Rogue midwives Nicola? We don't think so!

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SAFE MATERNITY CARE

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There is probably no other group of midwives whose practices are measured and reported on to the degree that self employed midwives' are. Here is proof of safe primary maternity care.
A member of MiPP has prepared this summary, as a calling card to give to Minister Roxon next week.

It's a woman's right to choose how she births

Recommended reading

who are the rogue midwives?

Consumer activist Justine Caines has reported that Health Minister Roxon is becoming increasingly frustrated, as the community responds negatively to her plans to shut down private midwifery practice. Last night, as part of a “Community Cabinet”, she was said to be fairly dismissive and wanted to keep the line that this is a small number of women and there are ‘rogue midwives’ out there.

Who are the rogue midwives?

Does this small number of women not deserve to be heard?

Do the 2000 submissions to the Senate inquiry mean nothing? (only a few have been posted so far)

Yesterday, at a meeting of self employed midwives from Melbourne and surrounding communities, each one reaffirmed our desire to continue practising midwifery, as primary maternity care providers in a one to one partnership with women, promoting health for mothers, babies, and families. Several have stated that they cannot face returning to employment in hospitals that treat women and babies with a production line mentality. From a workforce perspective alone this will represent a terrible loss.

To my knowledge, there were no rogue midwives present.

Yes, there were some who would accept certain women planning homebirth who would not be 'allowed' to plan homebirth under the risk management policies of publicly funded homebirth programs in other States and territories. Those who have had previous caesareans, or who are having their 7th or 8th baby. Do these women have no rights of access to the care they believe will best meet their personal needs? These decisions are not made lightly. The positive outcomes of private midwifery care both in this State and elsewhere have been demonstrated time and time again.


The following appeared on the polical/media site Crikey.com

"The ability of the Rudd government to comprehensively overhaul the nation's health system must be seriously doubted when the Health Minister lacks the nerve to stand up to vested interests in the first cab off the rank -- maternity services reform. Nicola Roxon has set up a Maternity Services Advisory Group to implement the recommendations of the Maternity Services Review, which included giving some midwives access to the PBS and Medicare -- a move the Minister described as an "historic step forward for midwives".

"Surprisingly the advisory group includes no currently practising midwives. There are two representatives from the Australian College of Midwives and a midwifery academic, but no midwives who are actually working in the system (still a total of only three members representing the perspective of midwives). Compare this with the 11 members who are doctors and specialists and you start to see that it is highly unlikely that group will facilitate any comprehensive reforms."

A-HAAA!

We are experiencing socialist health policy on Prozac/Viagra/steroids/whatever - the lot!

Policy makers think they can put human lives into tidy pidgeon holes; imagine that all publicly funded maternity care can be simplified to what is acceptable to the loudest interest group.

People behind desks imagine they can, with the stroke of the legislative pen, overnight, bring in a new homebirth program that has not been tested, at the same time as they vilify and destroy the most basic and proven professional midwifery practice that has served the community through many generations.

The sad fact is that this is all being done under the guise of protecting the public through mandating professional indemnity insurance.

The predictable outcome will be more harm, more suffering in the maternity community.

We MUST object loudly and clearly to the attempt by our elected representatives to vilify midwives, and to discount and devalue women who employ a midwife privately.

PLEASE write to Health Minister Nicola Roxon

Nicola.Roxon.MP@aph.gov.au or fax to 02 6273 4146.

Every person can write a brief message, telling her who you are. Include a photo. Women whose stories include birth outcomes which you experienced with a private midwife could include pictures if you wish. Midwives could highlight who you are, Mother, Grandmother, Midwife for X years etc; not a rogue midwife!

You can make sure that Ms Roxon is forced to reflect on her statements, and to amend her maternity reform legislation to protect the private practices of midwives.

Submissions to the Senate Inquiry

We can now access some of the submissions to the Senate Review into the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills.

Q&A on ABC TV

If you missed this program, you will be able to download the podcast here after about 2pm today.

There was some discussion on home birth, midwives, indemnity etc. As one midwife commented, "Sadly less time, less vigorous and less informed discussion than there was on climate change."

A woman who had given birth at her home 11 weeks ago (first baby) was accepted into the audience. This is her story from last night:

I submitted my question to Q&A a few days ago and went along tonight. When I got there they told me there would be no opportunity to ask it. I went and spoke to one of the organisers who said that homebirth would not be discussed on the program tonight so we thought stuff it, we’re not staying around if there’s no opportunity to talk about what we want to talk about.
We got home and watched the program and there you go – a question was raised about homebirth (and answered with the typical level of rehearsed spin by the minister).

Perhaps we need to let Media Watch know, Q and A’s title, Adventures in Democracy, doesn’t seem like it.

I am going to write to Media Watch about this and have already complained (via a phone message to the Qand A ‘audience producer)




As I listened to Health Minister Nicola Roxon I had to ask how can she be so poorly informed about these matters? She (Roxon) is articulate, intelligent, and with one hand she is overseeing the (beginning of the) dismantling of medicine's strangle hold on maternity care, by providing Medicare for midwives. Yet with the other hand she is pushing midwifery back many years, enforcing a supervision of midwives by medical overlords, and using weaselwords such as 'collaboration' in her spin.

Roxon: "But, to be completely honest, I do not think there is an easy way around, in the next couple of years, the completely independent midwife home birthing with no sort of back up with a GP, obstetrician or hospital."

Roxon went on to explain to the wide-eyed panel and audience that the midwife after 1 July next year will collaborate with GPs and obstetricians, and will make backup bookings at hospitals.

EXCUSE ME! WHAT DOES SHE THINK HAPPENS NOW??? Who is telling the Minister this nonsense?


There is a guest book for comments.

For your enlightenment, here are a few more gems of uninformed comment on maternity from this program:
NICOLA ROXON: "We are increasing opportunities for women to have more choice about how they have their children." - as long as you don't choose to employ a midwife privately.
NICOLA ROXON: "... a very small number of people do want the right to have their babies at home" - How many do you need to take notice of?
NICOLA ROXON: "If we try to include home birthing in that indemnity product, it may well be totally unaffordable ..." Be honest - the decision to exclude birth was made before anyone attempted to cost that indemnity (for a "very small number" remember) or obtain a product.
TONY JONES: "So just to confirm this, on this issue, women don't have the right to chose what to do with their own bodies, is that right?" NICOLA ROXON: "Women do have the right to choose." That's what she said!!!
CHARLIE TEO: "... our major concern is that if you bring in physicians' assistant and nursing aids and stuff, then the doctors are going to lose some of the control they have ..." who mentioned anything about physicians assistants and nursing aids and stuff, Charlie? Do you know what a midwife is? "... We don't support a system that doesn't allow medical backup." You might be a brilliant neurosurgeon, but you obviously haven't a clue about things maternity.

JULIAN MORROW: "I can understand that it's [homebirth] a choice that some women want to make. I mean, to summarise my position on this, I actually agree with the minister. It's not a question of a woman's right to choose, in the sense that it's not illegal to have a baby at home." or whatever!!! For a social commentator that's spineless.
NICK MINCHIN: "Look, on this subject I agree with Nicola." how's that for bipartisan agreement! "I think she's in the right space on this. I mean, my wife had our three children in hospital." so??? "I personally worry about home birthing. I think that's a very big decision to make and one that, you know, has real risks attached to it and I, frankly, personally, would encourage people to have their babies in hospitals with the proper medical care, and I sympathise with Nicola on this." Women will thank you Nick, for your conclusions based on your experience of three! And what are those real risks at home? How about the real risks in hospitals? And did Mrs Minchin give birth in an over-crowded public hospital?
AUDIENCE MEMBER: "The taxpayer ends up footing the bill if something goes wrong ..." That's true. The taxpayer is already footing the bill for the high cost of indemnity insurance for obstetricians, for at least twice as many caesareans than would be reasonable, for untold emotional suffering as women are robbed of their right to give birth and nurture their babies in harmony with their natural physiological processes.

conferences and meetings for midwives

The Australian College of Midwives 16th Biennial Conference:
"Midwives & Women: A Brilliant Blend"

Adelaide Convention Centre 22 - 25 September 2009


*************
Launching The New Eastern and Southern Regions Branch of the Australian College of Midwives Victoria (ACM)

Monday July 27th 6-10pm

The Victorian President, Patrice Hickey and Victorian Board members of ACM, Updating you on:
 National ‘Midwives’ registration
 What ACM is doing for You
 Why You should join ACM
 Medicare funded care by midwives
 PBS for midwives
 Public funding for home births
YOU NEED TO BE THERE TO HEAR FOR YOURSELF
Monday July 27th 6-10pm
Lecture Theatre 2
Monash Medical Centre
Light refreshments will be provided
RSVP for catering to dawnworgan@bigpond.com by 20th July
*********************


ANF (Vic branch) Midwifery Conference National and local contemporary issues in midwifery
Wednesday 2 September 2009 - Melbourne

submissions have been sent ...

... to the Senate Inquiry (today) and the National Registration and Accreditation exposure draft Bill B (last week).

The submissions will be made available for public access.

Today I would like to tell readers about the way one community responded to these inquiries. I received an email, followed by a phone call, from Ellie, a mother from Castlemaine. She and I had met some years ago. Ellie wanted to know what "we" - she and her friends - could do. She explained to me that there are 25-30 homebirths each year in that area.

After chatting, I suggested that Ellie ask anyone in her community who was concerned about the potential loss of private midwifery in their community should write an impact statement, and send it to me. I offered to save them as .pdf files and forward them on electronically to the inquiries.

Ellie quickly prepared a letter and distributed it. With only about a week before the submissions were due, I hoped a few people would be able to write their impact statements.

What a delight it has been to send off 29 impact statements today to the Senate inquiry, along with my own submission! The messages came by email, fax and post. Some are hand written. They are from mothers, fathers, grandparents, and local professionals.

The midwives who attend births in that area are truly loved and respected. On their behalf, I thank all those who took the time to write impact statements.
Joy Johnston

please write your submissions today!

TWO VERY IMPORTANT OPPORTUNITIES EXIST RIGHT NOW.
THE PUBLIC (THAT'S YOU AND ME) ARE INVITED TO COMMENT ON:

*1. Exposure draft of Exposure draft of Health Practitioner Regulation National Law 2009 (Bill B) by 17 July 2009.

"If you wish to provide comments on the exposure draft, please lodge a written submission in electronic form, marked Exposure draft, at nraip@dhs.vic.gov.au by close of business on Friday, 17 July 2009. Please note that your submission will be placed on the website after the closing date for all submissions unless you indicate otherwise." Communique - Ministers release draft legislation for National Registration and Accreditation Scheme.


*2. Senate Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills.
The Committee invites you to provide a written submission which should be lodged by 20 July 2009. A public hearing will then be held later in July. The Committee prefers to receive submissions electronically as an attached document – email: community.affairs.sen@aph.gov.au – otherwise by fax (02 6277 5829).

Notes from the Victoria stakeholders forum, 7 July

Victorian Forum on Bill B The National Registration and Accreditation Scheme on Tuesday 7th July 2009.

A powerpoint presentation prepared by the Health Department, and presented at the forum is available. Unfortunately this blog program does not enable posting to the site, but if you wish to see the presentation, please contact joy@aitex.com.au

Deadline for submissions July 17th - this is an opportunity for anyone to respond to the exposure draft of 'Bill B'

Clare Lane and Jennie Teskey noted the following points:

Mandatory Reporting: a new requirement to report any professional who is thought to be placing the public at risk of substantial harm, including through a departure from accepted professional standards.

Criminal history and identity checks
Public interest accessor to be appointed, who reviews findings of the Board.
Student registration from 2011
Registration categories -
General
Specialist
Provisional
Limited ( teaching or research)
Non-practising
Student- may not need to be registered in 1st year if no clinical placements.
If a person is now registered, you will be automatically registered with new board. Individuals who are not covered by professional indemnity insurance - ie MiPPs - will be registered as 'non-practising'

Further notes:
Maternity Coalition was represented by Janie Nottingham and Faye Kricak
Homebirth Australia was represented by Donna Sheppard-Wright and Joy Johnston

OVERVIEW
At several points in the forum we were reminded that regulation of health professionals is to protect the public. Yet our arguments that the public were being put at greater risk of harm by not having a midwife at home births seemed to fall on deaf ears.

No statement was made about recording the questions asked. It appeared that the forum was merely an exercise in public exposure – that directions are already set in all but minor matters. It would seem that any significant issues will need to be re-presented in submissions and in further lobbying.

Questions about independent midwifery and homebirth with a private midwife were asked by various stakeholders present. However after a very dismissive response from the Health Minister, Daniel Andrews; not responding to Joy’s question regarding the government’s heavy handed attempt to regulate and redefine midwifery, any further questions about the matter were met with an audible sigh from people in the audience. The audience was clearly sick of hearing about the homebirth questions.

The Minister used the opportunity to ‘announce’ publicly funded homebirth in Victoria in the ‘near’ future (no date given).


The points made by Minister Andrews and other presenters were
• The only thing that the Vic government will support is community birthing through a hospital setting

• The minister clearly stated that the government does not want to support the indemnity insurance for ‘a small pocket of women and midwives’, when there are what he said are ‘better ways to spend the public dollar across the whole health system’ (as he waved his arm across the room at all professionals). He appears to be dead set against independent midwifery, and nothing we said or didn’t say yesterday has changed a thing.

• It was pointed out to the Minister that the restriction of the midwife’s scope of practice, excluding homebirth, would impact on the definition of the midwife. This would have a flow on effect on education of midwives.

• The Minister quickly defended his position and passed the buck from state to federal when it came to the issue of professional indemnity insurance.

• The claim was made at the forum that “we have listened to and acted on your feedback in preparing the exposure draft Bill B” – yet the responses we received to any questions about private midwifery practice led us to believe that there is no such intention.

• The chair of the meeting was asked in the lunch break to advise on how we can progress the issue of independent midwives as a key issue in the second session. She responded that we just had to accept the way it was, and that we had had enough airing of our issues in the first session.

• The ANF (Aust Nursing Federation) wanted distinction between who holds responsibility to obtain PII: the registered professional or the employer. ANF pointed out that nurses working in private clinics may not have coverage under their employment. The comment was made that employers check a future employees’ registration and asked how will one nurse hold insurance between jobs to satisfy the registration requirements? The reply was they will need to have it written into their contracts.

• Any health professional who is not insured will be ‘non-practising’ under the act, and it will be unlawful for that person to practise their profession.

• There was no comment made by the ACM on Victorian midwives situation.

RECOMMENDATION TO FEDERAL AND STATE HEALTH MINISTERS:
We recommend that midwives practising the full scope of midwifery practice, including homebirth, be provided with indemnity insurance under the new Act. Furthermore, we urge the Minister to implement transitional arrangements to ensure that all women who book privately with midwives for planned homebirth after 1 July 2010 are able to continue receiving primary care from their known midwife.

Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills

Senate Inquiry

As we have been pointing out on this blog and elsewhere, the exclusion of homebirth from the government's current group of health practitoner reforms has potentially disastrous consequences for the public, restricting women's choice without any valid reason, and exposing some mothers and babies to the dreadful choice of proceeding to give birth at home without a midwife in attendance. Furthermore, midwives are being deprived of our ability to earn a living.

We need ALL midwives, consumers, and members of the public to sincerely plead that the Senate of the Parliament of Australia use it's power to force amendment of the relevant Bills before the House to enable midwives to provide private services to women in their communities, including homebirth.


Note:
Submissions Close 20 July.
A one page letter stating why you believe women should be able to employ a midwife privately for planned homebirth is enough. Please click on the link above for more information about the process of making submissions to a Senate Inquiry.

Victoria's private midwives

Photo: Midwives met in Camberwell 02 July 2009.

The midwives in this picture represent many years of dedicated professional commitment. Each year we provide expert midwifery services to over 300 women planning homebirth in Victoria, and many others who employ us to accompany them to hospital for birth and continuing on with postnatal care. We, and others, will lose our ability to practise our chosen profession UNLESS the draft legislation is amended.

Some of the women in this picture have recently graduated from the Bachelor of Midwifery university courses. They undertook this study with the purpose of being able to work with women in a primary maternity care model that promotes health. These midwives face the loss of the main practice option to which they have aspired for so long.

Some of the midwives in this picture have been working in their communities providing holistic one-to-one midwifery care for the past decade or more. Women for whom they have attended births - sometimes four or more in the same family - love them for their gentle and generous personal and professional approach. Their families know that these midwives are always ready for a call to attend a labouring woman; that they are constantly acting in a way that enables them to be 'with woman' when the time comes. Their families also rely on them for financial security.

The Report of the Maternity Services Review, and subsequent statements by politicians and obstetricians have made the point that homebirth, and independent midwifery care, is chosen by a very small percentage of Australian birthing women. That's true. The barriers to this option at present are professional, social, and financial. The commentators have gone on, pretty well unchallenged, to insinuate that because the numbers are small they are unimportant! What other minority group in our society can expect such systematic exclusion?


Let's imagine that for some reason, it was decided that self employed (ie independent) GPs (general practitioner doctors) were no longer welcome in our communities. Let's imagine that a powerful lobby group was able to convince the health minister that all primary medical care needed to be provided in *collaborative* services managed by hospitals, with layer upon layer of supervision and oversight. Let's imagine that the local doctors who had been working autonomously in their commuities for decades, seeing people who knew and trusted them, were told they had to be employed in the hospital GP super clinics and hospital emergency departments.


That's what self employed midwives face.

We cannot accept the inequitable treatment that is being dealt to us. No other profession is facing extinction due to unfair legislation that will restrict midwives to working as obsteric assistants in hospitals.

Song to Nicola Roxon

Song to Nicola Roxon
This is my body, my baby, my safety
How dare you tell us that we have no choice.