Doctors blocking us, say midwives

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. There are some inaccuracies in this article but the people who have been quoted were speaking from the best information they had at the time.

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Midwives have accused doctors of obstructing arrangements allowing them to practise privately, saying not one private obstetrician has signed a collaborative agreement with a suitably qualified midwife.

Such agreements represent the easiest way for midwives to accept and treat patients for care covered by Medicare, but the Australian College of Midwives says while some obstetricians are refusing, others are demanding upfront payments in exchange for their agreement.

In signs of continuing tensions between the professional groups, the peak standards body for obstetricians is in turn criticising the new rules as unclear and too lax, and a recently released guidance document as biased against them.

... obstetricians were concerned that under the proposed model they would be summoned too late and expected to deal with problems not of their making.

... Australian College of Midwives president Hannah Dahlen said none of the 10 midwives who had so far qualified to attract Medicare rebates had succeeded in signing an agreement with a private obstetrician. One specialist responded by telling the midwife he was "not in a position to form a collaborative arrangement with any independent midwives in any form", adding, "Please don't correspond with me any more on this particular matter."

"Other obstetricians [are] ... putting strict requirements in terms of when they see the woman or when they get called during labour," Ms Dahlen said. "Doctors have to get over their own self-importance in the health service . . . they are part of a team, and in a team everyone must be seen as equally important or there is no team."

A spokesman for Ms Roxon said meetings were planned with both obstetricians and midwives to discuss implementation of the changes.

"We are determined to work through any issues that are raised as these new arrangements give a greater choice for patients," the spokesman said.

Melissa Maimann, Essential Birth Consulting 0400 418 448