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Saturday, June 2, 2012

Newsletter June 2012

APMA is working to represent and advocate for private practice midwives at federal and state/territory levels, and provide support and encouragement for our members.

Private midwifery today 
Midwives have experienced enormous changes in the past few years, and no-where more so than for those who practise privately, with national regulation and the government’s reform package.

The National Maternity Services Plan, an outcome of the Maternity Services Review (2008), was endorsed by the Australian Health Ministers’ Conference in November 2010. This Plan provided governments with a strategic national framework to guide policy and program development.

One focus of the reform package is private midwifery practice, extending options of primary maternity care for women who expect to be able to give birth in the care of a midwife – often referred to as 'low risk', or 'normal risk' women.

We are seeing trends in private midwifery, as more midwives access notation for Medicare eligibility. Midwives joining APMA today are less likely than in previous years to be working in the private homebirth scene.

Highlighting a few points of interest
  • Prescribing course: The Nursing and Midwifery Board (NMBA) has announced the approval the inaugural program of study which will lead to Endorsement for Scheduled Medicines for Eligible Midwives. This is a program of study will enable eligible midwives, once their study is completed, to obtain an endorsement to prescribe scheduled medicines. The accredited program is within a Graduate Certificate in Midwifery at Flinders University (South Australia).  See previous post.
  • Attempts by midwives to achieve admitting rights in hospitals have been met with little encouragement, and a great deal of discouragement. 
  • Midwives who have achieved Medicare eligibility and set up private practices, with the intention of attending women for birth in hospital, express great concern over the obstructions and restriction of trade that they face in practising their profession. Perhaps an unintended outcome of the reform process will be increased numbers of private homebirths and increased numbers of midwives upskilling to private homebirth practice! 
  • The College of Midwives (ACM) is setting up a private practice committee, to advise its governing Board on private practice matters. APMA expects to receive an invitation to nominate a representative for that committee. 
  • Private practice and homebirth have in the past often been referred to interchangeably. This is no longer the case, and APMA is clear that we represent private practice midwives. 
  • The need for regulation of midwives by midwives (ie a Midwives Board) is obvious.
Professional Indemnity Insurance 
APMA and other midwifery organisations (including ACM, Midwives Australia) have met with representatives of the Department of Health and Ageing, and insurance group MIGA.

APMA’s position is that we consider the current available options for professional indemnity (PII) to be inadequate for midwives, and therefore not in the public interest, with the potential that midwives will be prevented from lawfully practising midwifery because they are unable to obtain suitable insurance. This is unacceptable.

We have been told that the lack of PII cover for intrapartum care has already led to some midwives not renewing their registration and working as unregulated birth attendants.

Issues include the indemnity cover for
  • a midwife who is called at short notice to work as locum for another midwife 
  • the midwife who attends a homebirth as second midwife 
  • cost and sustainability, especially in setting up 
  • a midwife joining a group practice 
  • students and mentoring of midwives entering private practice 
APMA strongly recommends the introduction of a no-fault compensation scheme to replace or reduce the impact of mandatory PII requirement for midwives. The statutory regulation of midwives should be the point of entry into the midwifery profession, not the availability or affordability of indemnity insurance.

Invitation to midwives to join APMA 
Membership is open to all current private midwives, midwives with previous experience in private midwifery who wish to remain informed, and midwifery students that wish to enter private practice after completion of their studies.
If you wish to become a member, please email details of your private midwifery experience/aspirations. Membership fees Renewal of membership is now due:
• full membership $80
• student or non-earning members $40.

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