Wednesday, September 10, 2008

Greater Roll for Midwives

Midwifery is on the national agenda today. There has been wide coverage on television and newspapers. Finally we are seeing a shift by the government towards midwifery care. This is long overdue. My fingers are crossed the government is serious about implementing the planned changes.

Here is the report in today's Sydney Morning Herald (on the front page).

Mark Metherell - September 10, 2008

Midwives would be given doctor-style responsibilities such as being able to order diagnostic tests and prescribe drugs under proposals being considered by the Federal Government.

With a shortage of nurses and doctors straining maternity services at a time of near-record birth rates, the Minister for Health, Nicola Roxon, will release a discussion paper today proposing a boost in the role of Australia's 12,000 midwives.

The paper cites fragmented services, professional restrictions, funding problems and a lack of affordable indemnity insurance as barriers to greater use of midwives. Australia's use of independent midwives compares poorly to other developed countries, including New Zealand and Britain.

To provide a comprehensive service similar to that of general practitioner obstetricians, the discussion paper says, midwives require rights in hospitals to enable them to visit and refer their patients to specialists, to order diagnostic tests, prescribe drugs and have access to Medicare payments for the work they do.

The proposals are likely to encounter resistance from the Australian Medical Association, which has previously raised concerns about patient safety - claims that have been rejected by the Australian College of Midwives.

The discussion paper is part of a comprehensive review of maternity services being led by the Chief Nurse and Midwifery Officer, Rosemary Bryant, to be completed by the end of the year.

The review will cover issues including support for a greater role for midwives; opportunities for women to have more birth-care options, including home births; the shortage of maternity staff and services, particularly in rural and remote areas; and rising levels of post-natal depression.

The paper says that as there is no Medicare benefit payable to midwives for management of labour and delivery, there is only limited support for midwifery services through private health insurance.

In most cases, mothers choosing to have their babies outside hospital pay the full cost of midwife services, which is typically more than $1000.

A key issue was expanding the scope within both the public and private sectors for women "to achieve greater choice and increased continuity of care.

The report states that Australian women often had a range of different health-care providers during pregnancy.

This was despite international studies which had consistently demonstrated that continuity of carers improved satisfaction for both patient and carer, and improved health outcomes.