Friday, October 25, 2013

Midwife prescriber Part 2

A scheduled medicines’ endorsement identifies those midwives who are considered by the Board to be qualified to:
·        administer, obtain, possess, prescribe or supply specified schedule 2, 3, 4 and 8 medicines to the extent authorised under the relevant legislation that applies in the State or Territory in which they practise;
·        use those medicines appropriately for the management of women and infants during the pregnancy, birth and post natal periods; and
  apply to Medicare Australia for a Pharmaceutical Benefits Schedule prescriber number.  (NMBA 2011)

obtain ... possess ... prescribe ... supply ... administer 

Useful links are:
Medicare Australia's e-learning site: PBS for new Health Professionals
Pharmaceutical benefits scheme (PBS) for midwives
NMBA search for 'midwife prescriber formulary'
Victorian gazetted drugs - The list of Schedule 2, 3, 4 and 8 poisons approved by the Minister for Health for the purposes of Section 13(1)(bc) of the Act for registered midwives was published in Victoria Government Gazette No. S 410 Friday 30 November 2012.

It's easy to become confused or unsure when venturing into new territory, such as that of an endorsed 'midwife prescriber'.   Prescribing covers a cluster of activities, some of which every midwife is familiar with, and others which are new.  A restricted drug such as Syntocinon (synthetic oxytocin), and other oxytocics, have been used by midwives in home birth situations, for many years.  Although midwives have not had authority to prescribe, the usual process has been that a prescription has been written by a General Practitioner for a pregnant woman who is planning homebirth.  The midwife takes responsibility for decisions around the use of the medicine.

It seems that midwife prescribers are now able to tick all the boxes as far as the law is concerned.  This is good.  Noone wants to face a challenge when a medicine group as basic to midwifery, and as potentially life-saving for women, as oxytocics are concerned. The endorsed midwife prescribers are also able to manage other important drugs within our scope of practice: a significant extension of practice for most who have referred women to their GPs for anything from Maxolon for vomiting. to antibiotics for urinary tract infection, postnatal uterine infection, or mastitis.


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