Please have a read of the statement below issued by the ACM regarding midwives having to abandon their women at hospital due to an apparent lack of insurance for private midwives in public hospitals. I will also post the NMBA’s statement regarding the same matter, issued today, stating that midwives may continue to be a support person for women attending public hospitals, Juliana
Women forced to be abandoned by their midwife at hospital door
On Thursday 25th August
2011, the Australian College of Midwives (ACM) issued a media release expressing concerns about the Nurses and Midwives Board of Australia (NMBA) plans to interpret recency of practice guidance as the role and scope of practice of a midwife. This issue has been picked up in the media being reported in the Sydney Morning Herald, The Age and The Canberra Times over the weekend.
The issue came to a head when members advised the ACM of their shock and disbelief at the prospect of not being able to continue to support women when they become public patients.
Tracy Martin, President of the ACM said ‘The role of the NMBA to protect the public has failed women needing to birth in hospital under these new maternity reform arrangements’. The Australian College of Midwives has stood behind the Government in supporting these reforms and the potential they had to improve care and options for childbearing women in Australia.
The NMBA states: “Nurses and midwives must not practise their profession unless they are covered in the conduct of their practice by appropriate professional indemnity insurance (PII) arrangements”.
‘Women are most vulnerable around the time of labour and birth and we know that the best outcomes are achieved when women are supported by someone they know and trust’.
‘Many public maternity services have come a long way in achieving this standard but the majority of women are not afforded this safety net’ Ms Martin said.
This interpretation by the NMBA means that midwives would be considered essentially in violation of their registration as a health professional for continuing to be with women as a support person when the hospital staff are responsible for midwifery care. If this interpretation by the NMBA is correct, this would mean less safety and choice for women and more anxiety and risk for midwives.
MIGA has issued a communication clarifying the position for midwives insured with it which is available via its website at www.miga.com.au. The ACM recognises that MIGA can only provide insurance cover to the extent permitted by Federal legislation which means that MIGA cannot provide cover to midwives for the treatment of public patients.
A Safety and Quality Framework for Privately Practising Midwives attending homebirths (in place until July 2013) has been introduced to allow midwives “to be exempt from requiring insurance for providing intrapartum care for homebirths”. However the NMBA has provided the following definition of midwifery practice: “Any role, whether remunerated or not, in which the individual uses their skills and knowledge as a nurse or midwife. For the purposes of this registration standard, practice is not restricted to the provision of direct clinical care.
This means midwives cannot even remain with the women to provide non-clinical support such as massage and comfort.
The slow take up of the new maternity reforms enabling Eligible midwives to provide Medicare funded services has already been hampered by the requirement for midwives to have a collaborative arrangement with a doctor.
The President of the ACM said ‘These one sided, anti-competitive collaborative arrangements, as predicted have almost been impossible to achieve. There are virtually no hospitals yet to allow midwives to have Clinical Privileging like private doctors have but midwives have at least been able to stay with the women they care for in hospital and support them like a doula or support person would. This recent move will certainly grind the reforms to a complete halt and force midwives to abandon women or lose their ability to practice’.
‘What was meant to be major reform and expanded choice and increased access to maternity care for women has turned into a nightmare of red tape and discrimination’ Ms Martin said.
‘We call on Governments to get serious about the protection of the public by redressing the discrimination legitimised in the collaborative arrangements requirements, by addressing duty of care legislation to require midwives to attend women in labour and birth and implementing a robust safety and quality mechanism known as supervision of midwifery in the United Kingdom for all midwives in Australia’ Ms Martin said.
Australian College of Midwives