Australian College of Midwives Media Release

Media Release, June 2009
Mothers and babies at risk: Access to qualified midwives for homebirth under threat. Private midwives will no longer be able to attend homebirths under new national laws proposed for registering health professionals to have effect from 1 July 2010.

The national registration scheme for health professionals, which has been being developed by COAG and health ministers since 2007, released the draft laws last week. One of the requirements of the new scheme will be that all health professionals have professional indemnity insurance, as a measure to ensure consumers have access to compensation if they successfully prove negligence.

But private midwives have been unable to buy professional indemnity insurance since 2001. Most midwives are indemnified by their employers, typically a public or private hospital. But midwives in private practice are the ones who have historically provided women with access to the choice of giving birth at home. Access to indemnity for private midwives ceased in 2001 following the collapse of HIH and September 11, which caused insurers to reassess their liabilities.

“The national registration laws will require a midwife to be indemnified for all areas of her practice. This will effectively make it impossible for a midwife to legally care for women planning homebirth, because there is no professional indemnity available for homebirth care” said Dr Barbara Vernon, Executive Officer of the Australian College of Midwives. “This is devastating news for private midwives, as this policy threatens to throw them onto the unemployment queues” Vernon said.

“It’s also a very dangerous move by registration officials” Vernon said. “It is essential that women who choose to give birth at home have access to experienced midwives. The widely reported tragic death in March of a baby born at home without a midwife or doctor in attendance is testimony that unattended homebirth is dangerous.”

“Midwives have knowledge and skills that ensure women who labour at home can do so safely. They closely supervise the labour to ensure that everything is proceeding normally, and can arrange for timely transfer if they are not. They also have skills and equipment to perform life saving emergency care in the unlikely event of a mother or baby need urgent transfer.”

“The Australian College of Midwives is gravely concerned that if midwives are prevented from providing professional care to women planning homebirth, that some women will proceed to birth at home anyway, unattended. Any attendant they might have would not be a regulated health professional like midwives are, accountable to competency standards, codes of ethics and conduct, and required to maintain professional knowledge and skills. This is a retrograde step”.

Health Minister, Nicola Roxon is set to introduce legislation to federal Parliament soon that will assist private midwives to access professional indemnity insurance. This assistance will be for midwives who become eligible to provide Medicare funded care to women in the community for pregnancy and postnatally and for labour and birth in a hospital.

“We welcome the Minister’s recognition of the valuable contribution midwives make to maternity care evidenced by the Budget decision to give Medicare and PBS rebates to women or care by eligible midwives” Vernon said. “The support for eligible midwives to access insurance for such care is also vital given the market failure in this area of insurance”.

“Now that the national registration laws will effectively render it illegal for midwives to attend women planning homebirth, it is vital that the government’s support for midwives to access indemnity insurance is extended to include women who choose to labour and birth at home” Vernon said.

“This is the only option if the government is serious about maintaining safety and quality for all women needing maternity care in Australia”.