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to lobby for the National Health (Collaborative arrangements for midwives) Determination 2010 to be disallowed, withdrawn and rewritten in an acceptable form.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