When considering maternity service reforms, Australia must not to follow the ‘disastrous’ New Zealand example which puts midwives ahead of GPs as obstetric providers, the AMA says.
In its submission to ... Maternity Services Review, the AMA says Australia currently has “close to perfect” obstetric outcomes, with perinatal deaths rates continuing to drop.
And while the AMA acknowledges that Australia’s 30% intervention rate is cause for concern, it says “It would be disastrous if these strong results for Australia were turned around because of poorly considered reforms.”
In particular, it points to New Zealand, where maternity reforrms in 1990s allowed midwives to be ‘lead maternity carers’ ...
This resulted in GPs to withdrawing from intra-partum care, so almost all maternity care is now delivered by midwives or specialist obstetricians.
As well as reducing the choice of obstetric providers, the AMA says there is emerging evidence of higher maternal death rates and perinatal death rates ...
... The AMA says it support expanded funding arrangements for midwives within a team-based, medically supervised model, using “for and on behalf of items” for midwives on the Medicare Benefits Schedule
But giving midwives access to independent MBS items for maternity services would create two streams of maternity care, and would push up medical indemnity premiums by increasing the amount of ‘fire brigade’ obstetric emergency responses by doctors.