Maternity Reforms: Good news for expanded birthing options

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Maternity reforms came into effect in November 2010 which gave women access to Medicare benefits for private midwifery care for the very first time. In addition, eligible midwives were to be able to order relevant tests and ultrasounds through Medicare. Medicare benefits are available to clients of eligible midwives for pregnancy and postnatal care, however there is no benefit for birth care at home.

So, 6-odd months on, how are things looking for maternity care and what possibilities await us?

Well, for a start, we had around 200 private midwives in Australia. 6-odd months into the reforms and we have at least 30-40 eligible midwives. Some of those 200 midwives have ceased private practice, leaving about 100 in private practice. So 30-40 eligible midwives represents a 30%-40% update of the maternity reforms by the current private practice workforce in just 6 months. That is phenomenal. As well as this, private practice has become a more attractive option to employed midwives now that private practice is medicare-funded and indemnified. So in months and years to come, we will have more midwives in private practice, and less in the hospital employed system. This is not a concern as the hospitals would not need their own staff: women will bring their midwife with them to the hospital when they come in to birth their babies. From the hospitals' perspective, this is excellent news: they may benefit from significant cost savings in terms of recruitment, retention, staff education, pay-roll, rostering, management and so on.

What about for women? Well, it is well-known that women benefit from exclusive one-to-one midwifery care through pregnancy, labour, birth and the postnatal period. When women are cared for exclusively by one midwife, we know that they experience lower rates of interventions without compromising safety, and they experience higher rates of satisfaction with their birth and new parenting experience. When women choose a Eligible midwife, they can access significant medicare benefits that do reduce the cost by quite a lot. Depending on the number of pregnancy and postnatal consultations a woman has, the benefits range from say $1,000 - $2,500.

However, in order for eligible midwives to provide medicare-rebatable services, midwifery care needs to be delivered within a collaborative arrangement. And this does open the possibility for private midwives and private obstetricians to work together in collaborative practice. The huge benefit to the woman is that she has midwifery care right the way through, from early pregnancy to 6 weeks after her baby arrives, with the reassurance of having a known obstetrician who is available is needed. Women meet the obstetrician twice in pregnancy, and the obstetrician is available for labour and birth if his care is needed, and in this way, women can benefit from the ultimate in continuity of carer. This model of care is now available for the very first time in Australia history, and we are very pleased to be able to offer it to women. So far it is a very popular option! More to come.