In dreadlocks and a colourful dress, birth advocate Lisa Barrett did not cut a sympathetic figure as she faced a Coroner’s inquest into the death of three babies.
Barrett has remained largely silent in the face of censure from the state’s deputy Coroner in June and criticism from the Health Complaints Commissioner who recommended she stop attending births.
The report and the coverage put the contentious topic of home births on the agenda of the state’s health minister – with Barrett the public face of controversy.
Sipping coffee while a mother and baby played nearby, Barrett was friendly but cautious as she spoke to Indaily in an exclusive interview at Birth Place on Glen Osmond Road.
She would not directly talk about the cases involved in the Coroner’s Court, instead revealing how it has affected her.
“Did I want to be this person?
“No. I didn’t want people to think I was dangerous, or a maverick or whatever they think that I am, but it was thrust on me because I really believe in a woman’s right to choose.”
To Barrett the issue is clear. A woman should be able to have bodily autonomy and choose where and how to give birth to her child.
“You don’t have to believe in home birth, you can hate home birth but we must protect a woman’s right to bodily autonomy,” Barrett said.
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“It’s about your right to choose a caesarean or an epidural or a myriad of other things and women choose that every day.
"“I believe in women’s bodily autonomy, I believe in a woman’s right to choose, I believe women are highly intelligent and if they make the choice they are better off being at home [to give birth] then they deserve the right to do so.”"
In 2009, despite a national campaign to prevent it, the rules for midwives attending home birth changed.
“We fought really hard as a country-wide group not for them to change the rules but they restricted midwives’ ability to attend vaginal birth after caesarean, and attend women who wanted to be at home for that.”
The changes effectively restricted midwives from attending all homebirth considered “at risk” which include births in the breach position, twins and obesity.
These rules would eventually change Barrett’s life.
She decided that it was more important for her to be available to women who chose to have at risk home births than to remain a midwife. She terminated her registration in 2011.
“I was a well-respected midwife. I was on every single committee – neonatal committee; I was on the SA Water birth committee, the home births committee and I was well-respected.
“It was very difficult. It took me quite a long time to look at the pros and cons and the way the law lay.
“I didn’t want to work outside of the law so I decided it was the best course of action so I could continue with my clients.
“I don’t think preventing a midwife from staying with a woman, prevents a woman from staying at home if that’s what she wants to do.”
She is now a “birth advocate” and says she works in a non-clinical capacity at births. Once relied upon as an expert in breach birth and other areas, she is now persona non grata to the medical world in Australia after the Deputy Coroner’s findings in June.
Already under investigation after the deaths of two babies in separate home births when she was registered, the case escalated in publicity and attention after Barrett attended the birth of twins, the second of whom died.
Deputy Coroner Anthony Schapel was scathing in his report on the three deaths, which recommended that it be a criminal offense for non-registered midwives to attend births.
He also recommended that people planning to have an “at risk” homebirths be reported to the Health Department and referred to a senior consultant obstetrician for advice.
Schapel had found that all three of the babies involved would have survived if they had been born in a hospital by caesarean-section.
With the death of infants at the forefront of public attention, homebirth is a naturally evocative topic. In 2008, 0.4 per cent of homebirths resulted in deaths, compared to 0.007 per cent for hospital births.
For many women that chose homebirth – which makes up less than 1 per cent of births in Australia – the perception of risk is different.
In America an unexpectedly high morbidity rate for mothers in birth has been related to caesarean sections though it is still relatively rare.
Barrett said a woman should choose the best course of action for herself.
“If there was an issue of you saying a woman would be safer in one particular venue or another and you say it is safer to be at a hospital but the woman says my own perception of that risk is different. Who then gets to have the final say? That is an issue of human rights.
“It is impossible to say that if a woman has a caesarean section her baby will definitely live because if that was the case a baby would never die from a C-section and a woman would never die from a C-section because that is not the case.”
Barrett said preventing a midwife from staying with a woman did not prevent a woman from staying at home.
“All our job is, is to tell them really inertly what are the risks of staying at home and what are the risks of going to hospital and then they get to decide.
“Even if a woman says I understand all of these risks and this is what I want to do, then she deserves someone to stay with her.”
When New Zealand changed its rules to maintain support for homebirth.
“In New Zealand when they changed the rules around midwifery when it was in parliament all they did was ask the right question.
“Instead of asking do you believe home birth, where lots of women would go no, they said do you believe in women’s bodily autonomy … and every woman crossed the floor.”
So far Barrett has paid dearly for her choices. She has suffered financially and almost faced jail for contempt of court after refusing to speak on a case and break her client’s trust.
But Barrett said she is now “taking a rest” and that she would do it all again.
“It’s hard because I don’t want to make excuses for myself and I don’t want people to feel sorry for me, because I don’t feel sorry for me.
“I did everything with my eyes open, unfortunately, and I really believe that if no one is fighting for bodily autonomy than we are not going to have any left.”
