Hitting a Brick Wall

The National Health (Collaborative arrangements for Midwives) Determination of 2010 (This instrument determines the collaborative arrangements with the kinds of medical practitioners that an eligible midwife must participate in when providing midwifery treatment in order to satisfy the definition of 'authorised midwife'.). This Determination is clearly not working and needs to be amended or rescinded.

Obstetricians benefit from Eligible Midwives not being able to practice. Is it fair and equitable that this group can monopolise the market? Should the role of a collaborator be given to a Health Service or an independent body rather than a ‘named obstetrician’?

I am an Eligible Midwife and have a Medicare provider number. The government introduced the Maternity Reforms in 2010. With these reforms came the Determination for Midwives 2010. At the time of the Determination the then Minister of Health Nicola Roxon acknowledged that there were issues with the AMA but encouraged us (Midwives) to try and make the determination work. We are almost at the 2 year mark and this determination is not working. There is a multitude of evidence to show that obstetricians do not want to collaborate with midwives.
Here are some comments from Obstetricians

‘ I will do the birth you can do the rest’
‘I will not collaborate, I am happy with the status quo’
‘we do not support homebirth regardless of the risk, therefore I will not collaborate’
’I am very comfortable with the situation as it stands and I am not interested in supporting your model of care’

It seems that there is a condition with an offer to collaborate, which means that as a midwife I cannot work to my full potential. On the other hand, there are some private midwives so frustrated with the current political system, they have rescinded their registration and are working as birth attendants. These birth attendants support and assist women’s birth choices and are not responsible to any regulatory authority and are not insured. I wonder is this the answer?

This piece of legislation is a bad law it needs to be changed urgently to allow the Eligible Midwife to work as they were intended. That is to give women more choice, more continuity of midwifery care and for women to claim a Medicare rebate for those services.
Call or email your local member of Parliament and have you say: Ask for your right to see a Midwife and claim your Medicare rebate:

Legal issues? Homebirth again!

The Medical Observer writes Homebirths GP's new legal dilemma.... "If your patient decides on a midwife-led home birth and asks for prescriptions, could you be legally liable if something goes wrong?"
sometimes I am still amazed at what the AMA will come up with next..... really it should be no surprise that this tactic would be used.....
"Midwives are able to legally administer Syntocinon but cannot prescribe it, until 1 November when changes to federal laws mean nurse practitioners will have limited access to the MBS and PBS."
Giving syntocinon has always been part of a Midwives role, this drug is not new to the profession....it is part of our job, however the drug is only used if there is postpartum hemorrhage.
Part of a midwives course is a detail pharmacological unit, which entails knowing about the drugs used within midwifery there use and contraindications of drugs..... the way this article reads is as if this is a new drug that midwives have no idea about.....midwives are trained professionals.

According to Homebirth Australia spokesperson Justine Caines, the group has had reports of women in the ACT, NSW, Queensland, Victoria and SA who have been refused scripts for Syntocinon, vitamin K and ultrasound referral by their GP.

She says there is a steady growth in home birth as more women become what she calls “refugees” from the hospital system, reluctant to return for another birthing experience of “substandard or unsafe care”.

Ms Caines condemns the decision to refuse women these scripts and believes GPs are being unnecessarily cautious.

“I think [GPs] have less to fear than when they normally prescribe, as in this case the woman is in the care of a registered midwife,” she says.
Indemnity insurers are not so confident. There are legal risks for GPs if they do choose to prescribe painkillers, vitamin K or Syntocinon to patients wanting a home birth, they say.
Cheryl McDonald, medico-legal manager at MIGA (which will handle the new Midwives Insurance Scheme) says GPs are quite within their rights to refuse to write scripts in the case of home births, where they have no control over the medical outcome.

This really makes a mockery of the Collaborative arrangements Determination 2010....and really begs the question, how well thought out was the collaborative arrangements....? and did the AMA plan this all along knowing that these arrangements would not be workable. I am all for good collaborative arrangements that are workable, fair and equitable, not power orientated.

As midwives we have to be as proactive as the AMA..... we need to be allowed to practice our profession just as they are......this is about monopoly, money and power.
We need to be considering "women's choice" fairness and equity and right to refuse....

ref pic: littlekanga-roo.blogspot.com