This site is maintained for Midwives in Private Practice (MiPP), a collective of independent midwives in Victoria. We are committed to the essence of midwifery, being 'with woman' - each woman and her midwife preparing to welcome the child she bears, working in harmony with and protecting intuitive natural processes in birth and nurture of the newborn and the establishment of loving, resilient families.
Saturday, August 18, 2012
An update on midwife prescribing
Midwives who have achieved eligibility for Medicare (MBS) under the Commonwealth Government's National Maternity Service Plan (2010) are also preparing to extend our practices to include prescribing, and participation in the Pharmaceutical Benefits Scheme (PBS). Midwives with PBS authorisation will be able to prescribe, supply, and administer scheduled medicines.
Historically, midwives attending homebirth have obtained the few medicines we need in private midwifery practice through a doctor's prescription. The midwife has administered these drugs without a legislated process. Oxytocics for the management of post partum haemorrhage by intramuscular injection have been prescribed by doctors for women in our care, and purchased (in boxes of 5 ampoules) from local pharmacies. The midwife assesses the woman's condition, and administers the drug on her/his own authority. The management of the third stage pf labour is basic to midwifery, and it is in the public interest that all midwives maintain their competency in the use of oxytocics: that this is not restricted to those who have PBS authorisation.
A number of Victorian midwives are enrolled in the 6-month Pharmacology course at Flinders University in Adelaide, which is the only such accredited course for midwives seeking PBS authorisation. We know of a couple of midwives who have completed courses in pharmacology which have been accepted by the regulatory authority (AHPRA) as equivalent.
Each state and territory have already either undertaken, or are in the process of making,
the necessary legislative changes to authorise registered midwives to
prescribe under the PBS.
The Victorian Health Department has appointed the 3CentresCollaboration to consult with stakeholder groups, and to prepare a draft list of Schedule 2, 3, 4 and 8 medicines for prescribing by
midwives in Victoria. The work has advanced to the final checking of the list before it is approved in the law. The stakeholder groups
and experts who have been invited to review the list include relevant midwifery
and obstetric colleges, unions and professional organisations, employers of
midwives, consumer groups with a remit or interest in midwifery, maternity
services or associated services as well education providers (ie midwifery
pharmacology course providers).
The scope of prescribing is limited to
medicines appropriate for midwifery practice across pregnancy, labour, birth
and post natal care (including neonates up to six weeks). Midwives who will use their PBS endorsement include those providing private antenatal and postnatal
care in a variety of settings and intrapartum care as a private midwifery
provider to a private client either at home, or (when midwives are able to have clinical privileges/visiting access) within a health service.
[MiPP has submitted a response to the draft documents.] Your comments are welcome.