Midwives improving outcomes: Diversity in action:

AMC WA Branch presents: Midwives improving outcomes: Diversity in action:

Friday 4th May 2012 0830-1630 City West Function Centre
45 Plaistowe Mews, City West, West Perth

Join us for a celebration of Midwifery in both National and international settings.
Share the experiences and challenges for midwives who are striving in diverse environments to improve outcomes for childbearing women and infants in local and international contexts.

Finish the day networking with friends and colleagues at the sundowner enjoying drinks and nibbles.

Midwifery in Tanzania – Jen Shannon
Gestational Diabetes-Addressing risk with Indigenous women and their families – Dr Christine Kenney
Aboriginal Group Practice- Providing holistic and culturally secure midwifery care – Andrea Loftus
Using technology to improve outcomes – Belinda Barnes
Promoting Normal Birth Discussion Panel - Midwives from diverse settings including both private and public hospital settings and midwives from CMWA
Childbirth and Mental Illness Clinic – Yvonne Hauck and Suzi Allen

REGISTRATION 08.30 - 09.00
Registration includes refreshments & lunch
Sundowner drinks and nibbles 16.30 - 17.30

Free parking all day
REGISTRATIONS CLOSE 2nd MAY 2012
EnquirIes: Elizabeth Ashton Liz.Ashton@health.wa.gov.au
To Register admin@midwives.org.au
ACM NATIONAL OFICE (02) 6230 7333 (freecall)1300 360 480

Register and pay online go to the ACM Website www.midwives.org.au

FUL DAY COST (GST INCLUSIVE)
MEMBERS $100 / NON-MEMBERS $120
STUDENTS $70 / GROUP BOOKING
(4 OR MORE) DISCOUNT $10 PP
ACM CPD points apply
*Program subject to change

See you all at the conference.

Please comment on the Homebirth Policy for WA

The Women's and Newborns' Health Network is seeking comments on a draft Home Birth Policy and Guidance for Health Professionals, Health Services and Consumers. The Review of homebirths in Western Australia released in August 2008 made recommendations for conducting home births in WA which have been incorporated into this Policy.

The Policy will be applicable to qualified health professionals (i.e. registered midwives and/or medical practitioners) working in the Western Australian public health system when caring for women who make an informed choice to give birth at home.

Please send an email to healthpolicy@health.wa.gov.au to request a copy of the Policy and a Feedback Form. The deadline for comments is 31 March 2011. Date has been extended to Friday 8 April.... please send in your comments:

Kind regards

Dr Janet Hornbuckle and Assoc Prof Graeme Boardley
Co-Leads, Women's and Newborns' Health Network

A year in reflection:

A reminder of the College Vision:

Our vision is to be the leading organisation shaping Australian maternity care for the benefit of women and their families
The Australian College of Midwives (ACM) is the peak professional body for Australian midwives, which strives to maximize the quality of midwifery and maternity care for Australian women and their families through:
• Providing a unified voice for the midwifery profession.
• Supporting midwives to reach their full potential.
• Ensuring all childbearing women have access to continuity of care by a known midwife.
• Setting professional practice and education standards

This has been an amazing year with many highs and lows.... everyone working hard for the College and the greater good ..... above all working to improve the choice for childbearing women and the midwives who work with women.


As I summarise the year from the blog entries I am in two minds as to how well we have done over the year....If I examine the word "well", skilfully, expertly, effectively, efficiently, adequately, admirably, conscientiously and proficiently - then I think as a Branch we have achieved this.... however as I read between the lines there has been some misfortune for me personally: as you can imagine writing a blog for the College I have to be mindful of confidentiality, defamation, ethics, conduct and my own professional standing....there is no such thing as freedom of speech.... however still offering news, honesty, general information etc.... therefore I have to be mindful of what is published.


I have to say that this rule has not been applied to myself and I am in the process of taking legal action against information wrongly published about me threatening my integrity and professional standing... this is a sad reflection of the times and soul destroying. Therefore this is a timely reminder to be mindful of what you publish on the Internet & email...... defamation is the fastest growing litigation....

The blog to date has had over 4500 hits...the blog posts have almost doubled and is up to date with current issues:

January was meeting the then Prime Minister & the Honorable Nicola Roxon, the Big Picture tour of the proposed changes for midwives; Februry.... new midwifery students and Homebirth rallies..... March... GoGirlAustralia... April.... ANMC here to stay as the "appointed accreditation body"... submissions for the "eligible midwife"... May... IMD celebrations...24hr Virtual IMD ..... and the farewell to Jill Banks....June... came the insurance debate, options and collaboration...July was D-Day for National Registration....and Collaborative arrangements... Determination 2010; concern for private practice, fear, stress, tears, it was a nightmare....


August...Australian Election....the nightmare continues; a hung Parliament... Homebirth...Collaborative arrangements...ACM National meeting & Breathing New life Conference Alice Springs....Sept... Determination still dominated the midwifery world... lobbying, emails...meetings with politicians...etc... GoGirlAustralia leaves Fremantle.....


October.. WA joins National Registration... APHRA comes alive for us.... Victorian conference and AGM also AGM for National.... November... History is made... Medicare Provider Numbers for eligible midwives..to date there are approximately 15 eligible midwives throughout Australia...December... first Midwife to get collaborative agreement.... lets hope this continues....
Trail Blazers, the inaugural Bachelor of Midwifery for WA prepares to enter the workforce as Midwives (who are not nurses), Barb Vernon EO of the ACM resigns and change is in the air..... i have always said as a College we need to be united... "united we stand divided we fall" I am going to pinch a quote from Obama's State Union address " we face big and difficult challenges, we do not give up, we do not quit. We do not allow our fear or division to break our spirit".


Xmas dinner
Thank you to a wonderful executive team we have in WA.... the whole team has worked very hard and continue to work hard for the WA members and women of the State....wishing you all a happy and successful 2011.

My wish for the College & the year ahead:

"Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results."~ Andrew Carnegie

"Coming together is a beginning. Keeping together is progress. Working together is success." Henry Ford

signing of for 2010, see you in the New Year, wishing you all a safe, happy, successful 2011. Pauline Costins

Red tape of AHPRA:

Next installment of my application for eligibility; here I was Miss Perfect at following instructions and I haven’t got it right; I had all my documents certified by a lecturer at the university stating "this is a certified copy etc"to be informed that this was not correct: for your information these are the certified people for AHPRA;

Who can certify documents?In Australia, the following people are authorized to certify documents:

Justice of the Peace, Bail Justice, Registrar or Deputy Registrar
Commissioner for Declarations, Commissioner for Oaths, Commissioner for Affidavits
Lawyer
Accountant (member of the ICA, ASA, NIA OR CPA)
Registered members of the teaching profession (not university)
Member of the police force
Sheriff or Deputy Sherriff
Public Notary
Permanent staff member of AHPRA

Alas this means I have to do it all over again; photocopy and resend. Second problem, the letter from my past employer was not sufficient, it was not enough to say that I had been employed across the spectrum of midwifery and that I was deemed competent by the institution, the manager has to address the ANMC competencies as well, this is a step too far… I have completed the Midwifery Practice Review which addresses each competency……I am a patient woman and I understand that you need to ensure that midwives are competent…. But this really is going overboard.

What I thought was going to be a relatively smooth process is turning into a mind field of red tape and bureaucratic nonsense; there is something to be said about waiting until the first batch have gone through to iron out all the problems, however one would not consider that there would be so many issues and the goal posts moving.
Watch this space: Pauline

How to apply for eligibility:

Today I sent in my application for an eligible midwife; like anything new the process is TIME consuming and there will be teething problems: I am hoping that I have completed everything as required; You do not need insurance to apply for eligibility; I have to say that I have had to send my application to Sydney as WA is not ready for this process: Here is my step by step process:

Step 1; Go to the AHPRA website and download on the first page fourth heading ‘Registration’ on drop down menu second one down click ‘Registration Process’; left hand side blue box; fifth one down; click common registration forms; Standard Format for Curriculum Vitae:print and save this form.

Step 2; While on the AHPRA website go to the Nursing and Midwifery site and download the Registration Standards for the Eligible Midwife third from the bottom; then on the left hand side fifth from the bottom click on forms; a third of the way down the page look for the heading Notations; click on Application for addition of notation as an eligible Midwife; print and save this form.

Step 3: Now you need to read and complete the forms; to make sure you meet these requirements before you apply; I have heard that there has been a problem with Independent Midwives who do not have Midwifery Managers.... so watch this space.... I would think that maybe one way around that might be that they could sign a statutory deceleration..... as this is legally binding.... but that will be for the Board to decide....lets hope they will work it out soon...

a. Current general registration as a midwife in Australia with no restrictions
on practice; You need to add your registration number with AHPRA:

b. Midwifery experience that constitutes the equivalent of 3 years full time
post initial registration as a midwife; Here you need a letter from your current Midwifery Manager outlining that you have worked across the continuum of midwifery care, antenatal, intrapartum and postnatal this letter is dated and signed;
You also need a statement of service; this is obtained from your HR department; I rang Health Corporate Network and gave them the years I work at the government institution and they sent me a very detailed statement of service;

c. Current competence to provide pregnancy, labour, birth and post natal
care to women and their infants; this can be proven by completing the Midwifery Practice Review (ACM) or some other accredited program(I don't know of any other one apart from the ACM one.

d. Successful completion of an approved professional practice review
program for midwives working across the continuum of midwifery care; as above

e. 20 additional hours per year of continuing professional development
relating to the continuum of midwifery care; if you have MidPLUS this will be easy you will just print out your summary; If you do not have MidPLUS you will have to produce evidence of attaining these points; copy your certificates and get them certified copies; I did not send any originals of certificates they were all certified copies.

f. Formal undertaking to complete within 18 months of recognition as a
eligible midwife; or the successful completion of: I wrote a letter using this wording saying that i will formerly undertake the course when it is ready.

i. An accredited and approved program of study determined by the
Board to develop midwives’ knowledge and skills in prescribing, or
ii. A program that is substantially equivalent to such an approved
program of study. As above.

Step 4: Follow the Standard format for CV; as it is slightly different to your current one; I just cut and pasted from my regular CV. One thing that is very different is the request for clinical / procedural skills - with this one I made up a table that gave the dates of my general clinical competences such as Obstetric emergencies; suturing, IV cannulation, neonatal resuscitation etc; and added certified copies of the certificates; You must make a declaration that your CV is true and correct and sign it. The CV has to be an original not a copy;

Step 5; add payment for your application; $90.00

Step 6: you also need someone to witness your signature when you have completed the application form

Step 7; Make sure you go through the checklist it is helpful to ensure you have completed everything; although the checklist does not ask for a letter from the manager and this is a requirement; Not sure why when you provide a statement of service;

Step 8; Take a copy of what you have prepared, I find this always good practice; double check it again and then post it to the AHPRA office in your capital city; if in WA post to Sydney NSW for the interim until the office is more settled in WA, as we only came on board middle of October.

I found this process tedious especially having to photocopy and get 16 copies certified of my qualifications and certificates; the CV was not problematic but had to be changed from my usual format; the letter from the employer was not difficult nor was obtaining the statement of service you just need to allow for the time to prepare for this application; I am hoping now that I have all this information that hospitals who require credentially will not want any more than this and when you have prepared it once it is then done.... life should be easy now....NEXT STEP MEDICARE PROVIDER NUMBER:

Lets hope I have not forgotten anything and have completed the application as required... will let you know how I get on......go on be daring take the step and apply for eligibility;

For more information visit the AHPRA website;

AMA Position on collaboration:

Here is the AMA document for collaboration; yes there are parts of it that make me cringe.... however it must be equally difficult for the AMA, not that any midwife wants to hear that; Click on the link to read the document;

Collaborative Arrangements what you need to know? the irony of this document has to make you laugh or cry:

"Working with other health professionals is an everyday feature of clinical practice for a modern medical practitioner. Effective teamwork can improve patient outcomes, create new opportunities for learning,and build a shared understanding of the skills that each person brings to the care of a patient."

If we do not embrace these changes, then pressure will mount on the Government to relax the requirement for collaborative arrangements to be in place. This would risk fragmentation of care to the detriment of patients.

This is the most telling statement of all.... this means the AMA is seriously concerned that if they the doctors do not collaborate then changes will be made......this is in our favour.

As always I am presenting you with the information and you can decide for yourselves; As i have stated before; My vision is that all women will have the choice of continuity of midwifery care with a midwife and the right to claim a Medicare Rebate for fee for services;
Whilst I do not like the wording in this Determination I can see that this is still a historic time for midwives and midwifery....

Come and welcome Marg Phelan...... in Fremantle

Hi All Midwives and Women / families who read this blog and live in WA;

Marg Phelan arrives: If you are free on Friday 3rd Sept from about 1pm.... Marg is due to arrive in Fremantle at Big 4 Caravan Park, 132 Cockburn Road, Munster WA: Woodman Point Caravan Park: They will be setting off from Burns Beach Joondulup in the morning and cycling to Freo..

Want to know something about Marg Phelan visit her website http://gogirlaustralia.net.au/sponsorship/4537288921

Australian midwife Marg Phelan cycles around Australia for midwives, women, normal birth and breastfeeding. Marg Phelan, a mother and midwife from the Northern Territory, feels so passionate about women’s right to access midwives that she is cycling around Australia to spread the word that women have the right to choose where and with whom they give birth and to be properly supported in these choices. Marg Phelan says, “We believe that every Australian woman is entitled to continuity of midwifery care and good support to help achieve a normal birth and be able to enjoy breastfeeding. Far too many women are not well informed about their options in pregnancy, childbirth and early parenting.”
Go Girl Australia is a not-for-profit venture that aims to promote continuity of care from a known midwife, normal birth and breastfeeding.

Come down and welcome her, bring family, friends, a balloon and share the excitement......wave and support this extraordinary women into Freo.....

Cheers Pauline

Calling all members of the ACM......it's time for the annual general meeting;

To all financial members of the College, it is time for you to have your say....do you want something? do you want to changes something? or just soak up the atmosphere? be proactive this is your College: I will be sending some of the photos of our study days from WA.... if you have some photos you want to send for the slide please send them to the National office or I am happy to send them for you.
Have a weekend in Melbourne.....enjoy the AGM and then a show or and evening out...dine at some of Melbourne's finest restaurants.....

The Australian College of Midwives (ACM) will be holding its Annual General Meeting (AGM) on the 9th October 2010 in Glen Waverly (Melbourne), Victoria. Meeting papers will be arriving in the post in early September with more details.

As a valued member of the ACM you are warmly invited to attend this event and be updated on one of the most extraordinary years for maternity.

You also have the opportunity to create Motions to be heard at the meeting. Please note that all proposed Motions for consideration at the Annual General Meeting must be:

• Submitted in writing to the National Office by close of business on Monday 6th September, 2010;
• Proposed and Seconded by financial members of the ACM; and
• Accompanied by a brief rationale supporting the Motion (100-200 words)

Each year the team at the National Office creates a slide show photographs to pictorially portray our great achievements over the past year. We are keen to receive any photos that you may have that help us celebrate this wonderful profession.

If you would like to contribute photographs of yourself, colleagues or women and babies you have cared for, please email them through to Siobhan Gregory at reception@midwives.org.au

PLEASE NOTE: It is important to obtain permission to use images of others prior to sending through your photos.

We look forward to hearing from you and seeing you in October!

Midwives Insurance options made easy:

If you are a private practice midwife / independent midwife you will need insurance cover: your choices are MIGA and Medisure/Mediprotect - I have discusse these options on a previous blog.... however some midwives have expressed the need for an easier expanation.

What you need to do is read what both companies have to offer: In a nutshell:
MIGA - offers a comprehensive insurance and the cost is up to $7500.00 per anuum, this insurance also has a run off compontent.... and what that means is that it covers you for when you stop working:

Professional indemnity insurance is provided on a claims made basis – this means your policy will only cover you for claims that are made and reported to MIGA while you have a current insurance policy with MIGA
• If, in the future, you no longer need the insurance because you have ceased private midwifery practice, you may require insurance to cover your prior practice. This type of cover is called 'run-off cover'
• Run-off cover insures you for claims made in the future which relate to incidents that occurred in your prior practice
• You need to maintain run-off cover for the whole time that you have ceased practice in order to be protected against claims that may arise in the future.

For a quick easy read, check out Questions and Answers for Midwives
Now also review the Maternity Care Plan Check list by MIGA; click the link.

Medisure / Mediprotect by calling 07 3426 0400 OR Downloading the Application Form, and either Faxing it to (07) 3426 0444 or Via E-mail to admin@medisure.com.au

This insurance does not have a run off cover, if you want to purchase one it comes at a higher price. Also the amount of insurance cover is less than MIGA, the other difference is eligibility....To be eligible for this cover, practitioners need only be registered as a ‘practising midwife’ with the Nursing and Midwifery Board of Australia.

Vero/Medisure/Mediprotect is a cheaper insurance with no run off insurance which allows you to be registered with the NWBA and therefore able to continue to work.... it is not as comprehensive as MIGA..... you will have to decide which insurance will be right for you and your practice!

OF COURSE NO INSURANCE COVERS YOU FOR A HOMEBIRTH

GOOD LUCK.......


Ref cartoon: www.legaljuice.com/judge%20funny%20cartoon%20...

National Health (Collaborative arrangements for midwives) Determination 2010

The day has arrived we know what collaborative arrangements are: here is the document for you to read; I am still absorbing all the information: on the first read I was upset....however after digesting it there is room to move and I am more positive about the whole agreement. It is a difficult paper to read and understand and you have to read it several times to find the areas which we can use to our advantage.....so have a read and then lets discuss our options...click the link

National Health (Collaborative
arrangements for midwives) Determination
20101

4 Specified medical practitioners
For the definition of authorised midwife in subsection 84 (1) of the Act, the
following kinds of medical practitioner are specified:
(a) an obstetrician;
(b) a medical practitioner who provides obstetric services;
(c) a medical practitioner employed or engaged by a hospital authority and
authorised by the hospital authority to participate in a collaborative
arrangement.

5 Collaborative arrangements — general
(1) For the definition of authorised midwife in subsection 84 (1) of the Act,
each of the following is a kind of collaborative arrangement for an eligible
midwife:

(a) the midwife is employed or engaged by 1 or more obstetric specified
medical practitioners, or by an entity that employs or engages 1 or
more obstetric specified medical practitioners;
(b) a patient is referred, in writing, to the midwife for midwifery treatment
by a specified medical practitioner;
(c) an agreement mentioned in section 6 for the midwife;
(d) an arrangement mentioned in section 7 for the midwife.
(2) For subsection (1), the arrangement must provide for:
(a) consultation between the midwife and an obstetric specified medical
practitioner; and
(b) referral of a patient to a specified medical practitioner; and
(c) transfer of a patient’s care to an obstetric specified medical
practitioner.

(3) A collaborative arrangement, other than an arrangement mentioned in
section 7, may apply to more than 1 patient.

(4) However, an acknowledgement mentioned in paragraph 7 (1) (c) may apply
for more than 1 patient.

6 Agreement between eligible midwife and 1 or more specified
medical practitioners
(1) An agreement may be made between:
(a) an eligible midwife; and
(b) 1 or more specified medical practitioners.
(2) The agreement must be in writing and signed by the eligible midwife and
the other parties mentioned in paragraph (1) (b).

7 Arrangement — midwife’s written records
(1) An eligible midwife must record the following for a patient in the midwife’s
written records:
(a) the name of at least 1 specified medical practitioner who is, or will be,
collaborating with the midwife in the patient’s care (a named medical
practitioner);
(b) that the midwife has told the patient that the midwife will be providing
midwifery services to the patient in collaboration with 1 or more
specified medical practitioners in accordance with this section;
(c) acknowledgement by a named medical practitioner that the practitioner
will be collaborating in the patient’s care;
(d) plans for the circumstances in which the midwife will do any of the
following:
(i) consult with an obstetric specified medical practitioner;
(ii) refer the patient to a specified medical practitioner;
(iii) transfer the patient’s care to an obstetric specified medical
practitioner.
(2) The midwife must also record the following in the midwife’s written
records:
(a) any consultation or other communication between the midwife and an
obstetric specified medical practitioner about the patient’s care;
(b) any referral of the patient by the midwife to a specified medical
practitioner;
(c) any transfer by the midwife of the patient’s care to an obstetric
specified medical practitioner;
(d) when the midwife gives a copy of the hospital booking letter (however
described) for the patient to a named medical practitioner —
acknowledgement that the named medical practitioner has received the
copy;
(e) when the midwife gives a copy of the patient’s maternity care plan
prepared by the midwife to a named medical practitioner —
acknowledgement that the named medical practitioner has received the
copy;
(f) if the midwife requests diagnostic imaging or pathology services for
the patient — when the midwife gives the results of the services to a
named medical practitioner;
(g) that the midwife has given a discharge summary (however described)
at the end of the midwife’s care for the patient to:
(i) a named medical practitioner; and
(ii) the patient’s usual general practitioner.

All the above information is taken from the National Health Act 1953 (click the above link for the whole document)

Please feel free to ask any questions

Insurance for Midwives:

There are several choices for midwives in relation to insurance. If you work in a hospital you will be covered by the hospital vicarious liability, you will however need to find out what that insurance covers:

To practice as a private practice or independent midwife you will need some form of insurance in order to be registered with the Nurses and Midwives Board of Australia. Currently these are your choices:

Option 1
The Government Insurance:
MIGA (Medical Insurance Group of Australia) has won the contract to offer midwives professional indemnity insurance, with support by the Commonwealth under the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010 and the Midwife Professional Indemnity (Run-off Cover Support Payment) Act 2010. See blog 14 June
MIGA have a News Flash in relation to collaborative arrangements click here to see more....
Further information about Collaborative requirements appears below.

I am interested in securing formal Collaborative Arrangements, but I don't think I can obtain an obstetrician's or a hospital's agreement to collaborate with me before 1 July. Can I still be covered by the MIGA insurance?
Yes. If you are unable to obtain a Collaborative Arrangement for a particular woman, you will still be covered if you communicate a maternity care plan for that woman to a public hospital that provides obstetric services.

Option 2
Vero insurance policy for antenatal and postnatal care only - the agents for this will be Mediprotect http://www.mediprotect.com.au/
The policy will cover activities such as, the provision care and education services, but will exclude birthing. Midwives will be able to choose between two categories for their activities.
The insurance will cost between $1800 - $3010.00 ( cover will be from $1,000,000 - $5,000,000
Information about the Vero policy can be obtained from the Mediprotect website or by phoning Mediprotect on 07 3426 0440.

To be eligible for this cover, practitioners need only be registered as a ‘practising midwife’ with the Nursing and Midwifery Board of Australia.

Option 3
The ANF is contemplating an insurance option this is still to be confirmed, the best thing to do is to check with your local office....

Watch this space for more information......
Remember there is no insurance cover for Homebirth;

Cheers Pauline

ref for cartoon: www.getmilked.com/.../ThankYouInsuranceMan.html

What does collaboration look like with MIGA

The Hon Nicola Roxon MP - Minister for Health and Ageing has announced that MIGA has been awarded the contract to be the sole provider under a new Government supported Scheme to provide Professional Indemnity Insurance to privately practising midwives MIGA - the Medical Insurance Group A full time equivalent will cost you $7500.00 per year. (The Australian College of Midwives will also have a competitive insurance so watch this space)

This insurance company has outlined what collaboration will look like: here are the exerts from the document on collaboration to read the whole document click this link;

A Collaborative Arrangement must provide for:
- consultation between you and an Obstetric Specified Medical Practitioner;
- referral of a patient to a Specified Medical Practitioner; and
- transfer of a patent's care to an Obstetric Specified Medical Practitioner.

A Collaborative Arrangement means one of the following types of arrangements:
- a patient is referred in writing to you for Midwifery Services by a Specified Medical Practitioner;

or
- an arrangement in writing between you and one or more Specified Medical
Practitioners which provides for consultation between you and the Medical
Practitioner(s), referral of patients to the Medical Practitioner(s), transfer of a
patient's care to the Medical Practitioner(s) and which is signed by you and the
Medical Practitioner(s);
or
- you have met each of the following requirements for each patient:

- you have recorded the name of the Specified Medical Practitioner who is (or will
be) collaborating with you in your written records;

- you have told the patient that you will be collaborating with a Specified Medical
Practitioner and recorded this in your written records;

- you have an acknowledgement by the named Medical Practitioner that they will
be collaborating with you in the patient's care and you have recorded this in
Your written records (this acknowledgement may apply to more than one
patient);

- you have recorded in your written records plans for the circumstances in which
you will consult with an Obstetric Specified Medical Practitioner; refer the
patient to a Specified Medical Practitioner; transfer the patient's care to an
Obstetric Specified Medical Practitioner;

- you have recorded any consultation or other communication between you and
an Obstetric Specified Medical Practitioner about the patient's care in your
written records;

- you have recorded any referral of the patient by you to a Specified Medical
Practitioner in Your written records;
- you have recorded any transfer by you of the patient's care to an Obstetric
Specified Medical Practitioner in your written records;

- when you give a copy of the hospital booking letter (however described) for the
patient to a named Medical Practitioner, you have recorded the acknowledgement that the named Medical Practitioner has received a copy of the hospital booking letter in your written records;

- when you give a copy of the patient's maternity care plan prepared by you to a
named Medical Practitioner, You have recorded in your written records the
acknowledgement that the named Medical Practitioner has received the copy of
the maternity care plan;

- if you request diagnostic imaging or pathology services for the patient, you have
recorded when you give the results of those services to a named Medical
Practitioner in your written records; and

- you have given a discharge summary (however described) at the end of your
care for a patient to the named Medical Practitioner and the patient's usual
general practitioner and recorded this in Your written records.

I will leave you to ponder on this and comment.....

cheers Pauline

Will you be an Eligible midwife?

The Nursing and Midwifery Board of Australia has submitted to the Ministerial Council for approval: the Registration Standard for Eligible Midwife and Registration for Endorsement for Scheduled Medicines for Eligible Midwives.

What does this mean for the average midwife in Australia?
Requirements
To be entitled to be identified as an eligible midwife, a midwife must be able to demonstrate, at a minimum, all the following:

Current general registration as a midwife in Australia with no restrictions on practice;

Midwifery experience that constitutes the equivalent of 3 years full time post initial registration as a midwife;

Current competence to provide pregnancy, labour, birth and post natal care to women and their infants;

Successful completion of an approved professional practice review program for midwives working across the continuum of midwifery care;

20 additional hours per year of continuing professional development relating to the continuum of midwifery care;

Formal undertaking to complete within 18 months of recognition as an eligible midwife; or the 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, as determined by the Board.

My understanding of the above is that you can be deemed an eligible midwife and give the undertaking that you will complete within 18 months further study for prescribing and diagnostics.

Now we have to wait for the release of the courses that we are to do...those from WA who have already completed the Eligible Midwife program which was four units...should get some RPL (recognition for prior learning).....
Until these units are established it seems that midwives are required yet again to jump through hoops to give continuity of care.....

What does this mean: you will have to have three years experience across the continuum of midwifery before you can become an eligible midwife..... complete your Midwifery Practice Review and have an undertaking do further study within 18 months..... and you need to be insured.....indemnity insurance:

Watch this space!

Cheers Pauline

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

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

Go Girl Australia

Cycling for midwives, women, normal birth and breastfeeding
Who is Go Girl Australia you might well ask..... it is someone that you may well know..... Marg Phelan - Midwife

Go Girl Australia
I met Marg in 2003 when she was the was very involved with the College of Midwives (ACM) at state and national level, including a two-year term as National President. "Marg sees pregnancy, labour and birth as a normal physiological process, and believes that for normal pregnancies, homebirth is a safe and enormously rewarding experience. She recently had the honour and privilege to be midwife for daughter-in-law Mei Mei and son Paul during the homebirth of their beautiful boy in December 2008".

Now working in the Darwin Homebirth Service, Marg is able to offer the model of care to which she believes all women are entitled.

Go Girl Australia is a not-for-profit venture that aims to promote continuity of care from a known midwife, normal birth and breastfeeding.

Follow Marg's journey..... see the map..... she will be in WA:
Darwin to Broome (April - June 2010)
Broome to Perth (23 July - 2 September 2010)
Broome to Kalgoorlie (August - mid September)

If you know midwives in these areas please forward them this link and let them know when Marg is there area so that we can celebrate her journey..... and help the cause. Go Girl Go

Want to sponsor the cause click here
Go Girl Australia is a self-funded, not-for-profit venture and its purpose is not to raise funds, but to raise awareness and improve education. There are many ways you can support us.
Join us on part of the ride
Make placards and signs to display as we pass through your town
Organise a get-together for women in your area - Marg will be happy to speak at your event
Sponsor us with donations of cash, fuel vouchers, cycling gear, bike parts, accommodation, food
Advertise Go Girl Australia through your business or community group

Can't wait to greet you in Perth Marg and safe journey......

Midwifery: Diverse Care for a diverse Community

WA Branch of the Australian College of Midwives presents:

International Midwives Day - Midwifery Diverse Care for a diverse Community:

When: Saturday 1st May 2010

Time: 8.00 - 17.00

Where: The university club of Western Australia,
University of Western Australia, Hackett drive, Crawley Entrance No1,
car park 3

Come and celebrate, with your friends and colleagues, the work of midwives and the
profession of midwifery. Walk in the shoes of a rural midwife, gain some insight into the world of migrant women, obtain practical help with MidPLUS and hear the latest updates from the college. Finish the day and relax with some gentle
Tai Chi followed by sundowner (drinks & nibbles).

• Rural Midwifery - Arlene Manado
• Migrant Women: The Afghan Perspective - Susan Vessey &
Margaret Broadbent
• Having trouble getting started with MidPLUS ? Unsure about
Midwifery Practise Review? MidPLUS workshop -
Karen Kruit and Shelley Gower
• Midwifery Care in Tanzania - Janice Butt
• Meeting Diverse Needs: Women and Newborn Drug and
Alcohol Service - Sadie Geraghty
• Tai Chi - an introduction to the gentle exercise of mind and body
• Live Entertainment and Spot Prizes
• Johnson & Johnson WA Midwife of the Year Award

Please click this link for the application form

REGISTRATION 08.00 - 08.30 Registration includes refreshments & lunch
Sundowner 16.00 – 17.00 Free parking all day

REGISTRATIONS CLOSE
27TH APRIL 2010
Enquires:
PAULINE MOORE 0407 421 191
acmwabranch@gmail.com
To Register
www.midwives.org.au
ACM NATIONAL OFFICE
(02) 6230 733 1300 360 480
FUL DAY COST (GST INCLUSIVE)
MEMBERS $100 / NON -MEMBERS $120
STUDENTS $70 / GROUP BOO KING
(4 OR MORE ) DIS COUNT $10 PP
ACM CPD points apply
*Program subject to change

see you there............for the celebrations

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 pounds.....to 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

Meeting the Prime Minister: Australia Day Celebrations in Perth

The President (Tracy Martin) of the Australian College of Midwives WA Branch & guest (Pauline Costins) National Director representative WA Branch was invited to the Australia Day Celebrations at the Town Hall on Thursday 21st January. Over 400 hundred guests were present, the guests included members of parliament, multi denominational religious dignitaries, associations, unions, volunteers, hospital and health officials....... too many for me to mention, however a mixture of peoples. We were greeted at the door by the Hon Kevin Rudd, he held out his hand and said “hello I’m Kevin”...... not what I was expecting and on his right was the Hon Colin Barnett. It was all so surreal, the hall was very hot, the drinks were flowing freely and people mingling and talking.




There was the traditional opening, followed by the National Anthem: Advance Australia Fair and the Prime Ministers speech. The Hon Kevin Rudd praised our beaches and our natural environment.

“As a Prime Minister I am doing something a little different this year....... what I have sought to do this week is to take some time to travel to each of our State capitals.... to take Australia Day to the people”
“The nation is much bigger than Canberra. The nation extends – at least at my last report – beyond the boundaries of the Australian Capital Territory. This is a vast nation.

Tracy and I spoke to many people; including the PM, he knew the name of the midwife at his birth, that was impressive, midwives are certainly on the Federal agenda, it was a great early evening event. We met the Federal Member for Hasluck Ms Sharryn Jackson MP, I had recently sent Ms Jackson an email, as she is my local Member of Parliament, asking her what her position was on Homebirth, MBS, PBS and Midwifery models of care. It was refreshing to see she had read my email and responded by saying, "yes midwives not happy, I am not happy" so lets hope things move forward.


We were also fortunate to meet the Hon Nicola Roxon, the Minister for Health and Aging, what a delight Nicola is.... we spent quite some time discussing the issues surrounding midwives and midwifery... the take home message for midwives: was to work together, all come from the same page and support each other, which also means supporting the Australian College of Midwives who is actively fighting for the rights of the midwife in Australia.



It was a fruitful evening, networking and getting to talk to the parliamentarians, I was really impressed with Nicola Roxon.... she is dynamic and intelligent, a woman before her time.... I really hope it all pays off... I believe as midwives if we could get MBS & PBS off the ground and into mainline practice.... Homebirth will follow... we have a two year grace to work out a framework suitable for independent or private practice midwifery.... lets take one step at a time, ensure the first steps and the rest will follow.... don't throw the baby out with the bath water....it will happen in due course.....

The Big Picture in Midwifery – WA Branch Report

Allow me to begin by offering a huge and heart-felt thanks to everyone who worked so tirelessly and contributed to the organisation of the ‘Big Picture in Midwifery’ tour of Western Australia. Including all of the magnificent meals provided to me whilst I travelled – I got home a more ‘rounded’ version of my former self! 
I had the absolute honour and pleasure of meeting midwives, working across all spectrums of midwifery care from all over the state – managers, educators, researchers, those working clinically in a hospital, community midwives and those in independent practice. Thank you to all of you that took time out of your busy days (and so often on your days off!) to come and hear about how the Australian College of Midwives is working hard to help you be informed about and meet the coming changes to the way that you will renew your registration and also the implications for the profession with the funding of the recent Maternity Services Review recommendations.

I arrived in Perth on Friday 13th November, excited at having been asked to speak at the WA Branch’s ‘Magic of Midwifery’ Education Day. There were over 100 midwives attending and it was such an honour to have the entire morning with this group of incredible professionals, speaking about the proposed changes, answering questions and watching the group become more motivated and inspired about the possible ways forward for the profession.
On the morning of Monday 16th November, I presented to the team of midwives at Margaret River Hospital, before heading up to Bunbury for an afternoon session, where midwives from Collie, Bridgetown, Busselton and Manjimup joined us via teleconference. Thanks to the, Nurse Unit Manager at Bunbury Regional Hospital for all her help in getting this presentation and teleconferencing facilities up and running!
Tuesday 17th November, I flew to Albany to meet with the lovely team of midwives at Albany Hospital. Thanks to the Nurse Unit Manager for picking me up from the airport (only to drive me straight back again when I realized I’d left my suitcase behind ) and for organising a great lunch! By holding the presentation close to the Ward we had a great turnout – thanks to those of you who came in on your day off!

The following day, Wednesday 18th November saw me tripping off to Kalgoorlie to be met by almost 100% of the midwifery workforce of Kalgoorlie! We had a great afternoon and as always I felt a deep sense of personal satisfaction as I watched midwives begin to realise that their professional body cares very much about them and is supporting them to be informed about and supported to meet the changes with national registration and advocates for them on a daily basis amidst some of the most politically influential medical groups.
On Thursday 19th November, I was excited to meet with a large group of midwives at St John of God Hospital in Subiaco, Perth. Thanks for organising the session and also for my lovely box of chocolates! (More padding to the ‘roundedness’ that I took home with me!) 
After a lovely weekend with my Mum and children in Margaret River, I drove to Fremantle to meet with the fabulous team at the Community Midwifery Program WA. After some regrettable delays, due to technical difficulties with the data projector, the presentation continued without a hitch! Thank you to CMWA, and to those midwives in independent practice who were able to come along.
Tuesday 24th November found me in Geraldton, and despite the fact that my plane was delayed 1 ½ hours, it was wonderful to revisit where I had spent part of my childhood. Thank you to the, Nurse Unit Manager for her help in getting me to and from the airport and especially to all the midwives who waited for me to arrive (despite the SkyWest Airlines delays!)
Wed 25th November was the day I headed off to Port Hedland. I was thrilled to see so many midwives from Port Hedland Hospital and a major midwifery contingent from Karatha and also Tom Price join us via teleconference.
I had no idea that my final day is WA was going to be such a huge finale, but Thursday 26th November held a number of gems. In the morning I met with the, Principal Midwifery Advisor for the WA Department of Health. I was gratified to see that the Dept of Health is working hard for the midwifery profession to help prepare them for national registration. WA’s first priority is workforce planning – involving creating a workforce planning committee and looking at details like:
• How many midwives are there in WA?
• Where are they working?
• How many students and graduates are there?
• What models of care exist in WA?
• What is an appropriate midwifery workforce model to discern appropriate staffing requirements for maternity care?

The Principal Midwifery Advisor is clearly committed to her role as and is keen to make a swift and positive impact for West Australian midwives.
The final presentation of the tour ended at the King Edward Memorial Hospital in Perth. We had an overwhelming attendance of 26 midwives from the King Edward and no less than 13 sites joining us via teleconference!

Thanks to every midwife from Newman, Rockingham, Bentley, Busselton, Katanning, Derby, Narrogin, Broome, Denmark and Kalgoorlie who were able to attend!
I was so lucky to spend time travelling the state meeting with many midwives, and I can only hope that those of you that I met are now championing all the new and exciting information to your colleagues to make sure that every midwife is feeling supported to meet these changes! Please remember to keep in touch – that’s what a professional body is for – to support you and offer you a community.

Remember, the strength of the profession, lies in the diversity of the care that you offer women. Celebrate being ‘with woman’, in whatever way that looks like for you –WE DO!!!I look forward to seeing you again in 2010!

Kindest regards

Abby Clemence
National Programs Manager