According to a leading midwifery expert home births could land up in "fragile, secretive arrangements" after a Federal review rejected funding for the practice and this decision is the result of fear of extreme medical voices and not in the best interests of women.

Chief Nurse Rosemary Bryant headed a review of maternity services and recommended changes to Commonwealth funding arrangements to support a greater role for midwives. The review also suggests the Government provide professional indemnity insurance support to midwives, but rejects Commonwealth funding for home births.

Under the Australian Government's plan to streamline registration requirements for all health professionals from mid-2010, midwives will be required to hold professional indemnity insurance as a condition of practice.

Ms Jennifer Cameron, a Midwifery lecturer at Charles Darwin University said, "The report was very clear in that it did not support reforms that increased or funded women's access to home birth,'' she said.

"Women will continue to have babies at home; removing independent midwives and saying we won't do home births won't solve the problem.

"Most women birthing at home without a trained caregiver do so because they are unable to access midwifery care at home, and are unwilling to use hospital-based services. It is frequently a choice made in desperation and the best way to assist these women is to provide them access to a high standard of midwifery care in their preferred venue."

Ms Cameron said that although the review proposed some promising reforms and the potential to bring huge breakthroughs in many areas of maternity care, the move to effectively make homebirths "illegal" lacked any real basis and could ultimately lead to women being unattended when giving birth. "This will ensure an absence of standards, monitoring or evaluation of any home-birth outcomes.

"Given that safety and quality are key concepts underpinning the recommendations of the report, this seems counterproductive." She added that she believed that the Government needed to support midwives' indemnity costs as it had for obstetricians and other doctors to the tune of $54 million. "If this financial support is denied, you will have a number of people going underground, making very fragile, secretive arrangements," she said.