginia
authors.initials: V
authors.lastname: Schmied
authors.affiliation: School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: k.peters@uws.edu.au.
authors.forename: Kath
authors.initials: K
authors.lastname: Peters
authors.affiliation: School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: h.dahlen@uws.edu.au.
authors.forename: Hannah
authors.initials: H
authors.lastname: Dahlen
mesh_terms: D002755:Choice Behavior; D003266:Continuity of Patient Care; D036861:Delivery, Obstetric / Q000379:methods; D059037:Doulas; D005260:Female; D006076:Government; D006700:Home Childbirth; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services; D008880:Midwifery / Q000592:standards*; D011247:Pregnancy; D036301:Qualitative Research; D013021:South Australia
keywords: Doulas; Home birth; Midwifery regulation; Midwives; Unregulated birth workers