Saturday, February 28, 2009

Homebirth ban - ABC Unleashed

27 February 2009 Homebirth ban
Author Alison Leemen

"The Maternity Services Review report, released last weekend, was an attempt to delivery continuity of care and midwife-led services to more Australian women. In so doing, it has stripped that very same care and service from the only women who currently have it - homebirth mums.

"The fact that it did this in the face of having received the majority of its submissions from homebirth parents is galling and speaks volumes for the way "public consultation" occurs in this country. But the fact that the report's recommendations, if accepted by the Government and made law, would criminalise the high quality care currently delivered to women who choose to give birth at home by registered, professional, independent midwives to their clients is radical and dangerous.

"Good intentions have paved the way. The MSR was established partly in response to rising birth intervention rates and widespread concern that women were being poorly served by a maternity care system that was fragmented, expensive and increasingly medicalised.

"But the process became hijacked by ...



"Homebirth with an independent midwife is a great model of care for lots of reasons, key among them that it provides continuity of care with a known carer - something the Maternity Services Review says it wants to see in hospital -based models. So why is it killing off the only model that reliably delivers that care?

"Giving birth at home with a highly skilled and qualified midwife is not new or radical. Outlawing it is."

[Thankyou ABC Unleashed for speaking out.]

Thursday, February 26, 2009

From The Border Watch, Mt Gambier SA

Greater role for midwives proposed

Posted on February 25, 2009, 8:08am

"Both the Australian Nursing Federation (ANF) and the Rural Doctors Association of Australia (RDAA) have welcomed the newly released Maternity Services Review Report, which focuses on an expanded role for midwives and improving access to maternity services in rural areas." continued

For critical comment on this article and the MSR Report, go to

Monday, February 23, 2009


The Australian College of Midwives commends the Government for undertaking this much needed review of maternity services in Australia and for listening to the voices of the women and their families.
“The Review has read a large number of submissions and deliberated over many complex and at times controversial issues,” said Professor Pat Brodie, President of the Australian College of Midwives.
“We endorse and commend the recommendation to continue to deliver maternity services in this country within a collaborative framework based on informed choice, and expanded access for women to continuity of care by a known midwife.”

“We applaud the Review’s determination to close the gap on disadvantage for Aboriginal and Torres Strait Islander mothers and babies in partnership with Indigenous people themselves. We stand ready to work with the government, medical professionals and with Aboriginal women and their communities to help make this a reality.”
Professor Brodie said, “Also vital is the recommendation relating to improving the access of rural women to safe, collaborative maternity care as close as possible to where they live. Roadside births are on the rise with so many rural maternity services having been closed. This trend must be reversed.”

“The proposed extension of MBS and PBS access for midwives is essential to support the full contribution that midwives can make to maternity care in urban, rural and remote areas such as the Review is proposing,” said Professor Brodie. “We urge the government to make this a reality as soon as possible and to thereby bring Australia into line with other developed countries.

“The market failure in providing insurance for privately practising midwives also needs to be addressed urgently and we welcome the Review’s recommendation to ensure that suitable professional Indemnity Insurance is available for midwives,” said Professor Brodie.

Over the past 5 years a robust quality framework has been developed for midwives involving regulators, the professions and consumers. This framework includes national competency standards, Codes of Ethics and Professional Conduct for midwives, evidence based consultation and referral guidelines, a national continuing competence framework, and Midwifery Practice Review (a form of professional credentialing). “This quality framework provides assurance that midwives who choose to take up responsibility for providing continuity of care, provide safe and professional primary care to women and collaborate with doctors and other health professionals for the benefit of individual women and babies in their care.” Professor Brodie said.

“It’s not about women being cared for by midwives instead of doctors” Professor Brodie added. “Midwifery care is something all women need and stand to benefit from. Continuity of midwifery care is about each woman having a known midwife who provides her care throughout her pregnancy, her labour and birth and the all important follow up care at home after the birth. Midwives respect and value the expertise of obstetricians and other health professionals. When women they are caring for need medical attention, midwives work closely with doctors to ensure the individual woman and her baby have optimal outcomes.”

The effectiveness of midwifery care received the highest scientific endorsement in October 2008 when a systematic review of 11 randomised controlled trials and over 12,000 women from around the world demonstrated that outcomes for women receiving continuity of care from known midwives were better than for women who received fragmented care from multiple midwives and doctors. There is no longer any doubt that continuity of midwifery care offers women considerable advantages and supports great beginnings for their babies and families.

In the past 20 years there have been over 20 maternity reviews at State and Commonwealth level, and many of these have not been acted on. “Now is the time to stop talking and start acting. We urge the government to listen to the needs of women and their families and make sure that these recommendations are acted upon. The time has come to give all women the choice of continuity of care from a known midwife, with seamless access to medical expertise as required” said Professor Brodie.

Contact: Media Spokesperson, Australian College of Midwives, Assoc Professor Hannah Dahlen 0407 643 943,
President, Australian College of Midwives, Professor Pat Brodie 043 418 1953, Executive Officer, Australian College of Midwives, Dr Barbara Vernon 0438 855 529,

Sunday, February 22, 2009


Recommendation 1:
That the Australian Government, in consultation with states and territories and key stakeholders, agree and implement arrangements for consistent, comprehensive national data collection, monitoring and review, for maternal and perinatal mortality and morbidity.

Recommendation 2:
That the Australian Government, in consultation with states and territories and key stakeholders, initiate targeted research aimed at improving the quality and safety of maternity services in select key priority areas, such as evidence around interventions, particularly caesarean sections, and maternal experience and outcomes, including from postnatal care.

Recommendation 3:
As a priority, that the National Health and Medical Research Council (NHMRC) develop national multidisciplinary guidelines for maternity care to promote consistent standards of practice, quality and safety in collaborative team models. These guidelines are to be agreed by the professions involved, in consultation with consumers and state and territory governments.

Recommendation 4:
That, in developing the National Maternity Services Plan, consideration be given to the demand for, and availability of, a range of models of care including birthing centres.

Recommendation 5:
That, given the role of the states and territories in the provision of maternity services in rural areas, the availability of rural maternity services is a priority area for the Plan, requiring the engagement of states and territories.

Recommendation 6:
That provision of maternity services be considered in the context of all governments’ commitment to close the gap on Indigenous disadvantage, and be developed in partnership with Indigenous people and their representative organisations.

Recommendation 7:
In consultation with relevant state or territory governments, that consideration be given to funding expansion of Indigenous maternity care programs, based on current successful models, within a research and evaluation framework.

Recommendation 8:
That, in any initiatives that are aimed at supporting an expansion or upskilling of the maternity services workforce, particular focus is given to supporting an increased number of Indigenous people as members of the maternity workforce, across a range of roles.

Recommendation 9:
That all professional bodies and employers ensure that all health professionals and other staff involved in the delivery of maternity care receive cultural awareness training.

Recommendation 10:
That all professional bodies involved in the education and training of the maternity workforce ensure that cultural awareness training is a core component of their curricula.

Recommendation 11:
That consideration be given to improving the range of birthing and other pregnancy-related information and resources, including those on the internet, that is made available to assist women in informed decision making; with any information materials specifically recognising the needs of population subgroups such as culturally and linguistically diverse communities, women with a disability, Indigenous and teenage mothers.

Recommendation 12:
That consideration be given to the establishment of a single, integrated pregnancy-related telephone support line for consumers, possibly as part of the National Health Call Centre, providing both clinical and non-clinical support services, complemented by triage to a number of existing specialised support services.

Recommendation 13:
That in order to lengthen the duration of breastfeeding, further evaluation be undertaken to identify the health care or community settings in which breastfeeding information and support are most effectively received, with a particular priority on consulting and supporting women from diverse cultural and socioeconomic backgrounds.

Recommendation 14:
That the development of national maternity care guidelines (Recommendation 3 above) consider the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Audit.

Recommendation 15:
That consideration be given to support for the rural maternity workforce to obtain and maintain appropriate training and skills.

Recommendation 16:
That consideration be given to identifying the competencies and credentialing required for advanced midwifery practice.

Recommendation 17:
That, noting the potential issues to be resolved including the potential interaction with Private Health Insurance arrangements, the Australian Government gives consideration to arrangements, including MBS and PBS access, that could support an expanded role for appropriately qualified and skilled midwives, within collaborative team-based models.

Recommendation 18:
That, in the interim, while a risk profile for midwife professional indemnity insurance premiums is being developed, consideration be given to Commonwealth support to ensure that suitable professional indemnity insurance is available for appropriately qualified and skilled midwives operating in collaborative team-based models. Consideration would include both period and quantum of funding.




Media release

21 February 2009


[Full report]
Better services for Australian mothers and their babies are one step closer with today's release of the Government's report into maternity services.

The report follows a review led by Chief Nurse and Midwifery Officer Rosemary Bryant and is a key step in developing a national plan for maternity services.

The report focuses on the need to improve the choices available to pregnant women, access to high quality maternity services, and support for the maternity services workforce.

Australia remains one of the safest countries in the world in which to give birth. The review emphasises that changes to maternity care need to take place within a framework which maintains our strong record of safety and quality, and this will be a priority for the Government.

Recommendations include:
• Improving choice for Australian women by supporting an expanded role for midwives
• Consideration of the expansion of access to Medicare and the PBS for midwives – but only if accompanied by stringent professional requirements for midwives
• Consideration of support for professional indemnity insurance for midwives
• The development of new national cross-professional guidelines to support collaborative multidisciplinary care in line with best practice
• Consideration of the establishment of a single integrated pregnancy-related telephone support line
• Improved data collection and analysis, and further research
• Providing increased support for the maternity workforce, particularly in rural Australia

The report considered Commonwealth funding for homebirths but did not recommend it at this time.

All Australian women should be able to access high quality, safe maternity services, from early pregnancy through to postnatal care.

In 2006, 277,436 women gave birth to 282,169 babies in Australia – the highest number of births since 1971. This just underlines the importance of this report.

One of the Government's concerns is that good maternity health outcomes are not consistent across the country.

By developing a national Maternity Services Plan, we want to ensure that Australian mothers, wherever they live, are provided with the choices and care that they need.

Over 60 per cent of births currently take place in State-run public hospitals. The Maternity Services Plan will be developed over the coming months, and will involve discussions with the States and Territories.

The Australian Government will carefully consider all the recommendations of the report in the development of a National Maternity Services Plan.

The Rudd Government is committed to improving services for mothers and babies.

Saturday, February 21, 2009

Maternity Services Review in today's papers

Janie Nottingham, Victorian President of Maternity Coalition, Australia's leading consumer and midwife advocacy organisation, writes:

The release of the report is due today, I have scoured the Internet for some articles and have come up with the following.

The Age

The Australian

Sydney Morning Herald

The long & short of what I can determine from the press is that there is no public funding of homebirth going to be considered in the near future, medicare and pharmceutical prescribing rights are discussed but the details are sketchy. Welcome any discussion and opinions.



Friday, February 20, 2009

News from ACM

Australian College of Midwives
Important News Update

Breaking news - Review of Maternity Services

We are anticipating that the federal government's review of maternity services may be released very soon. The review was commissioned by federal Health Minister Nicola Roxon last September, and received over 960 submissions from individuals and organisations interested in maternity care.

Please keep an ear out on your local radio stations for the opportunity to phone in to talk back sessions and share your views about whatever the review might recommend. We have reason to believe the news will be positive for women and midwives but we don't have details.

Maternity Care in Public Hospitals alleged to be unsafe
You will probably be aware that there was media attention given this week to a study published in the Medical Journal of Australia alleging that babies are 2-3 times more likely to die if the mother gives birth in a public hospital.

This study is methodologically flawed, and the assertion is false. It does not account for the differences in the health and socioeconomic status of women who access public hospitals from private ones, nor does it account for the fact that most private hospitals do not have neonatal intensive care units, and therefore transfer sick babies to public hospitals.

The ACM provided extensive briefing to newspaper and radio journalists following the release of the article, to clarify the facts about maternity care by public hospitals. An example of one article is here:

Opinion Piece

ACM has also collaborated in this week with the ANF on an opinion piece ahead of the launch of the review. See it at

Victorian Media today

An article has appeared today in the Victorian media that may be of interest.

Maternity Units 'herding yards', Tha Age, Friday 20 February 2009:

Health Care Reform Writ large

Lastly, the Health and Hospitals Reform Commission has released its interim report to the Government on Monday this week. There is little specifically about maternity care in the report, but it maps out some options for major structural reform of Australia's health care services that would affect maternity care along with all other areas of care if adopted.

The report is an interim report. The Commission will hand down its final report to the government in June 2009.

To read the overview and/or details of the report, visit the Commission's website:

regards Barb

Dr Barbara Vernon
Executive Officer
Australian College of Midwives
Tel: 02 6230 7333
Mob: 0438 855 529

Can Humanity Survive the Safe Cesarean?

Human beings react differently from other mammals to interference with the birth process. When delivery of non-human mammals is disturbed, the effects are immediate and easily detected. For example, when animals give birth by c-section or with an epidural, the general rule is that the mother is not interested in the baby. Among humans, on the other hand, we need extensive statistics to detect what are mere tendencies and risk factors. These are much more complex in our species: We speak and we create cultural milieux. In certain situations, particularly in the perinatal period, human behavior is less directly under the effects of the hormonal balance than the effects of the cultural milieu. For example, a human mother knows when she is pregnant and can anticipate maternal behavior, while other mammals must wait until the birth when they release a flow of love hormones to kindle their attachment to their newborns.

Today, we understand that to have a baby, a woman—like any other mammal—has been programmed to release a cocktail of love hormones. Today the number of women who actually "give birth" to babies and placentas thanks to this hormonal release is ever-decreasing. First, because many women give by birth by cesarean. Second, most of those who give birth vaginally receive pharmacological interventions. Unfortunately substitutes block the release of the natural hormones and do not create the same behavioural benefits. We have to wonder what will happen, in terms of civilization, if this trend continues in future generations. Can humanity survive the safe cesarean?

— Michel Odent
Excerpted from "The Future of Obstetric Technology," Midwifery Today, Issue 85

Midwifery Today Community Blogs

Saturday, February 14, 2009

the midwives of the Congo

My heart is breaking as I listen to this ABC Radio National story of displacement and poverty and rape in the Congo. The transcript gives facts; and while I am reading I am listening to the midwives, who are singing.

We Australian midwives don't sing together - as a general rule! When we get together we have conferences or meetings with agendas, or we go to study days.

As I listen to these midwives singing I don't know what they are saying. But they are blending their voices in a strong and deliberate way. I think their songs will be of women and birth, but also of loss and pain and death - a constant reality. They will be singing their memories of better times, to keep hope uppermost in their minds. The hope for strong resillient families who have plenty to eat, and for a freedom from fear. As I sing the songs of my people I want to remember these sisters who are midwives in Africa.

Thursday, February 12, 2009

Australian Midwifery Scholarship

Just a quick reminder that the closing date for the Australian Midwifery Scholarship is the 28th February 2009

The purposes of the Foundation is:

· To provide scholarships for Registered Midwives to undertake research under the auspices of the Trustees of Funds and the promotion of education and practice of midwifery generally.

· To provide financial and other support to assist attendance of midwives at national and international conferences in midwifery and related fields, and the undertaking of study tours to investigate trends in midwifery overseas.

· To provide financial assistance for the sponsorship of visiting midwives to attend midwifery conferences or to undertake study tours within Australia.

· To provide provision of financial assistance for projects directed at public education in the field of maternal and child health.

If you are interested in applying please follow the link below for more information and to download the application form.

All applications can be sent to;

Australian College of Midwives Attn: Luke Sanders

PO BOX 87 Deakin West ACT 2601

Fax: 02 62306033


Wednesday, February 4, 2009

Article on insurance in The Australian

*CANBERRA is considering underwriting insurance for independent midwives rather than risk losing all those now in private practice.*

Scores of self-employed midwives could be denied re-registration next
year when a national scheme is introduced, unless their lack of
indemnity cover is resolved.
... more