There are currently 11 Medicare-eligible midwives in WA, but how many are actually practising at the moment I’m not sure. Some will do homebirths but others are only doing intrapartum care in hospital.
There are currently no admittance/access rights for eligible midwives, so care in hospital is usually achieved through an arrangement by which the midwife is casually employed by WA health when she does the intrapartum care in hospital. WA Health are currently developing an access agreement.
There are 3 or 4 other privately practicing midwives in Metro Perth and two in the South West. I don’t think any are currently doing VBACs at home. Some are only taking repeat clients.
The options in SA are limited because almost all of the midwives live in a similar geographical area. Most of us travel but it still is limited. Of the 9 working and taking on clients, 6 live in the Adelaide Hills and the next one coming into it also live up here. There are 3 who are Medicare eligible, 1 eligible midwife about to start, 3 who are not eligible but are registered.
Homebirth SA Blog
Midwives in Private Practice (MiPP) is a collective of midwives, and a participating organisation in Maternity Coalition. MiPP members work in Group Practices, partnerships, and solo practices, providing private midwifery services for women planning homebirth, as well as hospital births. MiPP members also mentor other midwives who are commencing private practice. Although Victoria is a relatively small State, there are areas where no private midwifery services can be accessed.
Recent government-funded homebirth programs have been offered for selected women through Sunshine and Casey Hospitals.
One Victorian Medicare-eligible midwife has completed a medications course which has been accepted by AHPRA. However, Victorian legislation needs to be changed before midwives are able to take up the PBS reforms.
In Melbourne more and more doctors are saying "no" to women who request referral or another pathway so that the woman can receive the Medicare rebate. The government’s reform is pretty empty if women can’t even access Medicare rebates. An obstetrician at the local hospital told me “I don’t support that model”
List of MiPP midwives
New South Wales
Northern NSW - there were about 8 midwives attending homebirths a few years ago, with maybe 3 being private practice (PPM) only, and the other midwives also working in public hospitals. Now there are no PPMs-only in this region, but there is one midwife who attends some homebirths and is also employed in a hospital, and one other midwife who is Medicare eligible and attends some homebirths and is also a caseload midwife. There is another PPM who lives on the Gold Coast Qld and travels to the region. We have also had a govt funded homebirth program approved here which should be up and running shortly. That may impact further on numbers of births available for PPMs.Marie Heath (Goulburn)
Toowoomba-Ipswich My Midwives offer women the choice of 4 midwives in Toowoomba and 2 in Ipswich. We also have a lactation consultant who just does lactation privately but is an eligible midwife (provides antenatal and labour as an employee in hospital). Women can choice place of birth (home, birth centre, public hospital). They only receive a Medicare rebate for birth for birth centre or public hospital. They receive Medicare rebates for antenatal and postnatal care no matter where they have their baby. Many of the private funds provide a rebate for some element of the woman’s care as well if the woman has private health insurance.
We bulk bill completely women attending Young Women’s Place for antenatal and postnatal care and we can attend women admitted as public patients under a fractional employment model with the hospital. The tendency though is not to admit women as public patients unless we have to because we do find that having them admitted as the primary client of the midwife rather than as a public patient makes a difference in terms of autonomy in the woman’s care.
We have a signed collaborative agreement with Toowoomba public hospital obstetricians. In practice one of us [midwives] meets with them fortnightly to discuss any issues we have or we book women in at a specific time for a referral or consultation. At the time of admission the women are admitted in the care of (or “under”) the primary midwife and we consult if/as required with one of the obstetricians. For women birthing at home, we just attend as normal and let the hospital know if we have any dramas.My Midwives
For more links to websites of privately practising midwives, go to Midwives Australia