Midwifery under the spotlight at obstetric malpractice conference

The 5th annual obstetric malpractice conference will be held in Melbourne, June 20 and 21 this year.

Key issues to be covered:

• Developments of the National Disability Insurance and Injury Scheme and National Injury Insurance Scheme and implications for obstetric practice
• The Coroner's perspective on inquests involving perinatal death
• Lessons learned from the midwifery indemnity model in New Zealand
• Practical and legal implications of the Open Disclosure Standard
• Practical legal measures for when a baby is born with Hypoxic Ischemic Encephalopathy or other unexpected birth outcome
• Managing the Risks inherent in women's choice in obstetric care
• Perinatal Review Process
• Medico-legal risks of female genital mutilation and female elective surgery
• Race-based pregnancy care. Is that good medicine?
• Implications of new genetic technologies on prenatal diagnosis
• Wrongful birth damages - the first detailed damages judgment
• FACILITATED PANEL DISCUSSION: Awful Lessons I have learned by being an expert witness
• PANEL DISCUSSION: Medico-legal risks and ethics of female genital mutilation

This list of topics includes several of considerable significance to midwives who practise privately.  However, there is one major hurdle for anyone who may be considering making a booking: the cost!  Even with earlybird discount, $1,700, added to the potential loss of income if a baby in the midwife's caseload needs to be born, and accommodation costs, is a LOT of money in midwifery-land.

The opening address on Day 2 is 'Lessons to be learned from the Home Birth Cases in Vic and SA' - speaker is the coroner Judge Ian Gray. It would seem to me that we need to have midwives who are practising privately in Victoria and South Australia to hear what is said and to respond if appropriate. 

Midwives who face disciplinary hearings or coronial investigations find ourselves, our actions, and our 'outcomes' thrust into the spotlight, within a legal and professional framework that may seem quite foreign to contemporary midwifery philosophies.  Midwifery notions of informed decision making and partnership and choice can be discarded as meaningless by legal experts who rely on guidelines rather than professional clinical decision making. Click here and here for recent examples.

I do not wish to suggest that midwives always get it right - there will always be a need for unbiased outside review of serious morbidity and mortality, or unprofessional conduct in professional health care.
  

Issues around a woman's right to decline treatments (usually medical) that are considered 'evidence based', or 'best practice' will be reviewed from obstetric, legal, and consumer perspectives.   The management of breech births is a good example, and two consumer presenters, Rhonda Tombros and Ann Catchlove, who are also lawyers, will discuss:

Breech birth: consumers, choice and consent

• Women with breech presenting babies near term often find themselves with limited birth options. Some change care-providers, hospitals or even travel interstate to access the opportunity to attempt a vaginal breech birth
• This presentation will explore issues around consumer choice and consent in breech birth with a focus on the legal and ethical issues that arise when women are given no option for birth other than planned caesarean section
• How can care-providers and hospitals facilitate care that is both safe and respects women's decision-making autonomy?

Both women come with a proven track record, in challenging obstetric dominance of women giving birth.  See Breech Birth Australia and New Zealand, and the breech fb group, and Maternity Coalition.

Midwives discussing this conference via the Eligible Midwives facebook group have called for recordings of the proceedings to be made available after the conference.  I will keep readers informed.


Post script:
Midwives may apply for financial assistance via Government Scholarships (administered through ACN http://www.acn.edu.au/sites/default/files/nahsss_continuing_professional_development.pdf).