Monday, August 10, 2009

a new business model for private midwifery services

I would like to hear from midwives in and around Melbourne who are interested in employment opportunities in private midwifery practice.

A plan is being developed, under which midwives who wish to enter the world of private midwifery practice in a casual employment model*, may begin getting experience in coming months, with the plan to move into extended practice models that become available after 1 July next year. Under this new model, midwives will be paid a minimum of the award hourly rate for caseload practice, and work with an experienced private practice midwife.

[* Note that the usual models for private midwifery practice in Australia are either a self employed midwife, or a midwife who practises within a group.)

The future of private midwifery in Australia is at present in the hands of our law makers, and although some midwives are hopeful that solutions will be found and amendments made before the draft legislation becomes the law, we face the real possibility that private midwifery practice as we know it will be unlawful after 1 July next year.

This new business model for providing private midwifery services has potential to minimise transitional disturbances for women and midwives, as the reforms are introduced in 2010 and beyond, if indeed private midwifery survives. If not, employment options for these midwives will be severely limited.

From my personal perspective, being one of the elders of the private midwifery community, I would like to be able to continue practising independently until at least 2015. I am not opposed to change. A profession that can not critically reflect on what it does, and make changes in an effort to improve its standards and outcomes, is not in a good place.

However I will continue to oppose changes that unfairly restrict consumer access to private midwifery, and restrict midwives' ability to practise independently within the scope of midwifery, promoting and protecting normal birth. I will strenuously oppose any attempt by legislators, or by other professions with whom midwives collaborate, or even by consumer groups, to dictate the boundaries and terms of midwifery.

Does this sound like paranoia? Am I overstating the issue? I don't think so. There have been many examples of serious threats to midwifery in the sorry saga of midwifery reform 'Yes, Minister'-style in recent months, approaching a climax last week in the Senate inquiry.

I am not sure what forms of private midwifery services will survive the government's current reform process. I am aware of the expectation that midwives who are considered eligible for any government support in the form of indemnity and Medicare (the two will be linked), will be required to accept a framework that describes policies and processes. The South Australian government's Policy for Planned Birth at Home has been suggested as a starting point for the development of a national homebirth framework. The South Australia homebirth policy was never intended as a framework for private midwifery practice: it was designed as a framework for homebirth services provided through public hospitals in SA.

When I eventually put down my Pinnard for the last time, I would like to be sure that there are midwives who know and will pass on the principles of authentic midwifery to the next generation. When I started writing this blog a couple of years ago it was with the hope that I would be able to put my knowledge and passion for midwifery into a form that is accessible by other midwives and women interested in promoting normal birth. My fear is that midwives with this skill may be lost to the maternity service world in coming months.


Laura Jane said...

I am very interested in such a plan but I am in WA.

I am sincerely hoping for a position in some new MGPs being mooted in the near future, but am prepared to seek a 'work experience' position with MIPP soon if this does not happen.

It would be criminal to lose the skills of authentic midwifery due to political interference in the natural processes of a woman's body.

They might as well try to pass laws about vomiting!

Anonymous said...

I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


Joy Johnston said...

Thankyou for these comments Laura Jane and Patricia. It's great to get some feedback. I have found blogging a very useful tool for communication during these turbulent days in the world of private midwifery and homebirth.