Monthly review

Last month I began a countdown to 1 July 2010. I hope to summarise and review progress over the past month, for my own sake as well as for others who are following events as they unfold. If you don't understand something I have written, or think I have got it wrong, please let me know.

We can be confident that a baby who is conceived this week will be born before 1 July.

A woman whose menstrual period starts this week and conceives when she becomes fertile a couple of weeks from now will attain 42 weeks' gestation in the first week of July.

If you are that woman, and are planning homebirth with a privately practising midwife, you will need to work closely with your midwife, keep a clear mind, and remember your personal rights and responsibilities in giving birth to your child.


In summary

# Health Ministers have agreed to a transitional clause in the current draft National Registration and Accreditation Scheme legislation which provides a two year exemption until June 2012 from holding indemnity insurance for privately practising midwives who are unable to obtain professional indemnity insurance for attending a homebirth. (AHMC Communique 4 September 2009)

Although this sounds like a useful reprieve at face value, I see it as a meaningless political gesture to get the pressure off the Health Minister and the government that is presiding over reform that is a dog's breakfast before it's even enacted. Curiously the two-year exemption was announced at 4pm on the last business day before the big rally!

# The Department of Health and Ageing is seeking tenders from insurance companies to provide indemnity for eligible privately practising midwives.

This could potentially make private midwifery technically lawful, while making it so expensive that it becomes more marginal and unaffordable than it is now.

# The Maternity Service Advisory Group, with hugely disproportionate obstetric and medical representation, has been set up by the (federal) Health Minister.

# Key players have been invited to send a representative to three technical working groups to be convened 24 September and 12 October, as a component of the national maternity reform process. The working groups will consider PBS (pharmaceuticals), MBS (Medicare), and eligibility (credentialing).

Australian Private Midwives Assn (APMA) and ACM have been invited to send one representative each. Maternity Coalition have been invited to send two representatives. I don't know who else is to be represented.


My comment:
I will be satisfied that we are moving in the right direction if there can be agreement on broad principles underpinning midwifery practice and primary maternity care.

These principles are well articulated in the ICM Definition of the midwife.

As long as the advisors to the Health Minister are ignorant of the principles underpinning midwifery, and are able to be swayed by interest groups who advocate for midwifery to be a support service to obstetrics, these principles including partnership between a woman and her midwife, promotion of normal birth, and professional competence will not be respected in any of the outputs from working groups and advisory committees.