Update on Home Birth and Independent Midwives
A Maternity services review was conducted last year and it was decided that in order to improve the options and standard of care available for women for their pregnancy, birth and postnatal time, that midwives need to be mobilized and play a bigger and actually more appropriate role in the care provided. This has now been legislated and the plan is that midwives can provide all care for pregnancy, hospital birth and postnatal care for women, and their fee will be medicare rebatable.
This is great news and will undoubtedly improve outcomes and levels of satisfaction for everyone.
Home birth has never been part of this discussion as it was stated in the review that it would increase tensions amongst the professions. Because of the position of the AMA and the college of obstetricians it was left out of the planning. Due to the new national registration of all midwives (it has been just state registration) there are some issues referred to by the government as “unintended consequences of the cross section of the legislation”. One of these issues is that conditions for national registration include that a midwife needs Professional Indemnity Insurance (PII). Currently there is not a product available for purchase and it is being developed. This PII product will be created for the new breed of private midwife as mentioned above, only for hospital births but no PII will be available for homebirths. The government has granted a 2 year exemption for the requirement for PII for midwives attending homebirths, so that they won’t be practising outside their registration requirements i.e. not having PII for homebirth . There are conditions for this which have not been finalised but are separate to the requirements for midwives having access to Medicare. The first draft of the framework has been circulated and was based on midwives complying with the ACM consultation and referral guidelines but the second draft should be out some time next week.
These regulations all start from July 1st 2010.
So will homebirth be illegal? no.
Will you be able to be attended at a homebirth by a midwife? Yes, if your situation is within the guidelines, or if you have made an informed choice in having a homebirth even if you fall outside the guidelines and the midwife agrees to attend you.
Will my care by my midwife be medicare rebateable? yes, if she is an eligible midwife and only for antenatal and postnatal care, not for the home birth.
Jane Hardwicke Collings
Teacher of the Women’s Mysteries
The School of Shamanic Midwifery