What you need to do if you want to be a Private Practice Midwife in WA

Western Australia is unique in many ways, but particularly in the area of Midwifery, it is the only State in Australia where you have to declare your intention to practice midwifery as a private practitioner to the Health Dept. In principle I think it is important for the regulatory body to know who is practicing independently, however I think rules pertaining to this should be National, not state by state. However despite my personal views it remains that for WA you need to register your intention to practice privately (independently).Therefore it is important to take several steps:

1. Ensure you are eligible to practice midwifery
2. Be a registered midwife (NMBA - AHPRA)
3. Review recency of practice standards
4. There are no rules as to how long after registration that you can practice privately(exemption until July 2013)
5. Review Health Act Regulations 1914 Midwives Notification
6. Lodge the form to the Health Dept (your intention to practice) Notification
7. Secure Insurance (VERO or MIGA) all private practice midwives (independent) must have insurance
8. Review guidelines for insurance (NMBA - AHPRA)

Medicare for Midwives: for this you need to be an Eligible midwife (private/independent)

An eligible midwife has completed three years midwifery covering antenatal, intrapartum and postnatal care.

1. Complete Midwifery Practice Review (or equivalent) (ACM)

2. Review the application form for addition of notation as an eligible midwife
3. Currently registered as a midwife, with no restrictions

4. Current competence to provide pregnancy, labour, birth and postnatal care to women and their infants.

5. Midwifery experience that is equivalent to three years full time post initial registration as a midwife.

6. Formal undertaking to complete within 18mths - course for prescribing (course has to be approved by the Board)
7. 20 additional hours per year of continuing professional development relating to the continuum of midwifery care.

That's it, not much to do.....but please remember to register with the Health Dept your intention to practice privately. Also remember there is currently no insurance for Homebirth.
We need more eligible midwives, so please consider taking up the challenge, and offering women continuity of midwifery practice.

Would you throw out the baby with the bath water?

Currently midwives particularly homebirth private practice midwives are up in arms (and rightly so) about the recent Determination where Midwives are to be virtually signed of by doctors. That is as a privately practicing midwife (independent) you need to collaborate with an Obstetrician or GP obstetrician before being able to claim a Medicare rebate for the midwifery services provided. I might add that there is nothing in the Determination to make doctors collaborate with midwives or any benefit for doctors to collaborate.... so I am not sure why they would even consider it as we (midwives) would be competition for them in terms of financial remuneration therefore less money in their pockets..... emm not sure this will work?

If you are a midwife this seems a sort of sellout, Medicare for collaboration; However the woman is able to recoup some funds with this system therefore allowing more women this option of care....that is continuity of midwifery care and also midwifery led care;

Now as I see it there are two schools of thought......

1: If the government does not change the wording of the current determination; you go all out and say no to collaboration as it stands therefore we lose the right to a Medicare rebate and the legislation falls over; and we maintain the status quo as in the past which is no funding or rebates for women choosing private practice midwifery led care.... and it does not go before Parliament again for three years.... and if the government changes we may never have this opportunity for a long long time.... we will still have insurance requirements and regulations, that will not change.

or

2: we say yes to the collaboration as it stands, work to make it a viable option and see how and if it would work and if it does not work we then collate the evidence and go back to the politicians to lobby for changes to the determination knowing it does not work, rather than speculating that it does not work....therefore whilst we are battling for change women are able to claim a Medicare rebate for midwifery services? and Midwives are recognised for the profession that it is... which should have a medicare provider number.....and be recognised as autonomous clinicians.

Once the system (Medicare) whether it is effective now or not would be beneficial as we can work on changes....but if we never get it in place it will be years before we get back to this position and all our work up to this point would be for nothing as would of achieved nothing and the status quo remains.

What would you do in this situation?

Eligible Midwife Australia.....this is what it looks like

The Nursing and Midwifery Board of Australia has submitted to the Ministerial Council for approval: the Registration Standard for Eligible Midwife and Registration for Endorsement for Scheduled Medicines for Eligible Midwives.

What does this mean for the average midwife in Australia?
Requirements
To be entitled to be identified as an eligible midwife, a midwife must be able to demonstrate, at a minimum, all the following:

Current general registration as a midwife in Australia with no restrictions on practice;

Midwifery experience that constitutes the equivalent of 3 years full time post initial registration as a midwife;

Current competence to provide pregnancy, labour, birth and post natal care to women and their infants;

Successful completion of an approved professional practice review program for midwives working across the continuum of midwifery care;

20 additional hours per year of continuing professional development relating to the continuum of midwifery care;

Formal undertaking to complete within 18 months of recognition as an eligible midwife; or the successful completion of:

an accredited and approved program of study determined by the Board to develop midwives’ knowledge and skills in prescribing, or

a program that is substantially equivalent to such an approved program of study, as determined by the Board.

My understanding of the above is that you can be deemed an eligible midwife and give the undertaking that you will complete within 18 months further study for prescribing and diagnostics.

Now we have to wait for the realise of the courses that we are to do...those from WA who have already completed the Eligible Midwife program which was four units...should get some RPL (recognition for prior learning).....
Until these units are established it seems that midwives are required yet again to jump through hoops to give continuity of care.....

the bottom line is that you will have to have three years experience across the continuum of midwifery before you can become an eligible midwife..... complete your Midwifery Practice Review and do further study.....oh and don't forget you need to be insured.....
We are the midwives paving the way for the future.... don't give up....lets beat the bastards and prove this can be done.....

Mother of all rallies:

As you may be aware if you have been reading my blog that on Monday in Canberra was the Homebirth rally.
I was excited to participate by having a virtual placard present, which I think is a fantastic idea. It was good to see the sea of virtual placards in attendance of the people who could not physically get there.


Women, babies, families and Midwives from all over Australia attended the rally to show support for Homebirth – the choice for women to have a homebirth, as from 2010 due to National Registration and legislation independent midwives would not be allowed to register to practice as a midwife if they did not have indemnity insurance.



What was exceptionally disappointing was there was very little media coverage about the rally. I rushed home after work to watch the news and subsequent current affairs programs and no one reported on the rally, not one channel – how unfair is that!
This is big news, over 2000 women, babies and families attended to show how they felt and no one picked up the story, my question is why?
This story made page 16 in the West Australian on Tuesday, bottom right hand corner, that’s just not good enough, who is listening to our voices?

Is it that we are women / midwives and the story is not big enough, do we not matter?

I do find it interesting that when the AMA has anything to say or protest about any issue it is always reported in the news, why is that?
What do you think?

The photos were supplied by a colleague midwife who attended the rally.

If you wish to read about what the rally was like from someone who attended visit Lisa Barrett's blog - rally thoughts!

watch this space!