Saturday, February 20, 2010

General Meeting with Barbara Vernon the CEO of the Australian College of Midwives:

The meeting was attended by approximately 25 members. It was brilliant to see the student representative’s coming to the meeting.... 3 from Curtin and 2 from ECU.
No guesses what we discussed....what everyone is talking about....the new legislation and National registration. Next week is important as three Bills will be presented to the Senate......that is
Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009
Amends the Health Insurance Act 1973 and National Health Act 1953 to: enable nurse practitioners and appropriately qualified and experienced midwives to request appropriate diagnostic imaging and pathology services for which Medicare benefits may be paid; and allow those health professionals to prescribe certain medicines under the Pharmaceutical Benefits Scheme. Also makes consequential amendments to the Health Insurance Act 1973, Medical Indemnity Act 2002, Medicare Australia Act 1973 and National Health Act 1953.

Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009
Introduced with the Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009, the bill establishes the Midwife Professional Indemnity (Commonwealth Contribution) Scheme to provide indemnity insurance to eligible privately practising midwives.
Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009
Introduced with the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009, the bill imposes the run-off cover support payment as a levy on insurers’ premium income for providing insurance cover to eligible midwives.

Other issues discussed were...Medical Benefits Scheme (MBS)....Prescription Benefits Scheme (PBS) and the run off insurance cover.

The most interesting part of the evening for me was discussing the many options midwives will have from this enormous change to the way we work in Australia.... and not before time.... but I have to ask.... Are Midwives Ready for this Change????

How is MBS going to affect midwives?
....women can be private patients of the midwife...therefore claiming a funding rebate... however not for intrapartum care.
....midwives could be contracted to hospitals for intrapartum care
...midwives could setup their own consulting service for antenatal and postnatal care....we just have to be clever how we do it...

What are the implications for midwives with these changes.....well you can be
........self employed, set up your own practice providing antenatal & postnatal care contracted to a hospital for intrapartum care
........participate in midwifery care
........relinquish the nurse component of your registration in the community

Where too from here?

These are very exciting times.... however.......we need to work everyday on these issues.... determining eligibility, designing MBS rebates.... CPD packages on MBS & small business management, searching for indemnity insurance....

What do you think? are you ready for this?

Thursday, February 18, 2010

Welcome to all Student Midwives

Welcome to the new Curtin post graduate midwifery students.... it’s always great to meet and greet the students on orientation day.... it’s a who’s who of nursing and previous life experience. I particularly like to hear what everyone’s passion is...and inevitably most of the students tell you that they are here because they have always wanted to be a midwife and the other comment has been “I wish they had direct entry midwifery earlier”. You can feel the excitement and enthusiasm in the air... of course there is anticipation and some trepidation as there is with any new path that we embark upon.... we would not be normal if this did not happen.

This is an incredible journey and often life changing....”The student midwife” one of self discovery..... It is often a spiritual journey one which makes some of you think of your own birthing experiences and come to terms with them.... and if you have not had children.... it may lead you to ask about your own birth.... it is a time to really discover who you are..... Because you share a very privileged time in a woman’s life and she is often dependent on your knowledge and support.... it is a time to learn how to truly be “with woman” and often this about knowing, when to be an advocate, educator, counsellor, silent and above all professional in every is about knowing what the woman wants, listening and letting go of your own ego...... it’s about empowering women to make their own decisions....

The midwifery students are from all different areas...rural, SJOG Subiaco and Murdoch, Mercy, KEMH, OPH, AKH, sorry if I have left any out...

“There are precious few times in life when you are fortunate enough to meet people who bring you a truly new perspective on a subject that you thought you knew – people who inspire you to ask different questions and re-evaluate the essence of what you’re doing” Professor Fiona Stanley.

Good luck to you all.... enjoy the journey....

We will be going out to ECU next week so will post the photos when we get this space.....
Cheers Pauline

Monday, February 15, 2010

National Day of Action

This is where it's happening in Perth....have any spare time please go along and have your say...... click on this link to find out more.... Our Bodies, Our Babies, Our Rights

Perth- Join Facebook Event Group
Outside office of Melissa Parke
Where: 62 Wray Avenue Fremantle WA 6160
When: Thursday, February 18 from 10:30 am to 11:30 am

Cheers Pauline

Here is an interesting artice relating to medicare rebates

Here is a nice easy read relating to the effects of cutting medicare funded rebates, until last year women could claim 80 per cent of out-of-pocket obstetrics fees after reaching the safety-net threshold. This will change things for both the woman and the obstetrician... and hopefully we will see more women seeking midwifery led care.......Anger over cut to obstetrics
Rebates for private obstetrics fees slashed
Public hospitals swamped by patient demand
Low-risk out-of-area patients turned away

Sunday, February 14, 2010

Graduation at Curtin University

As a midwife and a lecturer it is a really rewarding time to the year.... the culmination of years of study for the students, their graduation day... it is so nice to see them in their regalia, excited, relieved,enthusiastic and awakened. It is a great sense of achievement for them and for me a sense of pleasure that they have completed this journey and graduated. Now the next journey begins.....
Congratulations to all the Postgraduate Diploma Midwifery (27) and Masters (5)Students its great achievement, well done.

The Australian College of Midwives Membership Award was won by Ms Jacqueline Mawson.

King Edward Memorial Hospital for Women clinical Midwifery Prize was won by Ms Maree Edwards.

Now the journey continues, lifelong learning.... for some they begin as Registered Midwives....consolidating their midwifery program into practice facilitating and empowering women during their pregnancy birth journey.....and after a year or two they may embark on the next step... "MASTERS'.

The masters graduates will endeavour to put into place the work they have completed and as leaders they will continue to lead by example...empowering women.. and continue the journey of lifelong learning.

Remember to always 'follow your passion'... maintain your professional portfolio through the Midplus program offered by the Australian College of Midwives and good luck along your paths journey......

The ECU graduation is next week so watch this space for the report.......

Cheers Pauline

Saturday, February 13, 2010

Indemnity Insurance a problem globally

Private practice midwives / Independent Midwives, both mean the same and are used interchangeably. Just to put some issues in perspective this is a global problem and it comes down to money. Why is it we need insurance? ... this is because we live an over-litigious society.

The current situation in the UK....there is no professional indemnity insurance available to Independent Midwives, the bottom line is that they are liable for any negligence claim made against them as is the case in Australia.
The systems are similar between Australia and the UK. Hospital midwives, and Community Midwifery Pogram are covered by the hospital and in the UK by the Trusts therefore covered by vicarious liability through the employer.

Like Australia the Royal College of Midwives (RCM) provided insurance to independent midwives until Australia 2002 and UK 1994. The RCM decided to exclude those members who practised independently from the Private Indemnity Insurance cover, in order to keep RCM premiums at an affordable level. The insurance cover was half a million much to cover... However the UK did still have some insurers that would cover Independent midwives, despite having good outcomes the price still increase to 20,000 pounds per year for a midwife (A$45,000 per year). In 2002 the last commercial insurer withdrew from the market because it was not commercially viable due to the small numbers of independent midwives in the UK.
The UK is considering.... Independent Midwives and Contracting to NHS Trusts....its worth a thought....

Midwives have not had access to professional indemnity (PI) insurance since 2002/03, when Australia faced a medical indemnity crisis that resulted in large premium increases.

Just to add reality to the equation here is a case of negligence that resulted in a payment of $11 million dollars.....
In November 2001 the NSW Supreme Court awarded Calandre Simpson, an infant born at St Margaret's Private Hospital with cerebral palsy, fourteen million dollars (the award was reduced on appeal to eleven million dollars) for the overdose of syntocinon, which caused her birth defects. At that time the award was twice that of the next highest payout. This payout assisted in the collapse of Australia’s largest medical indemnity organisation, United Medical Protection (UMP, now Avant) and brought with it what we know as the ‘medical indemnity crisis’.

From this crisis came the key reforms was the introduction of the Policy Support Scheme (PSS), available to obstetricians, neurosurgeons and rural procedural GP’s.
and off course midwives were not included.... I think we missed the boat here.
Now this is an interesting concept that came out of this....
‘Under the PSS, if a doctor's gross medical indemnity costs exceed 7.5 percent of his or her gross private medical income, he or she will only pay 20c in the dollar for the cost of the premium beyond that threshold limit. In other words, the PSS meets 80 percent of the premium above the 7.5 percent threshold of an eligible doctor’s gross private medical income.

Justine Caines stated....Interestingly the rights of Australian women choosing private midwifery don’t have the same value as those women choosing the services of a specialist obstetrician or a procedural G.P. When I challenged the legal branch of NSW Health with this comment I was greeted with silence.

The Australian College of Midwives continues to lobby and negotiate for possible solutions to this current problem...... so watch this space....

The picture: Laura is my friend we did our Midwifery together at Hertfordshire University.. she is now an Independent Midwife......" midwives have babies too, and I can really empathise with the women I care for now"

Cheers Pauline

Birth - Childbirth as an athletic feat - Wellcome Collection

Check out the link below.... just click on the title it will take you to the website; it is a 1939 educational film, a class of expectant mothers practise ante-natal exercises designed by Kathleen Vaughn at the London County Council's Paddington Hospital. See the midwives uniform and the exercises.... I do not in anyway recommend these exercises.... I was just sharing a piece of history.. Do you think times have changed?

Birth - Childbirth as an athletic feat - Wellcome Collection

The WA Branch of the ACM will highlight some pregnancy choices, education / information for women & midwives in WA. We will start with "The With Woman Collective Inc" if you know of other organisations that you would like to see here please email me at and it will be discussed at our next executive meeting.....

The With Woman Collective Inc is a non-profit community group of midwives, doulas, lactation consultants and childbirth educators based in the City of Cockburn, Perth WA. We provide low cost pregnancy and early parenting information and resources to expectant and new parents in our area, and we also facilitate professional development workshops for midwives and other birth workers. For more information about our programs, go to our website and click on the picture of baby Lachie.

Thanks Sara

Thursday, February 4, 2010

Thank you to the outgoing executive members of the WA Branch

An enormous debt of gratitude is owed to the out going executive members of the WA Branch. I want to take this opportunity to say, thank you, Merci, Danke, Grazie, Xie xie, Ca’m on, Maita Henyu, to:

Jenny Owen - National Director, Tracey Gilchrist - Treasurer, Debbie Slater - consumer rep, Lesley Nelson - Aboriginal Liaison, Andrea Loftus - Education Officer, Taryn Murphy - Education committee, Alison Thrum - Education committee,

Your willingness, dedication, enthusiasm and passion to the midwives and women of this State are to be commended...Your direction and advice have been extremely beneficial and your invaluable service will be hard to emulate... you have set a high bar for the new executive members to follow.

I might remind midwives, students and members of the WA Branch, that everyone on the executive committee is here in a voluntary capacity which as you know requires many hours of commitment, dedication and hard work. We are constantly looking for new members and or people willing to help the College in some way. If you know someone who wants to volunteer some time, please contact me and I will point you in the right direction.

We are currently looking for a Treasurer..... do you know someone who would be willing to do our books?... working together with a book-keeper.

Once again a big thank you to the out going committee and good luck to the new committee.
The key to our success
rests in women like you,
who embody the spirit of informed choice
by saying, "Every Woman Needs a Midwife!"
Thanks for your inspiring dedication
and tremendous example to women & midwives

Thank you, Pauline


Tuesday, February 2, 2010

What is Twitter: it is instant messaging just like a txt but on the internet

this is an interesting article.....NEW mother Amanda Williams's "tweet" of her 12-hour delivery - mucus plug and all - should be compulsory reading for all new mothers...... now as midwives you need to beware of how women are using modern technology.... this is a story of how a Geelong woman twittered her labour.....

the Senate Inquiry is out......

Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills

The recommendation is that:

1.40 The committee recommends that the Health Legislation Amendment(Midwives and Nurse Practitioners) Bill 2009 with amendments, the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 and the Midwife Professional Indemnity (Run-Off Cover Support Payment) Bill 2009 be passed. is a minority report by Senator Rachael Siewert, who recommends:

That the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill is amended by replacing reference to ‘collaborative arrangements’ with a requirement that eligible midwives demonstrate collaborative practice and that in the definition of a participating midwife, midwives would be required to demonstrate ‘collaborative practice’ by using standardised clinical documentation for planning and provision of care. This would record specific indications of collaborative practice, in particular consultation and referral as required, with the consent of the women for whom care is provided.

We will still have to wait for about three weeks before it is discussed due to the cue in front of us...... lets see what happens....