It’s entirely understandable that politicians and bureaucrats are keen to sell new policies that they’re developing or implementing. They want to persuade us, and perhaps even themselves, that they’re doing the right thing.

But perhaps there should be a mandatory step in the process: to insist that the question be asked of any new program or policy – what might be its unintended consequences?

It might have been useful to have had this question answered by health planners back in 2004, when then Treasurer Peter Costello was urging couples to have ‘one (baby) for your husband and one for your wife and one for the country’, and announcing the “baby bonus” in an effort to boost fertility rates.

The subsequent baby boom has had serious ramifications for the health system and health costs.

It’s been especially problematic because the way we fund and organise maternity services tends to maximise the costs of birth, while often failing to meet the community’s needs. Just think of the vast distances that many country women now have to travel in order to give birth, far from their families and support networks.

Submissions to the federal government’s review of maternity services give some idea of the problems with our specialist-based maternity system.

Now two senior physicians have warned that an unintended consequence of the baby bonus may be an increase in the number of women with pre-eclampsia, a condition with potentially serious consequences for the health of mother and babe.

“The ‘political’ enthusiasm for women to have more babies will not come without a downside,” write Professor Mark Brown and Dr Sandra Lowe, of the University of NSW, in the 5 Jan issue of the Medical Journal of Australia.

“Complications such as pre-eclampsia – a major cause of premature delivery – are likely to become more prevalent as increasing numbers of women become pregnant when they are older or obese, and may affect up to five per cent of these women.”

If politicians and policy makers won’t ask the question about unintended consequences (at least in public) when developing new programs and policies, then perhaps it’s a question that others – whether in the media, community, academia or industry, for example  – could ask more often.

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