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Sunday, November 1, 2009

Position Statement

Position Statement on

Planned Home Births with a

Midwife

Adopted by APMA: 29 October 2009

Introduction

Australian Private Midwives Association (APMA) represents the majority of privately practising midwives in Australia, who are also the responsible professional attendants at the majority of homebirths in this country. APMA aims, through representing private midwives at national professional discussions, to support women through promoting and protecting continuity of midwifery primary care. APMA is a key stakeholder in any professional discussion about homebirth.

Many APMA members are active professionally in the Australian College of Midwives (ACM), as well as in groups that establish partnership between midwives and consumers, such as Australian Society of Independent Midwives, Midwives in Private Practice, Maternity Coalition, Homebirth Australia, Home Midwifery Association (Qld), Homebirth Access Sydney (NSW), Birth Matters (SA), and Birthing and Babies Support (BaBS).

The following statement represents the view of APMA on planned home births with a midwife. APMA reserves the right to revise and update this Position Statement as time passes. APMA encourages ACM and other stakeholder organisations to endorse this statement and adopt it without change as their Position Statement on Home Births with a Midwife.


Position Statement on

Planned Home Births with a

Midwife


    1. We support home birth with a midwife in attendance for women who have uncomplicated labours.

    1. Midwives practising in any setting are responsible and accountable for their decision making about their own scope of practice and referral and transfer of care.
    2. We support the use of the National Midwifery Guidelines for Consultation and Referral (ACM 2008) as a guide in midwifery referral decisions.

    2. We support and adopt the International Confederation of Midwives’ (ICM) Definition of the Midwife (2005) (attached below), which is foundational to all midwifery practice, including homebirth. The ICM Definition of the Midwife establishes the following principles which apply in this statement:

    1. The principle of ‘partnership’: “The midwife … works in partnership with women …”
    2. The principle of professional responsibility: “The midwife is recognised as a responsible and accountable professional …”
    3. The principle of continuity of carer (‘caseload’) – primary care: “The midwife … works … to give the necessary support, care and advice during pregnancy, labour and the postpartum period, …”
    4. The principle of primary care – on the midwife’s own responsibility: “… to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant.”
    5. The principle of health promotion: “This care includes preventative measures, the promotion of normal birth,…”
    6. The principle of detection of complications, consultation, referral, and carrying out emergency measures: “This care includes … the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.”
    7. The principle that midwifery care has broad community health implications: “The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.”
    8. The principle of ‘any setting’: “A midwife may practise in any setting including the home, community, hospitals, clinics or health units.”

    3. We support the right of every woman to access a midwife as the primary maternity caregiver who works in partnership with the woman throughout the episode of care, who is able to be the responsible professional in attendance at the birth either at home or hospital, and who is able to make appropriate referral and transfer of care when required.

    1. We support a woman’s right to self-determination and control over her body and her pregnancy, including the right to give birth in the place of her choice.
    2. We support and value the woman’s ability to make informed decisions about place of birth, and other choices as her pregnancy and labour progress, in partnership with a known and trusted midwife of her choice.

    4. We support the right of a midwife to practise privately1 in a fee-for-service or funded relationship with the client, or to take up employment.

    5. We support only those regulatory restrictions that are able to pass the ‘public interest’ test: “How does this promote health and wellbeing in the mother and baby?”2

    6. We support an expectation of equity, including equal pay for equal work throughout a midwife’s scope of practice. Midwives who provide primary maternity care are entitled to the same public funding, the same opportunity to charge a fee-for-service, the same access to hospital referral, and publicly supported indemnity insurance, as medical practitioners providing the same maternity services.3

    7. We support processes by which midwives are able to gain experience and mentoring in order to commence and demonstrate continuing competence in homebirth practice.

    8. We support seamless and reliable processes by which midwives are able to make hospital bookings for women planning homebirth, and arrange transfer to the hospital in a timely way when needed.

Definition of the Midwife

A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery.

The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.

The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.

A midwife may practise in any setting including the home, community, hospitals, clinics or health units.

Adopted by the International Confederation of Midwives Council meeting, 19th July, 2005, Brisbane, Australia

Supersedes the ICM “Definition of the Midwife” 1972 and its amendments of 1990