Australian Private Midwives Association: How is the private midwifery profession faring?

Thursday, June 2, 2011

How is the private midwifery profession faring?

Midwives have had six months since the federal government's Medicare reforms became effective (1 November 2010). Midwives, and the women who employ us, have a mere thirteen months before the exemption from professional indemnity for attending births in homes expires (1 July 2012). It's a good time to take stock of our situation.

There is a handful of midwives around the country who are 'eligible' to provide pre-and post-natal services for which Medicare refunds apply. Another handful of midwives are at various places in the application process. Other midwives continue to provide private midwifery services without seeking Medicare provider numbers.

Approval for notation as 'eligible' is granted by a State Board of the Nursing and Midwifery Board of Australia.

Midwives are able to purchase indemnity insurance that covers antenatal and postnatal care. No indemnity insurance is available for attending home birth. There is an insurance product that has Treasury support to provide cover for intrapartum private midwifery care in hospital. However we are not aware of any hospital yet that will award visiting access/clinical privileges to a midwife. The response that many midwives have received when making inquiries about being granted clinical privileges has been far from positive.

A person considering employing a midwife privately may wonder how to find an 'eligible' midwife, and thereby take advantage of the Medicare rebate. While there is no publicly available listing of these midwives, here are a couple of links and suggestions:

A: If you know the name of a midwife, a search of the public register at the AHPRA site will give information including 'notation' - curiously listed with 'conditions', 'undertakings' and 'reprimands'
Endorsements: No
Conditions: No
Undertakings: No

Notations: Yes

Reprimands: No

Then click 'view details' for that midwife, and you will be informed that:

Ms XX is an eligible midwife competent to provide pregnancy, labour, birth and post natal care and qualified to provide the associated services and order diagnostic investigations required for midwifery practice, in accordance with relevant State and Territory legislation. Eligible midwife, but NOT qualified to obtain endorsement under section 94 to prescribe Schedule 2, 3, 4 & 5 medicines required for midwifery practice in accordance with State and Territory legislation.

B: If you are searching for a midwife, and don't have a specific name to search, you may find a site that lists 'find a midwife'. After finding a midwife in your area, follow the instructions A above to check if that midwife has the Medicare notation on the register.
For example:
Midwives Australia
Midwives in Private Practice (Victoria)
Pregnancy, Birth and Beyond
Independent midwives and birth workers in South Australia
Homebirth Access Sydney
Home Midwifery Association (HMA) (Qld)

Confusion abounds about homebirth as a choice. New laws and regulations for midwives are poorly understood in our communities, and even amongst health professionals.

Readers are welcome to leave inquiries in the comments section of this blog, or to send an email message to Midwives Australia via the online contact form.

1 comment:

Joy Johnston said...: Discussion amongst a group of midwives has questioned the relationship between Medicare eligibility for midwives and homebirth.

A midwife can (at present) provide private services for anyone and charge (or not charge) as agreed between the woman and midwife. This agreement has nothing to do with Medicare.

There is no Medicare rebate item number for the 'birth' item in homebirths, even though the midwife may have a Medicare provider number, and a collaborative arrangement with a hospital to which the woman will transfer if needed.; June 6, 2011 at 10:44 AM

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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.