Update on national registration and its effect on homebirth

For further information, contact Melissa Maimann at Essential Birth Consulting.

The design of the New National Registration and Accreditation Scheme has now been published.

I was initially optimistic since the report does not mention insurance being tied to registration. I thought that perhaps insurance would not be a requirement of registration. My professional body, ACMI, have informed me today that insurance may still be linked to registration.

There is also a new clause: “Mandatory reporting of registrants”. This clause states that:

“there will be a requirement that practitioners and employers … report a registrant who is placing the public at risk of harm.

… reportable conduct will include conduct that places the public at substantial risk of harm either through a physical or mental impairment … or a departure from accepted professional standards. … This requirement will deliver a greater level of protection to the Australian public.

Protection of the public is an important concern. However, we also have a situation where the AMA and RANZCOG are opposed to home birth and free-standing birth centres. We also have Guildelines for Consultation and Referral, set out by the College of Midwives. The effect of this may be to limit private home birth services. In essence what it could mean is that all moderate and high risk pregnancies and births will need to be consulted to, or even referred to, an obstetrician for management. The Obstetrician, belonging to the AMA and RANZCOG, would most likely advise against home birth. If the midwife and woman proceed with a home birth, under the mandatory reporting of registrants, the midwife can expect to be reported to the Board for placing the public at risk of harm. The midwife, at all times, must act within her scope of practice – primary care provider for normal pregnancy and birth – and must act according to professional guidelines. Undertaking a home birth that was advised against by a doctor (for any reason) may leave the midwife open to being reported to the Board, and ultimately de-registered.

Sounds fair and reasonable? Perhaps, but what about the rights of women to choose where, how and with whom their baby will be born?

Luckily, women may take a private midwife with them to a hospital birth, and although the private midwife may not necessarily act as the accoucher for the birth, the advocacy and advice is invaluable, not to mention continuity of care and ongoing support. However, this does not help women who prefer to have their VBAC, breech or twin babies at home. I think it’s time for women to take a stand and demand private midwifery for home and hospital birth.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: birth, Birth choices, continuity of care, Home birth, hospital birth, Maternity Services Review, midwife, Midwifery, Midwifery, Midwifery services, Normal Birth, Public and private hospitals, women's rights

International Midwives’ Day – The World Needs Midwives Now More Than Ever

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link to article

The Australian Nursing Federation (ANF) celebrated International Midwives’ Day (IMD) this year by acknowledging the important role midwives play in improving maternal health in Australia and throughout the world.

Ged Kearney, ANF Federal Secretary, said that International Midwives Day focuses attention towards the contribution and commitment shown by midwives to the health and wellbeing of mothers and babies.

“Every year Australia’s midwives expertly assist mothers to safely birth their babies, caring for mothers, their newborn and families with professional kindness and skill. The World Health Organisation recognises midwives as the most appropriate health professionals to safely manage a mother’s maternal care and the birth of their babies. Their incredible contribution should be applauded by government, the media and the community.”

The ANF pointed out that although the contribution of Australian midwives is well recognised, particularly following the recommendations in the federal government’s maternity services review, Australian midwives still need action to enable mothers and babies to receive the full benefits of their professional skills.

“Australia has some wonderful examples of midwifery services that are collaborative and use a multidisciplinary approach to maternity care;” Ms Kearney said. “These models of care must be available to all mothers and their babies for the benefit of all communities.”

“Midwives make a significant contribution to the maternity care and education of families in Australia. It is essential that all mothers and babies benefit from this care, particularly in rural and remote areas. Australia needs the skills of midwives now more than ever.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies, birth, Birth choices, Maternity Services Review, midwife, Midwifery, Midwifery, Midwifery services, Normal Birth

The Benefits of Using a Midwife During Childbirth

For further information, contact Melissa Maimann at Essential Birth Consulting.

In Australia, all babies are born with the help of a midwife. This is true whether you’re giving birth in hospital, birth centre, at home or in an operating theatre. The question is really – what are the benefits to having a midwife as your primary care provider?

So, what is a primary care provider?
A primary care provider is someone who is responsible for your pregnancy and birth care. It will either be a doctor or a midwife, and in some circumstances, it will be both. Women may choose birth centre, homebirth or hospital midwifery care to benefit from primary midwifery care.

Primary medical care is provided by private obstetricians or through doctor’s clinics in public hospitals.

What are the benefits of having a midwife as your primary care provider?
Midwives generally have a firm belief in pregnancy and birth as natural processes that women can do. In other words, they believe that a woman’s body is perfectly designed for pregnancy and birth. They look for what’s right in the pregnancy and birth, while always being mindful of risks. Midwives help to keep pregnancy and birth normal by focussing on nutrition, lifestyle, health and well being. We that with health in general, healthy people are less likely to get heart disease, diabetes and so on. Well, it’s the same in pregnancy and birth: healthy women and babies are less likely to get sick. So midwives focus on health and well being, while always being alert for situations that need more attention.

Midwives use a holistic, or biopsychosocial model of care. What this means is that you’re not just a pregnancy or a birth to a midwife. You’re a woman, mother, friend, wife, partner, employer / employee and so on. Your midwife will seek information about your life, your family, your interests and so on, as well as your health and medical history. She will take all of this information into account when making recommendations and giving advice.

Midwives are less likely to use disruptive technologies that may lead to further intervention and complications. They’re less likely to induce labour, perform an episiotomy, perform vaginal examinations, break your waters and so on. So your labour is allowed to progress naturally. When you work with your body, it will work with you. When you interfere with your bodily processes, your body will not work as well. This is especially the case in birth where there’s a strong reliance on hormones to initiate labour and keep it going.

Women are usually very satisfied with midwifery care. They feel supported, emotionally, from seeing a midwife. They feel they can trust their midwife and that their wishes are respected. Women feel more comfortable to write a birth plan and discuss their hopes and preferences for their pregnancy and labour when they see a midwife.

So, what does this mean for birth and babies?
Well, there are lots of positives! When you have a midwife as your primary care provider, you can expect:
- choice of birth place (hospital, birth centre, or home)
- a lower rate of caesarean
- a lower rate of episiotomy
- you’re less likely to be induced
- you’re less likely to need pain medication in labour
- you’re less likely to have your waters broken
- you will be listened to and respected
- your birth plan will be respected
- you will be able to build trust with the midwife who will help you in birth
- you will be less likely to have an assisted birth (eg forceps)
- you will have a lower chance of getting postnatal depression
- you will be less likely to have birth trauma
- you will be more likely to bond well with your baby
- your baby will be more likely to breastfeed successfully
- you will most likely view your labour as being very positive

Melissa Maimann, Essential Birth Consulting 0400 418 448

Tags: Babies, birth, Birth choices, birth debriefing, Birth trauma, Breastfeeding, Caesarean, continuity of care, Epidural, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery, Midwifery services, Normal Birth, Obstetrics, postnatal depression, Public and private hospitals