A Festschrift to celebrate the careers of two remarkable women:

I was privileged today to find myself sitting amongst many wonderful people and some great academics, I heard many wonderful stories of two amazing women who have had diverse and awe-inspiring careers which has had tremendous impact on the midwifery profession and will do for many years to come, Pat Brodie & Nicky Leap.



Until today I did not know what a “Festchrift” was, I meant to look it up on the internet….but just did not get round to it…. So was relieved today when I heard lots of people had no idea what it was…..and that it actually means “a living book of your life” a celebration of your career by others on the occasion of retirement, what a fantastic idea, just brilliant….. Someone likened it to being at your own funeral, except you are there to enjoy it….. but then Pat said it would be a very long funeral” ….. to me it really is a bit like “this is your life”.



There was opportunity for great networking….. Too many wonderful people to name them all …. Besides you all know who you all are…great to see you and have a chat…. The energy and inspiration goes a long way to maintaining your enthusiasm for when you get home… and need to carry on the task of change and ensuring women have choice and midwifery care…….



For me it was an inspirational day, the room was filled with liveliness….. my soul was rejoicing at the many possibilities for midwifery…..if only we had this sort of leadership everywhere in Australia….some places are truly isolated and continue to have an uphill battle…..we need to spread the talent….

Key take home messages that resonated for me ……

“Square peg in around hole” - midwives
“The less you do the more you give” – care in labour
“Every woman needs a midwife and sometimes a doctor too” - collaboration
“Community based continuity of care for all risk categories of women” – private practice
“The key is good collaboration”
“Morbidity of women during childbirth is only going to increase due to repeat caesarean sections and the obesity crisis…..” – Obstetrician
“Midwives are essential for primary care”
“Address the equalities of women and birth”
"From little things big things grow - Group practice

A truely wonderful time in Sydney..... the only downside was that I didn't stay an extra day or two do some shopping.....not that I have money for shopping...lol

Homebirths in the news again....

It is interesting that the debate is always around homebirth...is it safe or not.... however should we ban hospital births because babies die there as well. The language used "doctors divided" "the Health Dept" is allowing homebirth to continue... where is the choice factor here for women.. in fact where is the discussion with the women... in what other form of health treatment do you get autonomy so blatantly ignored as in this one...if someone refuses treatment the doctors accept this ...why is it so different in this instance.... Women have the right to choose where and how to birth....a well informed woman will make the right decision for herself and her baby....no where do I see any of these considerations here.

See the full story on 6 minutes Doctors divided over homebirth reports
We all know that statistics can be manipulated.... and the figures don't break down the women who choose to birth at home when they know their baby is going to die through an abnormality.

I would also like to know if BBA (Born before Arrival not planned homebirth) and en route births are registered as a hospital or homebirth.... also we know that statistics can be manipulated to which ever outcome you want....the figures also do not separate the women who choose to have a homebirth whose baby has an abnormality:

The other group of women that are missing from the report are the ones that Freebirth.... this is an unknown entity...we know it happens and these figures would alter the homebirth outcomes.... so really we still don't have a good indication as to the statistical value of the current outcomes.

The more the medical profession demand that women birth where they want them to the more the divide will grow…. It is time to listen to what women want…. The choice to have information and make and informed choice whether it is one the medical profession agrees with or not…... It is called autonomy. Dome doctors are openly hostile about homebirth. It is about communication, trust, building a therapeutic relationship, not based on fear, it is about being flexible and learning new ways of doing and communicating with women about birthing options.

The one thing that’s a reality is that women are being bullied and made to feel guilty, for choosing a homebirth. Their autonomy is being eroded and paternalism reigns supreme. It is time to change this……its about informed choice and autonomy.

Medicare and the Midwife

The journey to obtaining Medicare Provider number has been an interesting one..... Now to learn all the things I need to know about what and how I can claim......
The Medicare provider number is a unique number issued by Medicare Australia to registered health professionals. They are also used to identify health professionals. As a health professional you need a provider number for each location you work..... Therefore I have two... one for the office and my home is the other one.
Currently a midwife can use the provider number to refer to a specialist or for pathology and diagnostic imaging, once we have done the required course in pharmacology then we will be able to also prescribe......
A provider number does not necessarily mean you can attract Medicare benefits for the services you provide.
Before a health professional can attract a Medicare benefit, they must satisfy legislative requirements set out in the Health Insurance Act 1973 which for midwives is the Determination – see Midwife Reform Legislation Fact Sheet.
Medicare has a great online service which makes it easier for you to do business with Medicare Australia; It will make claiming and downloading forms much easier.....also online e-learning, I just completed a couple of e-learning packages.. can't wait for the prescribing course.... one would think that this would of been in place already.
I think it is great that women will be able to claim for midwifery services.... it is long overdue....

The question is do you use a partograph or not?

The partograph or partogram graphically represents key events in labor and provides an early warning system for the health professional caring for the woman. Until recently I had not given this much thought, I just accepted as part of my practice. I would use a partograph as part of my normal care in labour. I do notice when I go to different hospitals how they all vary slightly. Some are just cumbersome, some not practical and some just down right difficult to use......... and as for that action line....that is a different question all together... I would happily use a partograph without the action line...because part of my normal practice is to know that if the woman is at 4cm and contracting well (3-4:10) then her cervix is dilating and I would make a mental note that in 6 hours I would expect to being seeing signs of being fully dilated.

I understand possibly the need for a partogram in the hospital setting when you have several people looking at the notes; therefore there needs to be a quick review process. However in a home setting you are the only person as well as your partner midwife looking at the notes...so I question the value of using a partogram:

As I was doing a search on the web looking for a partograph template, I found lots of literature supporting the use of the partograph and the action line in preventing or recognising obstructed labour. In fact The World Health Organization partographs are the best known partographs in low resource settings. Some people argue the partograph is essential for good decision making.....and therefore is considered best practice...

A midwife is legally bound to document to clearly / comprehensively all our care, recognise / interpret /act / inform on abnormalities found in a timely fashion however does this mean she/he has to use a partogram to do this?

I am thinking that it is not necessary to use a partogram in the home setting if your documentation clearly tells the story.

What do you think?

can you write your notes in a fashion that does not need a visual expression of what is occurring? and does it make a difference using a partogram?

please leave me a comment on what you think?

Insurance for Midwives:

Now that I have a Medicare Provider number & eligibility it's time to consider my insurance; the options that midwives have are:
A government supported insurance through MIGA (The Medical Insurance Group) or Mediprotect insurance;

The question you have to ask is which insurance do you choose? here is all the information: an important factor to consider is which company offers run-off-cover:

Read MIGA information Booklet:
Frequently asked questions:
Payment options:
Risk Managment workshops:
Maternity Care Plans & Collaboration
Product disclosure Statement:Application form:


Mediprotect - Vero - wording of policy document:
Application form:

As you can see from the summary of information available.. there is more information provided by MIGA than Mediprotect:

The most important factor for me is, I need intrapartum cover when birthing in a hospital as a private practice midwife and run off cover; therefore my choice of insurance will be governed by this; I have therefore applied with MIGA and will see how much my costs will be, although I have a good idea of what it will be.......

I have also sort guidance from my accountant and lawyer.....so that I am fully aware of my requirements.....it is exciting times....

Writing My Memoir Journey:

Ian and I have come down to Margaret River for a well earned break just for a few days; as usual we spent some time in the Margaret River bookshop...and I spotted this book “write your memoir – the soul work for telling your story” by Dr Allan G Hunter....what attracted me to this particular book is that it refers to your writing as your soul work, that resonated with me, because I think that when you write your life story you have to also be thinking at a deeper level and this may also bring about change...so I had to have it...my wonderful husband Ian bought it for me.


Ian is such a patient man, he supports all that I do, he must think there she goes again...another project started. In his wisdom, he said ok, this is a great place for you to start writing, and he is correct it is tranquil, nature surrounds, the birds, butterflies and flies for company and the occasional truck or car that flies along the road, just to remind you that life goes on. I start to type away on my computer under the grand Oak tree that has its own stories to tell, I can at least say the memoir has begun.

I have wanted to write my story for many years it is something I want to do for myself and I did begin several years ago compiling a timeline of events to keep me on track, I will have to put it together with this work and keep writing. This off course is a long term goal, so I will chip away at it slowly. We have decided that it would be good to book a regular yearly holiday to Basildene Manor to keep the project going.... and Ian well he is sitting beside me listening to his ipod story..... enjoying the same wonderful peace and quiet.....


Busselton Jetty:

Medicare Provider Number:

At last I have my Medicare Provider Number.... yeah...First eligibility,(see blog how to apply for eligibility) then Medicare Number and Insurance... all set to go.... website, business cards, flyers, something is missing.... yes the "women" wanting continuity of midwifery care.... I have booked my first woman.... and so life goes on... poor Ian is wondering how we are going to pay for the insurance......???

Applying for a Medicare Provider Number is relatively easy, however I have to say for WA applications are not processed here they are sent to Canberra so might take a few extra days for this reason..... interestingly you have to provide a signed form for every address that you will be working from and you will receive a provider number for each location.... for example if I was to work out of two officers, I would give each address and for a home visit I will use my home address as the office... therefore potentially you could have several address and provider numbers...

I have sent my application for my MIGA insurance today... and hopefully that will take a week or so to sort out and then I am set to go.....this is an interesting journey.... a brave new world....