Australian Private Midwives Association: APMA Position Statement on Collaborative Arrangements

Monday, October 11, 2010

APMA Position Statement on Collaborative Arrangements

Australian Private Midwives Association (APMA) represents midwives in private practice.

The National Health (Collaborative arrangements for midwives) Determination 2010

requires written agreement or acknowledgment by a medical practitioner for Medicare funding to be available for services provided privately by a midwife
defies the International Confederation of Midwives (ICM) Definition of the midwife - it prevents autonomous practice for Medicare funded midwives.
defies the ICM Declaration (Glasgow 2008) which states that legislation developed in member countries must enable midwives to practice in their own right.
prevents most current private practice midwives from accessing Medicare funding.

The impact of the National Health (Collaborative arrangements for midwives) Determination 2010 on ALL of midwifery is likely to include:

Low uptake of these reforms by midwives
Minimal benefit to women whose seek a midwife as their primary maternity carer
Uptake only by midwives working for obstetricians as they will be able to access the required arrangement

Midwives working for obstetricians are likely to practice within the medical model, rather than a midwifery model. This will lead to progressive erosion of midwifery as a profession, and progressive loss to women of access to midwives who are skilled in the art of midwifery

As midwives become more entrenched in the medical model, midwifery skills will be lost and women's access to normal birth will be diminished even further than it is now

Private practice midwifery will become known as the model whereby midwives are working in private medical practices, with little regard for those self employed midwives who currently provide true midwifery care at this current time

Acceptance within the maternity workforce that midwives require medical sign off for Medicare and therefore further erosion of opportunity for midwives to work autonomously

APMA is opposed to Parliamentary progress of the National Health (Collaborative arrangements for midwives) Determination 2010 in its current form.

APMA will continue to lobby for the National Health (Collaborative arrangements for midwives) Determination 2010 to be disallowed, withdrawn and rewritten in an acceptable form.

The NHMRC Draft National Guidance on Collaborative Maternity Care document is at http://www.nhmrc.gov.au/guidelines/consult/consultations/ngcmc.htm

WHO ARE WE?

The Australian Private Midwives Association represents midwives in private practice. The association is focused on the safety of women, the ability of women to access quality midwifery care across Australia and the partnerships between women and midwives. APMA supports women’s choice in maternity options within a framework of quality and safety and believes in women being able to access midwives in all settings. APMA unites all midwives seeking to provide continuity of care for women.

APMA strives to provide midwives in private practice with information relevant to their practice and advocacy in the political process.

Enquiries:
Joy Johnston joy@aitex.com.au
Marie Heath NSW and National 0407 266004
Clare Lane (Vic) 0416 130219

APMA 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. 2. We support and adopt the International Confederation of Midwives’ (ICM) Definition of the Midwife (2011), which is foundational to all midwifery practice, including homebirth. 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. 4. We support the right of a midwife to practise privately 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?” 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. 7. We support processes by which midwives are able to gain experience and mentoring in order to commence and demonstrate 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.