Diversity: Midwifery Celebrations for IMD

The new ACM (WA Branch) education committee did well with the recent celebrations for International Midwives Day; it was a great success, thank you team. Attendance was good there were about 60 participants and UWA is always a great venue, with superb food. It is always good to see a good turnout of midwifery students, well done.
Our President Tracy Martin opened the day with words of encouragement, her message was about remembering the grass roots of midwifery and to recall why we became midwives. In these times of change we need to remain grounded and stay focused and women focused.

Some of our Postgrade and undergraduate student midwives:

Beth O’Neil who is an accomplished singer, also one of our inaugural Bachelor of Midwifery third year students conducted the next session. Beth said “I love singing, but I am not going to sing to you, I am going to teach you how to sing so we can all sing together” brilliant idea….although I have to say I love hearing Beth sing….she is just magnificent…. However she organized a noisy group of midwives into a chorus of singers…. It was such fun and I had forgotten how well for the soul singing is… so thank you Beth for a job well done…… a most enjoyable session.

Time for a cuppa and a chat:

Next I gave a review of the current political status, National Registration, Bill C and the current position in WA, which is that it has not yet been passed which may result in us not going forward with the other states. Points of note from the National meeting in Canberra were; ACM national membership has increased and WA has a 15% increase, as well as a strong student membership; Online education and face to face teaching will continue and needs to include packages to assist the transition for midwives to eligible midwife; learning packages to include business management for Midwifery Group Practices; indemnity insurance will be provided by the college and will be cheaper for members; lobbying and submissions;

Janice Butt gave a thought provoking presentation about her recent trip to Tanzania, where they have 100 births a day and one woman dies every minute. She also reminded us how we are not meeting The Millennium Goals.……
What are the millennium goals check out this link

Goals 4 Reduce Child Mortality & Goal 5 Improve Maternal Health are the ones that need urgent attention.

Shelly and Karen presented the ACM MidPLUS and Midwifery Practice Review (MPR) made easy..... well they certainly made it look easy...how to navigate the requirements for National Registration by investing in MidPLUS and if you are looking at becoming an eligible midwife you will have to consider doing your MPR.

We then had a rather sobering presentation about refugee women from Afghanistan, and how hard the transition can be from leaving their homeland……the expectation to assimilate to something so foreign to these women…..and how vastly different cultural lifestyles can be…..these sessions are invaluable in helping midwives understand different ways of being…..undoubtedly food for thought.

This was then followed by Sadie’s talk, about drugs and alcohol in pregnancy……addictive listening, her statistics astounded me…. I am aware of the problems but certainly not the extent and across all social boundaries. Sadie also discussed life in prison for women, and pregnant women get no better treatment….. In fact the word treatment is an underestimation of the lack of care that is afforded these women, still human beings; again I was totally horrified that this type of lack of care is so prolific in the twenty-first century, that because the woman is pregnant she is not given or even considered to be worthy of consideration…… well done for bringing this to light and trying to do something about it…..to all that fight these types of inhumane injustice keep up the good work and let the world know what is happening…….. Great work Sadie and team……

The official day ended with a session on Tai Chi….. not my cup of tea… but most people joined in and looked as if they enjoyed it….. For me I took some time out and sat reflecting on the sessions at the river…
The program was as diverse as was the title….. my thoughts were that it was a thought provoking day, looking at what a diverse population we have and how our care needs to reflect diversity, compassion, understanding and tolerance. It also reminded me of how fortunate we are in Australia to have such wonderful maternity care (except if you are in prison)…. Even though it needs fine tuning to cater for the needs all women and that means Homebirth & Midwifery led Care for those who choose it.

The day came to a close with a well earned sundowner…. This is a wonderful time to network and reflect on the amazing day; Happy International Day of the Midwife.

Our new Merchandise


Cheers Pauline Costins

Farewell to Jill Banks....

We all make decisions to move on for one reason or another, this is our Farewell Jill Banks, our Publicity and Fundraising Officer for the ACM WA... we will sadly miss Jill, as she begins her new adventure with her partner interstate.... it is our sad loss and their gain....

I first in-counted Jill when I went down to the South West for a teaching session and met the manger who was Jill, as we talked we discovered we had a mutual friend... i had not long returned from working in the UK with the mutual friends.... it really is a small world.....our paths continued to cross and when Jill moved to Perth our friendship grew through our involvement with the college.....I will sadly miss you Jill, a great friend, colleague and manager all rolled into one fantastic woman.... and a Northern Woman (UK)at that.....straight to the point, an excellent clinician, with a heart of gold.... oh, not to mention that terrible habit that you have.... "the one that can not be mentioned"...lol... wishing you all the best in your new phase of your life and keep in touch..... Pauline Costins

Just wanted to let you know Jill, that Queensland's gain is definitely WA's most grievous loss. I will miss those dulcet tones on the other end of the phone, and the women of the South have certainly lost a huge ally in their interpartum hours! Still, I hope those Northern women appreciate what is coming to them, and I pray you can achieve even more than you have done in Fremantle.

Wishing you love, light and laughter, Penny Hardy

Dear Jill
You will be sadly missed as a friend and colleague. My earliest memory of you is going 'down the road' from Port Hedland to Point Samson for fish & chips when I thought I may never get back to Perth! I enjoyed sharing your Masters journey with you and have been very impressed by your clinical leadership especially at Kaleeya. It is a real pleasure to work with a Manager who is so supportive of women, students and midwives. You are a 'Yes - can do' person with a great personality. Thanks for all that you do for midwifery - Queensland is gaining a fantastic recruit. Take care and keep in touch - do they have wine in Queensland?
Love Janice Butt


Ah Jill, you will be missed! Dependable, fun, hard-working and always the capacity to surprise (Pardon me!)Laura.

Cheers....Pauline

Happy International Midwives Day 2010

Here is a video of part of our celebration on the 1st of May 2010 @ UWA - please excuse my voice..... we celebrated in style and had so much fun.... a huge thank you to Beth O'Neil for her expert tuition and guiding us to sing....it reminded me that singing is so good for the soul... it was a memorable exercise and uplifting..... Review of the sessions still to come......also a big thank you to the superb organisation of the education committee.
Enjoy International Midwives Day - "Being with Woman"
Pauline Costins

International Midwives Day was first Celebrated on May 5, 1991.

This site is well worth having a look at A Celebration of Women..... Find out who is celebrating IMD.... and how...I just love this picture.....

Great news...ANMC appointed as independent Accreditation body

This is great news... and thank you to all those people who submitted letters, emails etc to their Member of Parliament to ensure that the ANMC did not disappear....
This was a huge error on the part of the profession not to have this body formalised years ago...another lesson learned..... Just to remind everyone the ANMC is a peak body established in 1992 to facilitate a national approach to nursing and midwifery regulation. The ANMC works with state and territory Nursing and Midwifery Regulatory Authorities (NMRA) in evolving standards for statutory nursing and midwifery regulation. These standards are flexible, effective and responsive to the health care requirements of the Australian population.

Tuesday, 27 April 2010
ANMC appointed as independent Accreditation body
The Australian Nursing and Midwifery Council (ANMC) welcomes the Australian Health Workforce Ministerial Council (AHWMC) decision to endorse a newly constituted ANMC as the independent accrediting body for nursing and midwifery. Read the full Media Release click here
Here is an example of lobbying working for the right result.....
“This is the result of years of lobbying and work by those in the nursing and midwifery professions who are heartened to see this day has finally come” said Adjunct Associate Professor Moira Laverty.

I am so pleased, because this means all current codes stay the same for a few years....thank God for some common sense....

Update on scheduled medicines..... midwifery

For your information........

On 1 April 2010 The Australian Health Workforce Ministerial Council announced its approval of national health practitioner registration standards in regards to the National Registration and Accreditation Scheme for the Health Professions. The approval includes standards for scheduled medicines endorsements for suitably qualified and rural and isolated practice registered nurses (RNs). The proposed scheduled medicines endorsements for midwives, provided by the Nursing and Midwifery Board of Australia (the Board), has been delayed "pending the outcome of further priority discussions between the Board, and Commonwealth, State and Territory officials." For more information, read the 1 April 2010 Communique – Health Ministers Announce Approval of National Health Practitioner Registration Standards.

Submission: to NMBA for 'eligible midwife'

This was the WA submission to the NMBA: lets see what comes from this......

Submission from: WA Branch of the Australian College of Midwives (ACM) Executive.
The ACM is supportive of most of the requirements within this document. We have some concerns around the wording in the 2. Practice, continuum of midwifery care… within this document. We have outlined our concerns and points for clarification.

Re: WA Branch Australian College of Midwives’ Response: Endorsement to practice as an Eligible Midwife

1. Registration standard for the endorsement of midwives as eligible midwives.
• Accepted

2. Practice for at least three years across the continuum of midwifery care (antenatal care, intrapartum care and postpartum care of the women and their infants), within the previous 5 years.
• At the entry point of registration in Australia, midwives are licensed to practice across the full scope of midwifery practice and in accordance with the International Definition of the Midwife (2005).
• We are concerned that the 3 year practice requirement is unnecessary, unfounded and excessive it fails to recognise the academic level to which midwives are now being prepared, which will expand further with the implementation of the 18 month program. If post-registration experience must be a criterion, we support a graduate program IF it incorporates at least the same amount of time working in a continuity of care model as working in a hospital.
• There is confusion as to what the three years means; 3 years full time or part time, which is the most common work pattern for many midwives. An arbitrary requirement to book 30-40 women per year is exclusive. Many midwives work part-time and will wish to continue doing so.
• A caseload model of 30-40 women will exclude a number of midwives who could not manage this full time load but might be very keen to offer continuity of care across the continuum for a smaller number of women.
• Is there provision for those midwives who choose to work only with antenatal and postnatal women and refer women to hospitals for birthing, those whose focus is either/both antenatal & postnatal care?
• What exactly is meant by continuum of midwifery care? Does this imply it has to be the caseload model where there is a continuum for a particular woman? Or could it be that a midwife is practicing over the whole spectrum of the midwife’s role but not necessarily on a day to day basis? Does ‘over 3 years’ mean that all spheres of midwifery should be covered in the 3 years and also, is this 3 years of FTE equivalent or 3 years of part time? How part time could it be?
• We are not sure where the evidence for 3 years has come from as we are not aware that this forms any part of the prescribing requirements for midwives in other comparable countries such as UK. We have had a quick look at the NMC site and cannot find any evidence in the regulations that suggests a timeframe. We have also looked at the New Zealand (NZ) model and they are able to work in the community from day 1 of being registered. NZ does have a mentoring program in place for these midwives. (http://www.midwife.org.nz/index.cfm/1,171,html)
• We could accept the completion of one year as a graduate if initial registration is not accepted.

3. Participation in an additional 20 hours per year of continuing professional development relevant to the continuum of midwifery care.
• Additional CPD of 20 hours in addition to the one semester accredited course at PG level also seems excessive. The scope of practice is the scope of practice, midwifery skills are midwifery skills regardless of the work setting and all midwives will need to do 20 hrs CPD, why are eligible midwives going to be different? They will have already completed an extra course and will be required to do MPR.
• We do support the need for a specific course, there needs to be a decision as to whether this would need to be repeated, how is knowledge to be updated for new drugs etc.

4. Successful completion of a NMBA approved professional midwifery practice review program for midwives working across the continuum of midwifery care.
• We accept MPR (Australian College of Midwives)
• MPR should be mandated for all midwives in clinical practice, and if this a requirement, will the fee be subsidised by the government?

5. Compliance with the collaboration requirements for eligible midwives – that is the requirements for midwives to work collaboratively with other health professionals as outlined in regulation and national health policy instruments.
• Collaborative requirements as per Guidance document emphasises that this means equality in professional relationships and not one profession directing another, which needs to be re-iterated in this document
• The definition of collaboration must be re-stated in this and all documents related to this transition, so that the message gets across loudly and clearly that it does not mean midwives may only practice in this model if a doctor or service says they will provide consultation and care if referral is required. (National Guidance on collaborative maternity Care: NHMRC)

6. Successful completion of an accredited and approved program of study determined by the Board to develop midwives’ knowledge and skills in prescribing, or a program that is substantially equivalent to such an approved program of study….
• There is little emphasis on initiation and interpretation of diagnostic tests, which will also be included under Medicare – We think the educational preparation should include this aspect as was recommended in the previous NHMRC Effective options for childbirth document some years ago, which the Enhanced Role Midwife course was based on in WA.
• Will there be a set list of medications (as there is currently for newly qualifying midwives in the UK) or no set list but only drugs that are ‘within the normal scope of midwifery practice’ (as is currently in New Zealand). Whichever is decided upon we think it should include drugs that would be used in an emergency (as listed in the South Australian consultation paper which also includes, for example, Ergometrine, Adrenaline and Magnesium Sulphate).
• Our preference would be that Pharmacology, Prescribing, Screening and Diagnostics unit becomes part of the pre-registration courses so that midwives qualify with these skills, as they do in New Zealand. However, we can see this is very unlikely so a one year post registration is enough of a consolidation to then be able to undertake such a course to be an eligible midwife.
We take this opportunity to thank the NMBA for providing this opportunity to respond and recognise the need for midwives to be experienced across the full scope of midwifery practice. This document reflects the views of the midwives of the profession, and considers the safety of the public in terms of proficiency, wellbeing and knowledge of the ‘eligible midwife’.

WA Branch executive committee
Pp Pauline Costins

Have your say on what the 'Eligible Midwife' will be

Well here it is the Nursing and Midwifery Board of Australia has released a draft of what 'eligible midwife' may look like.....

The Key points are as follows;
1. Current general registration as a midwife in Australia with no restrictions on practice - having as it does all the requirements for eligibility for registration under the Act.

2. Practice for at least three years across the continuum of midwifery care (ante-natal care, intrapartum care and post-partum care of women and their infants), within the previous 5 years.

3. participation in an additional 20 hours per year of continuing professional development relevant to the continuum of midwifery care.

4. successful completion of a NMBA approved professional midwifery practice review program for midwives working across the continuum of midwifery care.

5. compliance with the collaboration requirements for eligible midwives- that is the requirements for midwives to work collaboratively with other health professionals as outlined in regulation and national health policy instruments.

6. successful completion of an accredited and approved program of study determined by the Board to develop midwives' knowledge and skills in prescribing, or a program that is substantially equivalent to such an approved program of study (at midwifery post graduate level and designed around the flour components of prescribing - information gathering, clinical decision making, generation of medication order and monitoring the review.

As the model of care for eligible midwives is across the continuum of maternity care, eligibility is contingent upon all requirements being met..... therefore once a midwife has been endorsed as an eligible midwife; and authorised and provided with the necessary provider number by Medicare Australia: READ the full document Guidelines & Assessment framework for the recognition & endorsement of eligible midwives

2 Endorsement to practice as an eligible midwife (to read the full document click the hyperlink)

To be entitled to endorsement under section 98 of the National Law an applicant wishing to be identified as an eligible midwife must be able to meet all the requirements including being a currently registered midwife in Australia; being able to demonstrate through professional review of practice at least 3 years experience across the continuum of midwifery care within the 5 year period preceding the application, comply with the collaboration requirements for eligible midwives; and have an approved qualification to administer, obtain, possess, prescribe and supply scheduled medicines required for practice across that
continuum of midwifery care.

Wording to appear on the register
Endorsed as an eligible midwife working across the continuum of midwifery care and qualified to provide the associated services, order diagnostic investigations and administer, obtain, possess, prescribe and supply schedule 2,3,4 & 8 medicines in
accordance with relevant State and Territory legislation, required for midwifery practice.

If you wish to provide comments on this paper, please lodge a written submission in electronic form by email to natboards@dhs.vic.gov.au by close of business on Wednesday 27 April 2010.

PLEASE FORWARD COMMENTS....if you wish please respond to the blog and I will collate the comments for a submission, but you need to add your name to the comments, otherwise they will not be included....... Now is the time to have your say..... get women, mothers, consumers....anyone who is interested in birthing in Australia needs to have a say....this is the future of Homebirth and Private Practice in Australia.....there is a short consulation period so please do it now!

Cheers Pauline

Have you registered?

Have you registered for International Midwives Day 2010?
Midwifery: Diverse Care for a Diverse Community At UWA May 1st

Register now!
It’s easy - just call ACM National Office (02) 6230 733 or 1300 360 480
and pay by credit card Or go to www.midwives.org.au Or email members@midwives.org.au
6 MidPlus points for attending

ACM Education Committee

Maternity Services Reforms: indemnity insurance - what is it going to cost?

Maternity Services Reforms
More choice for women – indemnity insurance for midwives
Indemnity insurance - protection for midwives

As you are all aware from July 1st 2010 National Registration starts: this means that Privately-practising, eligible midwives will be able to access Australian Government supported professional indemnity insurance from 1 July 2010. The Dept of Health and Aging has released this document; Maternity Services Reforms
More choice for women – indemnity insurance for midwives;

I am not so sure about the offer......The premium for a midwife in full time practice is expected to be around $7,500 per year, that is $144.23 per week. However this insurance will not cover the planned delivery of babies in the home – for which there is a two year exemption from the requirement under the National Registration and Accreditation Scheme for midwives to hold professional indemnity insurance. It should be noted that the exemption relates only to the actual homebirth.

I wonder how many hoops midwives have to jump through to be an eligible midwife? I would of thought that after completing the required course to become a midwife you would be qualified to work as a midwife..... but Alas this is not the case in Australia it seems that we have to do even more to obtain the new reforms proposed....they say that....Pregnant women and new mothers will have more choice in maternity care because the clients of eligible midwives with professional indemnity insurance will be able to access services subsidised by the Government through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS).

I feel that women will have less choice because there will not be any 'eligible midwives', and I suppose that will suit the AMA.....what happened to fair play? and equal opportunities? Where is the ethics in all of this?.... it seems that ethical principles have gone out the window....

I ask at what price is this privilege coming and by privilege I mean MBS & PBS..... we are introducing another word, phrase, type, description of a midwife... the 'eligible midwife' who is currently the private practicing midwife or independent midwife.... how many of the current private practice midwives will be able to jump through the hoops...and we do not yet know what those hoops are???? if this offer of indemnity insurance is anything to go by... I suspect we are in trouble......

Definition of a Midwife

A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery.
The midwife is recognised as a responsible and accountable professional who works in
partnership with women to give the necessary support, care and advice during pregnancy,labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.
The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.
A midwife may practise in any setting including the home, community, hospitals, clinics or health units.

Reference of definition: International Confederation of Midwives