Education and Maternity Care: Public, Home or Private?

I have long been aware of the statistics that place planned homebirth on a par with public hospital births in terms of best outcomes for mothers and babies. For just as long, I have been aware that births in private hospitals have the worst outcomes generally. This did not really surprise me when I discovered this, as I have long been doubtful of the ability of ‘the market’ to provide good quality care. Processes that force greater ‘efficiency’ tend to intervene in the natural course of a birth, and these ‘efficient’ processes are much more likely in situations where profit is a motive. For example, women in private hospitals are 20% more likely to have interventions such as caesareans, epidurals, forceps and suction caps (compared with public hospitals — obviously homebirths have even less intervention). And it is not because they are higher risk or anything like that, the studies by Professor Hannah Dahlen of UWS show that although the women involved in private care are slightly older, in general they enjoy many health and socioeconomic advantages over their public healthcare sisters. Prof Dahlen argues:

One of the major problems is that these private obstetricians have 200 to 300 women a year.  It’s not sustainable to a lifestyle to be on call and to be called out every night of the week, which is when most women go into labour and give birth.  So there’s an incentive for private obstetricians to schedule in woman to have elective births, whether that’s inducing them or doing a caesarean section. So that’s one of the problems; it’s the way the model’s set up – it provides an incentive to try and get women to birth during more reasonable hours.

What you are really paying for, in your top-dollar private birth experience, is the pretty wallpaper and sparkly bathroom. Some, like Prince of Wales Hospital in NSW, even let you transfer to a hotel on Coogee Beach while you recover with a midwife on call 24/7.  Some argue that this is the same idea in homebirth — give birth in your pleasant surroundings and sip a glass of champagne afterwards. But in terms of outcomes and the ability to reduce interventions, homebirth is about more than just a nice bed. It is about being in the best environment to listen to your body and move as it tells you to, it is about learning to birth powerfully, with the right support.

So this is all old news anyway. What I am thinking about it how all this relates to the education system. A recent Australian study revealed that there are no long term pay offs for private schooling, another fact I had long suspected after noticing the difference in self-motivated learning between first year students from private schools and those from public schools. My theory, after talking to (and receiving hundreds of emails from) private school students is that they were coached in how to pass exams/national standards rather than in how to learn independently. So passing exams or doing well in standardised assessments might get you into university, into the course you want to do and are passionate about. But it cannot replace learning how to think, question, and explore.

[As an aside, I want to point out there are differences between high cost private schools and low cost ‘special character schools’ such as the small Catholic college I went to, subsidised by church and state. The Australian study supports this to a degree too.]

Now, I absolutely do not think public schools are perfect in either Australia or NZ, but I think what probably happens in public schools and low-cost special character schools is that the kids who don’t want to learn independently don’t end up doing so well (because Mum and Dad are not paying for ‘results’ in the form of high grades on standardised tests). So the ones that end up coming to university have got there on their own steam, developing their own study skills and learning strategies. I think public schools are important, because it allows everyone a chance to get educated.  But I suspect the ‘gold standard’ for teaching kids to learn independently is in fact quality homeschooling. Like homebirthing with a great midwife, homeschooling with a great parent allows and encourages one to take their own pulse, to become aware of their needs and to follow the path that allows those needs to be addressed.

My husband and I have long been interested in homeschooling, but also have a strong interest in public education. But after a rough year for our 8 year old socially, we read this article on short-term homeschooling. I have noticed with my daughter that she is passionate about following up her own learning on her own terms, but as soon as outside standards come in, she starts measuring herself and getting more anxious. She does absolutely fine in school, and her teachers all seem pretty good, but I can’t help noticing that in the school holidays she is a totally different kid. More helpful, full of intelligent questions, motivated and so on. I wonder if a year of home-schooling would be a great boost to her self-confidence and learning development? When the subject was broached with her recently, it was definitely received well. Watch this space…