Firstly, appologies to my regular readers, there will be lots of lovely birth pics etc soon, but this is a serious issue for midwives at the moment.

I would like to share with you my letter to my college of midwives and their stock replies to our very serious issue in Australia.

To the College of Midwives Australia,

I appreciate the colleges ability to make statements when it counts, as with the tv programme (I don’t have a tv so I wouldn’t consider it very important myself). How about a statement in support of Independent midwives. I haven’t seen one from the college yet but would appreciate being directed there if I have missed it.

My concern is that No independent midwives are really being involved in the process through the college when the only people directly affected by the review is us. Even if none of the review is implemented it is pretty clear that we have a problem.

As an independent midwife with a very busy practice and an active member of the college I am not happy that Insurance is the focus of this. There are no circumstances that I can foresee that insurance is an option for a midwife like myself. I practice in the full scope of midwifery and stand with women regardless to risk if they have informed choice.

I see this as a human rights issue and request that my College does too.

I am disappointed that the College has supported insurance as part of the registration process. Even if the Board says it we don’t have to back this up. As long as practitioners are up to date, well researched and competent they should be able to register.

I want the college to represent midwives. I don’t want baby steps any more, due to this I am on the verge of being an illegal practitioner through no fault of my own, without ever being directly contacted.

Lisa Barrett

The answers:

I am not on the Board of the College and therefore am not a key player in setting strategic directions, however I thought you may be interested in some observations of yesterdays media work.

I heard Hannahs interview on ABC 666. I was pleased to note that the focus was very much on best outcomes for women and the unfair basis of the current stand of insurers and the way it leaves independant midwives personally exposed, the descriminatory nature of the proposed legislation and especially the quality of health outcomes for women who experience home births. Hannah made it abundantly clear that the proposed legaislation was unjust in that it would force homebirth ‘underground’ and force midwives into illegal situations. My interpretation was that she was being a very effective advocate for independant midwives which resulted in some of the best discussion I have heard on the general airways about homebirth. I have also just finished reading a critical review prepared by Hannah and Sally Tracey to the Robson and colleagues study published in the MJA. It too was excellent work and with its woman focus only served to strengthen midwifery.

I hope this helps.

And this:

I am not at all sure where the impression has come from that the College is not supporting midwives in private practice. It is on the public record that we do so, and the rights of women to choose to give birth at home supported by a professional midwife.

The College has several processes in place to consult with midwives in private practice: we have a Memorandum of understanding with ASIM and with Maternity Coalition, of which MIPPs is a member. We have a continuity of care advisory committee which is made up predominantly of midwives in private practice. Opportunities to participate in this committee are advertised from time to time in the Australian Midwifery News. We also have the benefit of a midwife in private practice as a Director of the national Board, Robyn Thompson. Robyn consistently and clearly advocates on issues that affect midwives in private practice within the College’s forums and committees.

An e-bulleting will be distributed in the next day or so to members of ACM who have indicated they either practice privately or are interested in doing so. It is important that people have accurate information on which to determine their own views of the maternity services review report. We are also planning to hold a workshop in association with the National Midwifery Conference in Adelaide in September, to provide a forum for private midwives to discuss the opportunities and challenges of the Maternity Services review with members of the College’s Board and with each other.

And this:

Re indemnity, it is not the ACM that has made a decision to focus on indemnity as part of national registration. This decision has been taken by heads of government in the council of Australian Government meetings during 2007 and 2008. This requirement will be placed on all health professionals to be registered under the new national scheme. As we have explained in each issue of the Australian Midwifery News over the past year and in various e-bulletins to members, ACM has been actively lobbying the federal government to restore access to affordable professional indemnity for midwives ahead of the move to national registration mooted for 1 July 2010. So I’m not sure where you got the impression from that the College has supported indemnity being part of the registration process. We have campaigned actively against this in a range of forums during 2008. Once it was made clear that there was no scope to influence this decision by COAG, we have been campaigning for access. This work is ongoing, but we have reason to be optimistic it will be resolved sooner rather than later.

Thank you for your interest in these matters.

And this:

It is a key issue – yesterday I was on ABC Brisbane radio and stressed that PI needs to be sorted before national regulation is introduced and made some of the same points made by Hannah. HMA (Qld) was on the same radio program immediately following me. I talked about how much money was pumped in to support doctors medical indemnity at a state and federal level and said it was timely to sort out the mess for all health professions.

I would encourage you and others to keep the pressure up on this issue – in all quarters.

Thanks Mary for this.

Having spent much of the week along with others working so hard on this issue I must admit I am perplexed and a bit disappointed. I have just written articles for Midwifery Matters, the NSW Nurses Association Lamp and the ICM News all pointing out the seriousness of this issue. We have the Insight program to be aired on March 10th SBS and now 7.30 Report to run next week on the issue. The front page of the Australian, second page of the SMH and at least 20 other papers have addressed the issue along with at least ten radio interviews that I know about. You couldn’t get this level of exposure if you paid for it.

I personally haven’t been to be bed before midnight all week trying to get all this done. Barb has spent so many hours in high level negotiation and advocacy over the issue I know she is exhausted and Pat and many others barely have a life anymore. Now more than ever before we need to band together and see the big picture. We need to fight for homebirth to be a reality in this country as we always have done without selling out the other 99.8% of women and midwives that stand to benefit under the proposed changes. I can’t imagine it could get much lower than it is under the current system so we can only go forward and we have never in history before had such a chance. It is the amazing consumers that in all honesty have got us here and many of them have had homebirths and are passionate about the issue. Together we are so incredibly strong and lets not divide but let us unite at this crucial time.

So, back to me for a second try:

Thank you for your replies. Hannah, please do not patronise me ever again. I don’t care how disappointed you are. You are the spokes person for the college of midwives and your job is to speak for us. Let me know how you feel when you are a midwife in private practice. Disappointment doesn’t even begin to describe how I feel. I didn’t see any actual support from the College of midwives for Independent midwives in practice in any of these pieces that didn’t say we want insurance and need it. I did see how if we were unregistered how dangerous we would become and how unsafe birth would be.

I will gladly add myself to any active process and I work as hard as any of you already, I actually work with women on a daily basis. The South Australian Independent midwives will be suggesting a no fault policy means that gp’s obs and midwives do not need insurance. It will be absolute cover for the women in the case of an adverse outcome. I don’t understand why this is not already on your agenda. Also insurance should not be linked to registration. Why isn’t the college actively campaigning for this.

All of your replies are stock statements. I am not the press I am a midwife providing gold standard care for women, care that every woman should receive and I want Independent midwives to be heard. We are not willing to be shafted.

Barb, look back at the previous front page ( the one recently taken off) to find your commitment to insurance for national registration. This is not a passing interest but my and other Independent midwives life. I would be interested to know how many Independent midwives you canvassed to ascertain what we wanted before you started this. I don’t know any working Independent midwives who want this as a priority.

The review hasn’t caused this just brought it to a head. It is an issue of national registration. The review may or may not get implimented. There are plenty of them to chose from. However the insurance issue is now highlighted. It is the job of the college to make sure that it is the human right of the woman to birth with a midwife of her choice, who is registered, in her own home. Insurance is a totally different issue.

I would appreciate a reply that deals with the issues that have been raised.

Thank you for your kind attention.

Lisa Barrett

I hate feeling patronised, feeling like a school girl told off by the principle because I won’t shut up in class.

Let me know what you all think.

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