Midwifery care: changes for the better - for hospital birth

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Caroline Homer, Professor of Midwifery, UTS, writes:

It’s a landmark night for maternity services for Australian women ...

Tonight’s announcement goes towards redressing the balance in access and equity in maternity care in this country, enabling midwives to, for the first time, to work as private practitioners, provide services subsidised by the Medical Benefits Schedule and prescribe medications subsidised under the Pharmaceutical Benefits Schedule.

The Improving Maternity Services Package is an initiative for all Australian women. It is an important move forwards and is strong evidence that the recent Review of Maternity Services has been addressed ...

Of course the devil is in the detail. What exactly does “subsidised medical indemnity for eligible midwives working in collaborative arrangements in hospitals and healthcare settings” mean for midwives who provide homebirth services? How will an “advanced midwifery credentialing framework” fit with the existing national peer review process for midwives?

... This is the moment to take a deep breath and develop new and more constructive ways of working together recognising and respecting our different skills and capacities. We must keep women and babies at the centre of the discussion, not our various professional perspectives.

This is the time to move forwards using the available workforce in the best way, ensuring that midwives, GPs and obstetricians can each work to their full scope and capacity to ensure the best possible maternity service for all Australian women.


Justine Caines, Maternity Consumer Advocate – Mother of seven, living in rural NSW, is also calling it a “Landmark Day for Women and Babies”. She writes:

The budget has announced new funding of $120 M over 4 years to introduce Medicare funding for midwives.

This heralds a new age for maternity care. To date maternity care has catered to the needs of health professionals rather than women and their families. The all powerful medical lobby has dictated the terms. It would seem that their greed has been a major part of the reform agenda.

In the 4 years since the Medicare safety-net was introduced, Obstetricians have increased their charges by approx 300%. This budget has reeled these obscene costs in with a cap to the safety-net. By enabling private practice midwifery through Medicare, private health funds will be able to finally offer choice to women. Importantly midwifery care will also have the capacity to reduce unnecessary costs (by reducing interventions, especially caesarean section and associated costs esp when babies are harmed through surgery and spend time in special care nurseries).

With the introduction of Medicare for midwives rural women can breathe a sigh of relief ... The social dimension of midwifery is well placed to make in-roads to close the gap for Indigenous Australians ...

The only down-side is that homebirth is not yet to be funded. It would seem medical groups will ‘die in a ditch’ over funding homebirth services ... Men in white coats wrangle to keep control of women’s bodies. Overall thumbs up to Nicola Roxon, I look forward to working through the implementation.

Private midwifery for hospital birth will be funded, but home birth will not be funded. Insurance will be tied to registration, and insurance will not cover home birth, only hospital birth wihtin a collaborative model. There is a possibility that private home birth services may still be possible, albeit unfunded and uninsured. There will be increased scope for midwives to provide services to women in a range of locations - hospitals and birth centres - either in a solo practice or a group practice. The finer details of collaboration and advanced practice have not been worked out as yet.

Melissa Maimann, Essential Birth Consulting 0400 418 448