Notation on the Register

The notation on my registration states:

Mrs Joyce Johnston is an eligible midwife competent to provide pregnancy, labour, birth and postnatal care and qualified to provide the associated services and order diagnostic investigations required for midwifery practice, in accordance with the relevant State and Territory legislation. Eligible midwife, but NOT qualified to obtain endorsement under section 94 to prescribe Schedule 2, 3, 4 & 5 medicines required for midwifery practice in accordance with State & Territory legislation.

I had applied for this eligible status last December, so it is with a considerable sigh of relief that I acknowledge this achievement.

Anyone reading this post who is not familiar with current maternity care in Australia may question the wording of the notation. I am now an 'eligible midwife'. I am now "competent to provide pregnancy, labour, birth and postnatal care" - care that I have been providing on my own authority, independenty, for most of the past 20 years.

So what's new?

The main new feature of my practice is that some women in my care will, as a result of this notation on the Register, be able to claim rebate from Medicare on my fees: women who have Medicare cards, and for whom I am able to set up sutiable collaborative arrangements with a doctor. As soon as I can organise the software and other technology, I hope to be able to process Medicare rebates from my office directly to a woman's nominated bank account.

Another new feature is, as the notation states, that I am now able to order diagnostic investigations required for midwifery practice. In the past I have asked women to have routine blood tests and any other investigations requested by their GPs.

I am not yet able to prescribe medication. I have signed an undertaking to complete a medication course for midwives , within 18 months of being recognised as an eligible midwife. However, to date the Board has not approved a program of study in prescribing, so I am waiting for that approved course to be announced.

Another feature of the government's midwifery reform package that is yet to be realised is the ability for midwives to attend women privately in hospitals. At present, when a midwife goes to hospital with a woman for whom she has provided prenatal care, the midwife's status is a sort of support person who has no professional role, and who can be seen as persona non grata. Midwives' ability to provide professional intrapartum care in hospitals is part of the government's Midwife Professional Indemnity Scheme.

In the 2009-10 Budget, the Government announced the 'Improving Maternity Services Package'. The package provides for the introduction of Medicare supported services to provide greater choice for women during pregnancy, birthing and postnatal maternity care, including the provision of professional indemnity for midwives. The Midwife Professional Indemnity Scheme (MPIS) includes a Commonwealth contribution initiative designed to assist with claims made against eligible midwives and encourage the provision of indemnity insurance policies for private independent midwives. The Midwife Professional Indemnity Scheme provides financial assistance to eligible Insurers who provide indemnity to eligible midwives.

There are now a handful of Medicare-authorised midwives. In Victoria, you can get Medicare rebates for private midwifery from a midwife in Echuca, and from a few midwives in Melbourne.  There is no Medicare rebate, or indemnity insurance for home birth.  Midwives are exempt from being required to have insurance for homebirth until the end of June 2013.

You can search for a midwife on Google, or go to Midwives Australia .

Thankyou for your comments