Monday, December 15, 2008


The Australian College of Midwives 16th Biennial Conference: "Midwives & Women: A Brilliant Blend" is being held at the Adelaide Convention Centre, from the 22 - 25 September 2009.

The Conference Committee has prepared a draft program and is now calling for abstracts consistent with the theme established for the Conference, "Midwives & Women: A Brilliant Blend". All abstracts must meet the theme and the following day by day structure:

Day one: Midwives Working with Women
This will explore the diverse ways that midwives and women work together to achieve safe satisfying maternity care.

Day two: Midwives Working for Women
This examines the innovative often-invisible ways that midwives work to enable healthy safe and satisfying birth maternity care in various environments and context.

Day three: Midwives and Women: Looking back and moving forward
This will be a fascinating day exploring what has been, what is and what our hopes and directions are for the future of midwifery and maternity care.


To register your early interest in presenting an abstract or poster, or attending the conference, or if you are seeking further information in relation to the requirements for abstract submissions, please contact the Conference Managers:

Shanna Sheldrick or Jessica Bosnakis
All Occasions Management
Telephone: +61 8 8125 2200
Email: or

Friday, December 12, 2008


On Tuesday this week the Federal Maternity Review published submissions on their website.
Go here for Nicola Roxon’s media release.

Contact: Justine Caines 0408210273
Melissa Fox 0404 88 2716

Yesterday, Federal Health Minister, Nicola Roxon released the first 400 of over 900 submissions received as part of the Maternity Services Review.
“This is an unprecedented response. The whole of health inquiry, The National Health and Hospitals Reform Commission only received 500 and yet one area of health, maternity care, elicits more than 900 and largely from consumers” said Justine Caines, National President of Maternity Coalition and mother of seven.
“It is heartening that the Minister is a Mother of a young child herself. Women across Australia are relying on Ms Roxon to hear their pleas and make major reform that sees maternity care focus on the needs of women rather than clinicians.” said Melissa Fox, Vice President and mother of two.
Also released yesterday was the 2006, Mother’s and Babies Report. While this reveals the statistics around pregnancy and birth, submissions to the enquiry provide a human face. Many submissions reveal a system that does not allow women to make choices about their bodies or their babies that is damaging and sometimes inhumane.
“Women are waiting longer before they start a family because they’re having careers and independent lives first. When the time comes to have babies, we expect to be treated with dignity and respect, and to make our own choices.” said Ms Fox

“The medical model is still (for the most part) stuck in the 1950's when women were expected to submit all decision-making to others, and to take the consequences in silent stoicism. This is why the review received over 900 submissions. Women are no longer happy to lie back and push out babies for their country.” said Ms Caines

“Welcome to the new wave of feminism: both career women and mothers want their intelligence and rights to be respected.” said Ms Caines

Tuesday, December 9, 2008

Maternity Services Review - Update

Approximately one half of the 900 submissions received by the Review are now available for public perusal at the Review website. There is plenty of interesting reading, both in the accounts of personal experiences in maternity care, in responses by special interest groups and organisations, and in large submissions by maternity-related professional bodies.

Here are a few snippets, to whet the appetite of blog watchers:
The Australian Society of Anaesthetists (ASA):
• believes that the existing model of obstetric care, where doctors and midwives collaborate together in a doctor led team, delivers the best maternity outcomes,
• ... and
• warns that proposals for change to the existing model of maternal care are driven mainly by social forces rather than concerns about the safety of mothers and their babies."

Women's Hospitals Australasia (WHA) ...
"recommends a national review of the medical indemnity insurance. ... WHA favours a universal no fault approach to medical insurance."

Midwives Naturally ..."We propose a changing of the entire system where funding is linked to the women (as in New Zealand). The client should be able to make an informed decision about where they give birth and with whom. Midwives are the only care providers who can provide a total service throughout the normal childbirth continuum. In order to achieve this, midwives must be able to order tests and ultrasounds, prescribe medications, within their scope of practice. At present midwives have to send their clients to other health care providers and this results in over servicing and increased cost to the woman. Midwives need visiting access to all hospitals. Currently some hospitals in Melbourne are refusing to allow women to make a backup booking for homebirth services, thus denying such women equal access to public health services that their hospital birth counterparts have full access to. This discriminates against women who are choosing home birth and therefore midwife led care, both of which are supported by research as being models of care that provide women with great satisfaction with their birth experience, less interventions and improved breastfeeding outcomes."

Australian Society of Independent Midwives
"Suggested changes to afford women a homebirth choice would include;

• Private Health Funds legislation making it compulsory for Funds to include
‘out of hospital birth’ packages alongside hospital birth benefits.

• Federal legislation to protect the public and the practitioners involved in
homebirths e.g. a National Midwife Practitioner Act

• Medicare provider numbers for Midwife Practitioners so that women do
not have to pay for the privilege of having their babies at home.

• Authority for Midwife Practitioners to request routine pregnancy
diagnostic and pathology tests

• Authority to prescribe emergency medications associated with the act of
giving birth e.g. life-saving oxytocics

• Professional indemnity insurance cover for Midwife Practitioners available
through Government-funded insurance schemes"

National Society of Specialist Obstetricians and Gynaecologists (NASOG):
"NASOG does not support the concept of independent midwifery led care for women in labour. As acknowledged at the review’s Models of Care round table consultation forum, all effective maternity care is collaborative. NASOG believes that it is preferable that a single individual carer take overall responsibility for care of a woman in labour and the obstetrician is the most appropriate choice for such a role. If a woman chooses to have care from a midwife, then NASOG believes that midwife should have a formal relationship with a nominated obstetrician/GP obstetrician."

Australian College of Midwives (ACM):
"While mortality outcomes for women and babies are good and comparable with other developed countries, there are nonetheless significant areas for improvement. Challenges include:
 the comparatively poorer mortality outcomes for Aboriginal and Torres Strait Islander mothers and babies;
 rising rates of caesarean birth with associated increased morbidity for mothers and babies;
 problems with equity of access to services especially for rural and remote women;
 the fragmented and stressful nature of care for most women, and in particular the lack of continuous support during labour;
 lack of choice for women wanting continuity of care (the only choice currently being a specialised obstetrician) For most women, there are no local services offering continuity of care by either doctors or midwives;
 an over-reliance on providing primary maternity care to mostly well women in acute hospital settings, which are increasingly overcrowded and understaffed; costly, and pose iatrogenic risks in terms of intervention, infection, medication errors, and other complications;
 lack of professional support postnatally, following discharge from hospital, to help in the critical early days and weeks with the transition to parenting a newborn baby
 shortages of midwives and GP obstetricians and a lack of co-ordinated strategies for addressing these shortages, and
 the current lack of accountability and transparency of services to consumers."

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCCOG)
"6. Home Birth
29. Home birth is NOT supported as it is associated with an unacceptably high rate of adverse outcomes.
30. RANZCOG recognises home birth will occur and therefore recommends minimum standards.
31. Women choosing home birth should be cared for by both an experienced medical practitioner and a registered midwife, each of whom has agreed to participate.
32. Women considering home birth should seek information from their home birth provider about the provider’s experience in home birth, and their contingency plan in the event of an emergency, including options for hospital transfer."

... ENJOY!
Your comments and discussion about these and other issues raised in the Review are welcome on this blog.

Friday, December 5, 2008

NSW - Acute services in public hospitals

The final report of the Garling Inquiry into acute services in NSW public hospitals was released on Nov 27th.

Quoting from the overview, p24
1.151 I received a large number of submissions about maternity services and the need to give midwives more freedom and responsibility for being involved with helping mothers have babies.
1.152 This is a complex question because some of the matters I was asked to make
recommendations about really belong in the Commonwealth sphere and don’t fall within
my Terms of Reference. As well, there quite complex issues about safety and quality
which require careful thought. Nevertheless, I felt able, on the basis of the evidence which I received to make recommendations about enhancing the midwifery workforce, and seeing whether midwifery case-load models of care where the same midwife looks after the mother from their first appointment until about 4 weeks after the birth of the baby can be introduced to more hospitals than at present. I make a specific recommendation, in the interest of the safety of the mother and child which is that NSW Health only offer birthing facilities for low risk mothers in hospitals which satisfy the following criteria:
(i) the hospital has an adequate number of health professionals qualified and trained to assist with the birth, such as midwives or VMOs with the necessary credentials; and
(ii) the hospital has, on-site, or else has the ability to transfer the mother within 30 minutes travel time to a hospital which has on-site, the workforce and facilities to perform an emergency caesarean section." [Report, p24]

Wednesday, December 3, 2008

Perinatal Data

The Victorian perinatal data collection unit (PDCU) has revised its data form, to be used from 1 January 2009. Midwives who are currently listed by the PDCU as those who attend homebirths will receive the new forms this month.

Five independent midwives attended a training day today, presented by the PDCU, to explain the changes to the form, and to discuss the planned electronic transmission of data from hospital data collection systems to the PDCU. Midwives reporting on homebirths, and small maternity hospitals which do not have the data collection systems running, will continue to fill out the forms manually, and post them to the PDCU. The information sent in hard copy will be entered into the system as it is at present.

New information fields that appear in the revised form include the aboriginality status of the baby as well as the mother; smoking; times of onset of labour, onset of second stage, and rupture of membranes; indication for induction; fetal monitoring in labour; waterbirth; amount of blood loss; hepatitis B Vaccination; and breastfeeding status. The leading intrapartum care provider (midwife, obstetrician, or GP) will also be recorded.

More information is available at the PDCU website , including the Guide for the completion of the Perinatal Morbidity Statistics form.