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.

1 comment:

Joy Johnston said...

Comment from Lisa Metcalf, NSW Maternity Coalition President:

While there is recognition of the importance of midwifery there is no substance in the recommendations to support it.
After reading the report very quickly much of the evidence presented is overlooked and the response is business as usual.
Many of the recommendations are already under way (Core Maternity Indicators, Core Maternity Compentancies, Midwifery national registration etc) and real reform it some way off.

Women will still be faced with limited choice (e.g. only 2 birth centres in NSW both in Sydney, more maternity facilities closing, and no certainty of indemnity for midwives in private practice).

Collaborative models where they exist are a hard won battles. (NSW has a total of 3500 places for continuity of care models (case-load and team midwifery) and we have over 93,000 women giving birth!)

There is a very long road to travel, but I am sure we can get there.