A LACK of insurance options for private-practising midwives is set to drive up already high rates of underground homebirths in the Northern Rivers.
The Australian College of Midwives has identified the Northern Rivers region as a 'prime pocket' for homebirths attended by underground, uninsured midwives and also for 'freebirths' where no qualified medical attendant is present.
There are concerns the potentially dangerous practices could escalate.
Last month the only supplier of Professional Indemnity Insurance to non-eligible private-practising midwives, Vero Insurance, announced it will withdraw its product from the market from July 1, citing rising costs.
The decision means an estimated 60 midwives who do not practise under the jurisdiction of a doctor as a Medicare-eligible midwife would be forced to ditch their medical registration and go underground.
Registered midwife Bronwyn Moir, whose insurance policy ends in March, fears that the loss of Vero Insurance may spark an increase in risky birthing practices in the Northern Rivers.
"When I started as a midwife seven years ago there was at least 10 homebirth midwives in the Lismore area. Now I am the only one," she said.
Ms Moir said she could not meet the demand for women wanting midwife-led homebirths in the Northern Rivers.
"I am limited. I can only work in a small area," she said.
Ms Moir believes a lack of homebirth midwives is prompting women who have had previous traumatic hospital birth experiences to choose to freebirth.
Generally freebirths are not attended by anyone with newborn resuscitation skills and equipment. Approximately 10% of newborns delivered in hospital require resuscitation assistance to breathe at birth. Less than 1% will require extensive resuscitation.
Ms Moir said as an insured midwife she can quickly organise a hospital transfer should a complication arise but warned midwives or birth attendants who work underground may be more likely to delay hospital transfers as they are not integrated in the hospital system.
Australian College of Midwives spokeswoman Hannah Dahlen said the Northern Rivers, along with Gold Coast and Blue Mountains had been identified as hotspots for freebirths.
Prof Dahlen said there is evidence that freebirthing rates are on the rise.
"In our interviews we have found that many women decide to freebirth because of previous traumatic experiences in hospital. Many believe they had unnecessary intervention," she said.
Prof Dahlen said another factor contributing to a lack of homebirth options is that about half of private-practice midwives have been reported to AHPRA by hospital staff as 'unsafe' because the birth did not follow strict health system requirements.
"Women have the legal right to birth how they want to," Prof Dahlen said.
"The midwives who support that right are being targeted.
"Private midwives are facing no carrot and increasing amounts of stick."