The Budget and Midwifery

Here is an excerpt from the budget in relation to midwifery. No coverage for homebirths as expected.

Improving Maternity Services Package

Expense ($m)

	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	8.8	24.7	29.7	49.5
Medicare Australia	-	2.4	0.7	0.8	0.9
Total	-	11.2	25.4	30.5	50.4
Related capital ($m)
Medicare Australia	-	3.1	-	-	-

The Government will provide $120.5 million over four years for the introduction of Medicare‑supported midwifery services to provide greater choice for women during pregnancy, birthing and postnatal maternity care. This measure includes $3.1 million in capital funding in 2009‑10 for Medicare Australia.

The new arrangements will allow midwives to work as private practitioners, provide services subsidised by the Medical Benefits Schedule and prescribe medications subsidised under the Pharmaceutical Benefits Schedule. The Government will also provide subsidised medical indemnity for eligible midwives working in collaborative arrangements in hospitals and healthcare settings. To ensure that Australia maintains its strong record of safety and quality in maternity care, a safety and quality framework, including professional guidance and an advanced midwifery credentialing framework, will be developed. A new 24‑hour, seven‑days‑a‑week helpline will also be established to provide antenatal, birthing and postnatal maternity advice and information to women, partners and families during the ante‑natal period and up to 12 months following the birth of a child.

The measure will also assist women in rural and remote areas by expanding the Medical Specialist Outreach Assistance Program to provide integrated outreach maternity service teams for women in under serviced areas. The expanded teams will include midwives, obstetricians, general practitioners and other health professionals, such as paediatricians and Aboriginal health workers. Additionally, funding will be provided for the professional development of midwives and for general practitioners to undertake additional training to become GP obstetricians or GP anaesthetists. The package will be implemented progressively from 1 July 2009.

New Activist Group in North Western Sydney

It is with great pleasure that we would like to announce the launch of a new website, SAVE BIRTH CHOICES (www.savebirthchoices.com.au).

Save Birth Choices has been the initiative of a group of women; mothers and midwives in North/West Sydney, passionate about birth and keeping all birth choices available to Australian mothers. We have seen the wonderful efforts of organisations and individuals in response to the Maternity Services Review and felt it necessary to create a central spot that is aimed at educating the greater public and communicating the collaborative efforts of organisations around Australia.

This website was launched two weeks ago with very little publicity other than a facebook causes group which now has well over 1,000 members joined in the past week. We are excited and encouraged by the response to our admin email address and requests for information about the Maternity Coalition’s postcard campaign in particular.

What we are aiming to achieve with this website is support from the greater public for all birth choices rather than targeting only women and families directly affected. We would also like to communicate community events and be a point of referral for all campaigns for birth reform that are being run around the country but not making it to the attention of the greater public. We are not a birthing organisation. We have simply created a website to appeal to the greater public as a tool to help birthing organisations like yours and as such, we would like to invite you to utilise this tool.

What we are looking to advertise is

Birth education classes
Campaigns and events and
Relevant news

We would also like to add you as a supporter to our site and would greatly appreciate a reciprocal link.

If you have any questions about Save Birth Choices please feel free to send an email to admin@savehomebirth.com.au. This email address can also be used to forward information you would like posted on this site.

With warm wishes,
Anna Russell
On behalf of Save Birth Choices
www.savebirthchoices.com.au

Homebirths 'as safe as Hospital'

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births. To read the full article go to http://news.bbc.co.uk/2/hi/health/7998417.stm

The Campaign Begins

Today I am beginning to coordinate a campaign in my local area to lobby to save the future of midwifery in private practice and homebirths. The Report of the Maternity Services Review failed to provide a provision for midwives attending homebirths nor to find a solution for professional indemnity insurance. As a requirement of national registration planned to be implemented mid 2010 - midwives will be asked to provide proof of professional indemnity insurance as to enable registration - as no insurance is available if midwives choose to attend a homebirth they will be practising illegally. Women have a right to a midwife attending them at home. More on my plans later. Enjoy this video produced by Homebirth Australia.

Photo and video editing at www.OneTrueMedia.com

Maternity Services Review

The date for submissions to the Maternity Services Review Discussion Paper has now past. I received the email below today to say my submission has been accepted. I now am waiting excitedly with the hope that real changes are going to occur such as midwives receiving Medicare rebates, professional indemnity insurance and that we'll have the ability order diagnostic tests and have prescribing rights.

Dear Jane

Thank you for your submission in response to the Maternity Services Review Discussion Paper, “Improving Maternity Services in Australia: A Discussion Paper from the Australian Government”.

Your submission, along with all other submissions and information, research and expertise assembled from other sources will be used by the Department of Health and Ageing in the development of a report to the Minister for Health and Ageing, the Hon Nicola Roxon, MP.

Thank you again for your contribution to this important process.

Yours sincerely




Rosemary Bryant
Chief Nurse and Midwifery Officer

Midwife-led versus other models of care for childbearing women

A friend has just emailed a link to this review from the Cochrane Collaboration (published October 2008) - I thought you might be interested:

Midwife-led versus other models of care for childbearing women
Hatem M, Sandall J, Devane D, Soltani H, Gates S.

Midwife-led care confers benefits for pregnant women and their babies and is recommended.

In many parts of the world, midwives are the primary providers of care for childbearing women. Elsewhere it may be medical doctors or family physicians who have the main responsibility for care, or the responsibility may be shared. The underpinning philosophy of midwife-led care is normality and being cared for by a known and trusted midwife during labour. There is an emphasis on the natural ability of women to experience birth with minimum intervention. Some models of midwife-led care provide a service through a team of midwives sharing a caseload, often called 'team' midwifery. Another model is 'caseload midwifery', where the aim is to offer greater continuity of caregiver throughout the episode of care. Caseload midwifery aims to ensure that the woman receives all her care from one midwife or her/his practice partner. By contrast, medical-led models of care are where an obstetrician or family physician is primarily responsible for care. In shared-care models, responsibility is shared between different healthcare professionals.

The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials, involving 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects. The main benefits were a reduced risk of losing a baby before 24 weeks. Also during labour, there was a reduced use of regional analgesia, with fewer episiotomies or instrumental births. Midwife-led care also increased the woman's chance of being cared for in labour by a midwife she had got to know. It also increased the chance of a spontaneous vaginal birth and initiation of breastfeeding. In addition, midwife-led care led to more women feeling they were in control during labour. There was no difference in risk of a mother losing her baby after 24 weeks. The review concluded that all women should be offered midwife-led models of care.

To read more visit: http://cochrane.org/reviews/en/ab004667.html

Proverb Translated from the Tao Te Ching

You are a midwife, assisting at someone else's birth. Do good without show or fuss.

Facilitate what is happening rather than what you think ought to be happening.

If you must take the lead, lead so that the mother is helped, yet still free and in charge.

When the baby is born, the mother will rightly say: "We did it ourselves!"

from The Tao Te Ching