Yesterday saw Nicola Roxon talking in SA about the new government maternity Services review document called “Improving Maternity Services in Australia -A Discussion paper from the Australian Government”

Nicola says that the baby boom and the raising ceasarian rate are two of the reasons they want to look at maternity care. They want to consider giving midwives medicare numbers and prescribing rights.

What we would like to do is make sure that women get a real choice about the sort of care that they want, and is appropriate for their pregnancy without our funding arrangements directing them in one direction or another.”

Then I discovered the pool on the herald website, are Obstetricians safer than Midwives. Oh for god sake! Midwives are specialists in normal Obstetricians are specialists in complexities.

I also read

Greater role for midwives
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.

Doctor like responsibilities, working like a GP. It seems to me that they are at the moment slightly missing the point. A midwife isn’t like a doctor and doesn’t want to be a doctor. The scope of practice already allows them to look after women throughout their pregnancy birth and beyond.

It is excellent that there are midwifery voices in the mix but I do not like the fact that midwives like myself, who obviously are affected more than any others aren’t able to get in there and speak. I work inside the college but am never quite able to get in there at the last moment as I’m outside the system.

You can access the discussion paper.

Related posts:

1. Latest Maternity Review News
2. Maternity Review – Push For Midwifery
3. Maternity Services Advisory Committee
4. Maternity Review Continued
5. Obs Bleating As They Get Scared For Their Pockets