Homebirth rally! Canberra September 7th 2009

In my last blog, I forgot to add the Homebirth website (Homebirth Australia) for the Rally in Canberra when is it:

WHEN: Sept 7th @ 11.30am
WHERE: outside Parliament House, Canberra

You can register your commitment to attend on face book
http://www.facebook.com/profile.php?id=1641140582&v=feed&story_fbid=9419...


Unfortunately I can not attend, however you can be part of this rally by being a Virtual Rallier what a great idea!

Be a ‘virtual rallier’. For every person who is unable to attend we are organising a virtual rally in conjunction with our ‘live’ rally. Pledge $25, send us a head shot, your name and location and 25 words or less that you want the politicians to hear. We will mount your head shot onto a cardboard pregnant belly with your message, which will be attached to bamboo and will be placed in the ground outside Parliament House. Your pledge will go towards the cost of your cut and our continuing campaign.

see you all at the Homebirth rally, virtual or real.

The Homebirth debate!

I'm a homebirth baby and I am not happy if my mummy does not have choice about my birth!



There is much debate around Australia amongst midwives and women, what’s it about? Homebirth! Now what brings about this discussion, yes it's National Registration: which means by 2010 all midwives in order to be registered with the Nurses and Midwives Board need to have indemnity insurance to conduct a homebirth.
It is interesting to note that within the profession of Midwifery there are many differing views on this subject. Historically nursing has been fractured and governed by the medical model; therefore this has carried forward into midwifery. You have midwives that consider themselves nurses as well as midwives who still follow a medical model. Then you have the midwives who consider themselves purely as a midwife. I do believe that the Bachelor of Midwifery will help change this perception within Australia. Try as it may midwifery battles with the medical model regarding health issues. We as a Nation hold a very medical model mentality; this is another reason why so many women choose obstetricians as opposed to midwives. However now with the proposed changes being made by the government which allows for midwives to have a Medicare provider number this is a huge step in the right direction. The introduction of the Nurses and Midwives Act 2006, further confirms the separating of the two professions, Nursing and Midwifery. Of course with every carrot there is a price to pay and in this case it is that the government will not provide indemnity insurance for private practice midwives (independent).

Midwives are highly skilled autonomous practitioners; however they may work in different ways. There are those who practice midwifery in every aspect, which is working with the women, antenatal, intrapartum and postnatal. You have midwives that only work in one area, so they choose either labour/birth suite or a ward area and only specialise in that area however they do know all aspects of midwifery care. When working within a hospital system (medical model) midwives can practice within a team model which is midwifery led care, referring to the medical model when a problem arises. Also midwives work providing high risk care in consultation with the obstetrician. Midwives always endeavour to keep labour as normal as possible for the woman. Even though midwives work within a hospital system there is also low risk normal labours and births with midwifery led care and without intervention.

As a midwife you can work in a birth centre and within the Community Midwifery Program which provides midwifery led care for low risk women. The only provision for Homebirth is in the community midwifery program. These midwives will be provided with indemnity insurance because they are attached to a health service. All other care is covered by Medicare or private health insurance.

Private Practice midwives (independent midwives) provide a homebirth service in which they will charge the women a fee approximately $4500.00. This fee will vary between midwives and is a reasonable fee as opposed to our medical doctors who charge much more, however the woman can claim this from her private insurance or Medicare.
Private practice midwives provide all facets of midwifery care and would refer to an obstetrician if there was a medical problem. The ideal is for private practice midwives to look after normal healthy women without any medical problems, therefore considered low risk. The Australian College of Midwives (ACM) provides National guidelines for midwives to assist them in which conditions are considered high risk. Remembering the definition of a midwife is to deal with the normal, anything abnormal is referred to an obstetrician for advice.
This is where some midwives differ in opinion; there are some who believe that all births should be in a hospital setting and those who believe anything goes. The most important point to remember is that it is the woman's choice as to where she wants to birth.
The conflict arises when a woman chooses to birth outside what is considered the ‘normal’ which is stated in the guidelines (AMC). A private practice midwife can choose to accept a woman even though she may be considered high risk. As long as the woman is well informed and has consulted an obstetrician for a medical opinion. The midwife needs to clearly document her discussion, care and plan of action; it is after all the woman's choice. However, the woman and midwife must accept the consequences of this action. The midwife has to remember to continue to work within his/her scope of practice as legislated by law. Fringe or radical midwives, whatever term you would like to call these midwives might accept any woman with what is considered a high risk pregnancy and this is where the problem lies. This is not an easy choice, because there are women that would go it alone rather than go to hospital. The question is who protects these midwives who choose to work with high risk women who are well informed and do not want medical intervention? Because the choice is that these women will go it alone.
I am pleased to work as a private practice midwife however I would not work outside the realm of 'normal' 'low risk' because that is what I consider the role of a midwife to be, anything that is abnormal is not considered for midwifery care within the home environment. There are midwives and women that would consider me to be conservative and not being ‘with woman’ because I choose only to take low risk women. I am happy to facilitate and care for a high risk woman within the boundaries of a hospital making her experience as much normal as possible.
I am sure that some women do not really understand the scope of practice of a midwife and that we are governed by legislation as to how we can work (Nurses & Midwives Act 2006). The big question is if the government does not provide indemnity insurance for private practice midwives, homebirths will no longer be allowed. This will surely push homebirth underground and more women will free-birth. This in fact will take us back to the dark ages, more women and babies will die. This is the last thing the government and society wants.
Change is slow - and maybe we need to take a step back to enable two steps forward. Medicare provider numbers are a step in the right direction; this will increase the visibility of the midwife and allow women to claim for the care provided by the midwife. Hospitals will give visiting rights to private practice midwives to birth women in the hospital under the care of the midwife and allow these women to go home a few hours later, continuing the care at home. Eventually the powers to be will see the value of birthing at home? 'It’s a nice dream'
I personally want to see women’s choice for homebirth being an option - by 2010 this may not be an option.


please contact your local politician and have your say!

Have your say! submissions due now!

The aim of this blog is to disseminate this information to as many people as possible and for you to read it and make comment. This is legislation that is going to affect your clinical practice, choices for women and the way in which registration and complaints will be dealt with. So please if you have never been proactive now is the time to start. It is time for public consultation and the submissions close 17 July 2009.

This is how we have a voice, by making submissions. We need to find a way to save independent midwifery, there are some very good practitioners out there that want to work in collaboration with our medical colleagues.

The National Registration and Accreditation Scheme for the Health Professionals:
The Health Practitioner Regulation (Administrative Arrangements) National Law Bill 2008 received Royal Assent on 25 November 2008, giving effect to the new national law.

The council of Australian Governments (COAG) in March 2008 signed an agreement to start the ball rolling creating a single national registration and accreditation system for health professionals. To start with, there are 10 health professions; chiropractors, dentists (including dental hygienists, dental prosthetists and dental therapists); medical practitioners, nurses and midwives, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, and psychologists.

Now it is time for you to review the next phase of this process The Health Practitioner Regulation National Law 2009 (Bill B)
Exposure draft of Bill B released for consultation - submissions close 17 July 2009

The bodies in the new scheme: Ministerial Council, Advisory Council, National boards, State/Territory boards (committees of national boards), Accreditation authorities, and Australian Health Practitioner Regulation Agency (AHPRA).

What does this mean to you as a Midwife – in a nutshell this is what is important:

Independent accreditation will be independent of governments – the final decision on whether the accreditation standards, courses and training programs are approved for the purposes of registration is the responsibility of the national board.

National accreditation standard which exist prior to the commencement of the new scheme are to continue until they are replaced by new standards.

Existing external accrediting bodies such as the Australian Medical Council are expected to continue.

CHANGES TO THE REGISTER;
- There will be both general and specialist registers available for the professions including medical and dentistry

- Separate register for nurses and midwives

OTHER IMPROVEMENTS TO QUALITY AND SAFETY OF HEALTHS SERVICES;
- Mandatory reporting of registrants – who is placing the public at risk of harm
- Reportable conduct

- Criminal history and identity checks

- Simplified complaints system

- Students registrations – students will now have to register from 2011

- PRACTITIONERS WILL BE REQUIRED TO HAVE SUITABLE PROFESSIONAL INDEMNITY INSURANCE during the period of their registration. (see clauses 69, 73, 75, 80, 83, 101 and 125)

73 Professional indemnity insurance arrangements
(1) Professional indemnity insurance arrangements in force in relation to
individual are appropriate for the purposes of registering the individual
in a health profession only if:
(a) the arrangements will not expire before the end of the
individual’s period of registration, and
(b) the National Board established for the health profession
considers the type and level of cover provided by the
arrangements are sufficient in the circumstances.
(2) A National Board may accept as evidence that there is, or will be, in
force in relation to an individual professional indemnity insurance
arrangements:
(a) written advice from an insurer or insurance broker that an insurer
has agreed to issue a professional indemnity insurance policy or
that the premium has been received and accepted by the insurer
for the issue of a professional indemnity insurance policy, or

These are some of the major changes, but for independent midwives the death nail is the requirement to have indemnity insurance with registration. See the above clauses within the Bill. The second most important issue is that of complaints. From my limited understanding at this early stage is the there will still be an office in each state – I will update you all on this section when I have finished reading it.

Please visit the http://www.nhwt.gov.au/natreg.asp site and make a submission:

go one just hit the hyperlink and have a read!

The Wedding

Finally the day arrived, after all the build up at last it was here. There was a storm warning for Thursday and Friday. The garden wedding was now going to be moved inside to the lounge room. It is funny how life works. Rob had his computer & computer desk in the lounge corner, it looked OK, to a man however, if you’re looking from a woman’s perspective it’s really not the place for a computer etc to be. But you know there are times you just have to be quiet, yes it’s me saying there are times you have to be quiet and eventually they see the light. The computer and accessories were moved to make more room so that the ceremony could be held inside. Thursday for Lorraine was spent pampering herself as you do the day before your wedding. Friday morning there was a storm warning the wind was howling, it was raining cats and dogs, as the saying goes. I did have faith that by the afternoon the weather would settle however was still concerned.



Now some of you who may be superstitious the sign of this weather would be disastrous, but for Lorraine and Rob, Mr & Mrs everything is ‘okay’ it was not a problem. Just out of interest I thought I would mention some of the traditional superstitious that I know of, not that I adhere to any of them and then we will see how Lorraine and Rob fair with them.

Wearing pearls means tears throughout the marriage. The bride and groom cut the first slice of cake together to ensure that they will conceive. The spouse that goes to sleep first on the wedding night is the first to die. If the bride cries on her wedding day it’s the last tears she will cry over her marriage. If the groom drops the wedding band, the marriage is doomed. The engagement and wedding rings are worn on the fourth finger of the left hand because it was once thought that a vein in that finger led directly to the heart.. It is lucky to marry on a day during the week that the groom was born, oddly enough Saturday was the unluckiest day for a wedding. The sun should be shining; rain means bad luck and tears. Wearing a garter is believed to bring good luck, and finally the first one of the couple to make a purchase after the wedding is said to be the dominant partner.



Now really that’s a load of old bollocks! Anybody knows that, but it is funny. How did the couple go, well Lorraine wore pearls, she did shed a tear or two, they did cut the cake together. Rob did not drop the ring, Lorraine wore a garter, the sun did shine, and it was a Friday. I’m not sure who went to sleep first if they did at all, after all it was the wedding night, and they haven’t been shopping yet. So my reckoning is they will live happily ever after, like the true romantic that I am.



There were approximately 30 – 40 people witnessing Lorraine and Rob taking their vows. Mostly family, Rob has three adult children and Lorraine two and of course a few friends. This was by no means a traditional wedding, it was simple, personal and elegant. Lorraine, her daughter and I got ready at the Hyatt, of course that meant starting with the obligatory champagne, nibbles and girly talk. Lorraine was calm, excited and very much in love looking forward to the ceremony. Rob was at home with his sons getting everything ready.



The plan was for Rob and Lorraine to meet and welcome the guests together before the wedding allowing them to mingle, drink and have nibbles to get to meet each other. We arrived at the house 15 minutes before the children were all to meet for the first time, um, not sure I would go with this plan, but it worked for them. Hey all got on well. Lorraine has 6 siblings and their partners, of whom only 4 could make it, and Rob has a sister and cousins of which some of them had met before the wedding. I did hear someone accuse Rob of being a “dark horse” um I wonder why that might be. Everyone mingled well, excitement was in the air, no one worried about the weather, there was no rain, however the wind was here to stay and we could not risk our hairdos to go outside.





We all moved into the lounge room, it was beautiful, they made a stunning couple, there was a glow in the air – Ian tenderly caressed my neck whilst we listened intently to the vows being made, I couldn't’t help but remember our wonderful wedding and the vows we made. Lorraine read a beautiful poem “the gift” which left a lump in your throat. The vows and rings were given and then there was ‘the kiss’ it was Mr & Mrs the deed was done, the signing was complete. It was now time to relax and enjoy, more drinking, eating and mingling. Photo’s galore, I was in my element, I love being behind the camera, catching the moment for prosperity. I think the digital camera was the best invention; you can just click till your heart is content and then delete what you don’t want, fantastic.



The sun is shining - no rain or wind - Mr & Mrs.............don't they look so happy!


The reception was at Indianas, exquisite – There was a lovely surprise for Lorraine when they arrived, some work friends were there to wish her well, meet the lucky man and see how beautiful she looked, it was great to see them, thank you ladies.



Ian and I sat with Lorraine’s family, her mother is delightful and her eldest sister was very gracious and her brother was charming it really was a tremendous evening. I spent time talking to everyone at the restaurant and taking pictures, I was the friendly columnist any excuse to talk and meet people. I really am an introvert at heart.



Ian and I had a lovely time we had fun reminiscing our own wedding, we chilled out and had a fantastic time. We had a late checkout and spent Saturday sleeping in till midday then the afternoon in Freo, it was superb, now it’s back to the rat race and it is still raining and cold.



The wedding is over, now the marriage begins, enjoy your honeymoon and a lifetime together. Wishing you both good health, love and happiness always.

Girls night out!

There’s nothing like a night out especially when you go out with a group of women. Now I say women, as opposed to girls, because girls denote young women or adolescent women not average age 50 year old women. However, it does sound good to say girl’s night out. We are out to celebrate Lorraine’s last girl’s night out as a single woman. Yes she is joining the ranks of happy married women.



There was much fun, chatting, catching up with friends that we have not socialised for a while with. The food at the Thai restaurant is always superb with ample to eat. Oh don’t forget the wine; bubbly always adds life to the conversation. There’s nothing better than to sit around sup some bubbly and share some funny stories about life, and do we have them, certainly do from babies to sex, oh did I say sex. You can’t have a girl’s night out without talking about sex, good, bad or indifferent.



I must say I was disappointed when it came to the discussion about how to prepare to the wedding night – there is the usual pre wedding, pamper session, facial, massage, nails, hair and trial makeup. That was all fine, however when it came to should Lorraine wax or not, have a Brazilian, high or normal wax, a trim and style perhaps a heart shaped surprise! To these suggestions came aghast of horror from my colleagues / friends, it just goes to show that age may play a part in this process. However I am in the same age group and am partial to a wax and to a heart shaped surprise! It adds zest to the relationship – after all, we are all midwives and there is nothing we haven’t encountered.



It is great to see Lorraine so happy and madly deeply in love, as the song goes, truly madly deeply – yes it warms the cockles of your heart. Rob is charming, they do seem well suited, after all he does love her apple and rhubarb pie. See there is some truth in the old saying "the way to a mans heart is through his stomach". I can't say what else he says she's good at, oh all right then, he says "my wife to be can crumb anything".
I loved my wedding day it was perfect and when I think of it, I smile that warm reassuring smile. There are times I think of Ian and just smile, it’s a wonderful feeling love, and it warms you from the inside and makes you feel brilliant. I am so fortunate. Thank you.

The trick is to maintain this kind of love, the truly, madly, deeply, in this busy world of ours. It is so easy to get caught up with work, life and children and put your relationship second; yes, on occasion I am guilty of this. Therefore we make the time to spend together to put ourselves first. I know that Lorraine and Rob will continue to have this truly madly deeply relationship and I wish them both the very best of everything. I am so looking forward to the wedding on Friday. It is just going to be fantastic.


Lorraine looking at her Rose bush 'Lucina' the midwife rose and her card with a fantastic gift voucher for David Jones, from all of us. "Happy Wedding"

Presenting to your peers!

Hoping the 'Dog Rose" strikes for my husband - his beloved Yorkshire Rose


I was asked last month to talk today about Scope of Practice and Career Pathways to some clinical development midwives, nurses and educators at my old hospital. My first thought was 'no'. However as usual you end up saying 'yes'. I normally don't worry about presentations but I was nervous about this one, the difference being that they are your peers. I feel particularly apprehensive in these situations, it is something I have to work on. Has anyone else experienced this feeling?

When you examine the career pathway for nurses and midwives, it can be limiting. However most importantly it is a continuous process of lifelong learning. As you progress up the stairway you can branch off into clincial specalist - education or non clincal fields, such as; project managers, research, or management areas - this then will lead to Director of Nursing. You will need to be considering masters and PhD by the time you reach the top.

The other issue is that sometimes it feels like you are teaching them to suck eggs, if you know that expression. What knowledge do you impart on people who know and teach the scope of practice? or guide others about career pathways.

I decided that I would set the scene with thinking about 'the self' being 'self aware' examining and processing how each individual approaches different life situations. Who are your role models, who do you aspire to be? for me this might be powerful women such as: Condoleezza Rice Catherine Hamlyn , Quentin Bryce and Fiona Stanley to name a few.

Also it is important to know what is it that you do in your spare time, what are your hobbies, how do you relax, wind down. This is all part and parcel of finding your career path because this all makes up who you are.
However most importantly you have to find out what is your passion, what is it that you like doing most, because once you find that out, you can then plan how you are going to achieve it.

A small step that every one can take is to set objectives or goals. This helps you when you are planning your future, 1 year, 3 year and 5 year plans. Some people found this daunting. If this is the case you need to take smaller steps, look three months ahead. Planning goals does not just apply to your work but your life as well. Set your holiday goals, when is your next overseas holiday, plan it and set it out. You will find once you set a goal it is easier to achieve, of course life can change and so do your plans, but get into the habit of setting goals.

I have always found it useful to set goals, short term and long term goals for both my work and personal life, it helps me achieve the things I want to in life.
If you don't set goals try it, see how well it works. Once you set the goal it is easier to plan how to achieve what ever it is you want.
Its all about taking little steps, when you look back you have reached the top of the stairway, and that's a tremendous feeling.

I am glad today is over, it all went well and according to plan, except once I start talking I can go off track and not stick to the game plan.

The take home message is set yourself a 12 month and 5 year plan, and watch it grow.

Yes luck with the Yorkshire Rose, lets hope they keep growing!

Time out for some fun! Shopping!

Wedding! what does the word conjure up? what is the first thing you think of when someone says the word WEDDING! it is a 'joining together' for me it is Love and commitment, then comes money, place, venue, guest list,rings, dress, sexy lingerie, jewelery, shoes, suits, ties, flowers, food, drink, and the list goes on.

When two mature people decide to take this leap of faith, love above all conquers all, I know this sounds corny, but when you think of all the compromising that is done, combining two homes into one, my lounge suite or yours, which books, CD's, orniments etc, it truly is a letting go of the ego - I remember it well, the two becoming one but still maintaining a sense of 'self' that is trick, that is the marriage.

It is about two people planning their wedding day, which is the first day of their marriage. The relationship and lives in marriage is more important and lasts a lifetime - or as long as it is meant too.



Now my gorgeous friend is getting married in four weeks, what a surprise..............it is so nice when love bites and everything goes well. When Lorraine asked me to go shopping with her for her bridal outfit, I was honoured and delighted, nothing like going shopping and spending someone else's money, within reason of course. Full of a cold, dosed up on medication, it was time to hit the shops. I was so excited, verbal diarrhoea, invitations, rings, dresses, colours, wine, hors deuv's, venue, place, girls night out, guest list, I wanted to know it all, oh so much to think about. Lorraine and Rob just laughed...........Oh something I forgot to say about the lovely couple they are both clutter free people, and yes you guessed it, I am Mrs Clutter, married to Mr Clutter but he is in denial.

We had such fun today, our aim was, a dress, shoes, and lingerie. Now that's a tall order for a day, but not for two expert shoppers who know a good thing when they see it. I would have liked to have bought the grooms tie while we were out, but that was overstepping the line....... respecting his wishes, just joking Rob!



The shopping expedition started in Nedlands at 11am, proceeded to Perth Murry St - time for a coffee in the mall then its off to Subiaco - Lorraine tried on several dresses, and finally decided on a beautiful, elegant, classical styled dress, that surpasses anything I would imagine, it looks perfect. You know when you put the dress on, this is the one! and this was the one! That's about all I can tell you until the day.................. we even got a swatch of the colour so that Rob could match his tie, thinking of you Rob!



The dress was bought,it was now time for the champagne cocktail, before we shop for the lingerie and shoes, which ever we see first. We were both intoxicated with excitement, it was all coming together. It was nice to sit and share a drink, laughing and telling stories of love and lust........ off course the two go hand in hand after all we have earned the right to enjoy the freedom of women, life is truly wonderful and sharing it with the beautiful people you love.

Shoes were next on the list, perfect, tried my hardest with the handbag but no joy - never mind you win some and you lose some. the lingerie was the hardest, we walked past what I thought was the perfect shop three times trying different places only to end up in the perfect shop, the one we walked past three times, but it was worth it, no compromising here, it looks sexy, fantastic is all I am going to say.



The day was done, all of the shopping done in 5 hours, home for a nice cup of tea, and rest our feet, we did consider Champagne but I had to drive home.



Addition: in clearing the clutter, Lorraine had more than one dogie bed, and offered it to Mrs Clutter who gladly accepted, Monty is eternally grateful for his new bed.

We had a superb time, we were like kids turned loose in a candy shop. We were both on the same wave, thanks for a wonderful day. I look forward to a wonderful wedding
day!

Cluttered closets mean a cluttered mind.
As you clean the closet, say to yourself,
"I am cleaning the closets of my mind".
The Universe loves symbolic gestures.
Louise L. Hay

All I have to say is our minds must be totally cluttered!!