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WWhhaatt iitt mmeeaannss ttoo bbee aa 
mmiiddwwiiffee 
DDrr BBeelliinnddaa MMaaiieerr 
AAddjjuunncctt AAssssoocciiaattee P...
• Why midwifery? 
• Cute babies? 
• Cushy job? 
• Career options? 
• Climbing mountains? 
• Feminism? 
• Being political?
• 1989 my journey to midwifery started
• 1989: Lacey normal birth on birthing stool 
• 1992: Macauley fast normal birth on 
birthing stool 
• 1997: Callum fast n...
• …a woman leaves her dignity at the 
door…?????????? 
• That’s the space that makes me a 
passionate midwife
• Dignity; is a term to signify that a being 
has an innate right to be valued and 
receive ethical treatment OR the quali...
HHoollllyywwooooddiissaattiioonn ooff bbiirrtthh -- 
aarrgghhhhhh
SSoo wwhhaatt aattttrraaccttss yyoouu,, wwhhaatt 
ssttiimmuullaatteess yyoouurr ppaassssiioonn ffoorr 
bbeeiinngg aa mmiid...
AGEING, C. D. O. H. A. 2008. National Consensus Framework for Rural Maternity Services. In: 
AGEING, C. D. O. H. A. (ed.)....
Midwife 
• A midwife is a person who, having been regularly admitted to a midwifery 
educational programme, duly recognise...
EElliiggiibbllee MMiiddwwiiffee 
• What is an ‘eligible’ midwife? 
• An eligible midwife is a midwife who meets further pr...
• So is a midwife a midwife or is there better 
midwives than others? 
• If I work in homebirth today, shift work 
model t...
WWhhaatt aarree tthhee ooppttiioonnss aanndd wwhhaatt 
sshhaappeess hhooww mmaatteerrnniittyy ccaarree iiss 
pprroovviidde...
EEmmppllooyymmeenntt aass aa mmiiddwwiiffee 
• Public 
• Private 
• Self employed 
• Hybrids of all of the above
NNaattiioonnaall aatttteennttiioonn ttoo wwhhaatt 
wwoommeenn wwaanntt?? 
• National Maternity Services Review – 
Commonwe...
National MMaatteerrnniittyy SSeerrvviicceess PPllaann 
•Five year vision 
• Maternity care will be woman-centred, reflecti...
NNaattiioonnaall RReeffoorrmm 
• Scope of practice 
• Professional identify 
• Private practice 
• Access for your clients...
ffuuttuurree 
• Greater access to visiting rights, indemnity 
insurance, credentialing… 
• Negotiated contracts…. 
• More ...
"TThhee ppeerrssoonnaall iiss ppoolliittiiccaall" 
• Are we living in an enlightened and equal 
society? 
• Risk has becom...
RRiisskk 
• Everything or nothing
• Why is it ok to assume medicine or 
midwifery can determine what is good or 
bad for women? 
• When did it become ok to ...
RRiisskk iinn ccoonntteexxtt 
• Amniocentesis versus VBAC 
• Children drowning versus relocation for 
birth
Fundamentally wwhhyy iiss iitt eevveenn ookk ffoorr 
aannyyoonnee ttoo ddeecciiddee aannyytthhiinngg ffoorr 
wwoommeenn?? ...
•• TThhee cchhaalllleennggee nnooww iiss ttoo pprraaccttiiccee 
ppoolliittiiccss aass tthhee aarrtt ooff mmaakkiinngg wwhh...
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
What it means to be a midwife inc national reform july 2013
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What it means to be a midwife inc national reform july 2013

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Presentation outlining National Maternity reform in Australia
Midwifery
Eligible Midwife
models of care

Publié dans : Santé & Médecine
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What it means to be a midwife inc national reform july 2013

  1. 1. WWhhaatt iitt mmeeaannss ttoo bbee aa mmiiddwwiiffee DDrr BBeelliinnddaa MMaaiieerr AAddjjuunncctt AAssssoocciiaattee PPrrooffeessssoorr GGrriiffffiitthh UUnniivveerrssiittyy 22001133 MMaaiieerr..BBeelliinnddaa@@yyaahhoooo..ccoomm..aauu
  2. 2. • Why midwifery? • Cute babies? • Cushy job? • Career options? • Climbing mountains? • Feminism? • Being political?
  3. 3. • 1989 my journey to midwifery started
  4. 4. • 1989: Lacey normal birth on birthing stool • 1992: Macauley fast normal birth on birthing stool • 1997: Callum fast normal birth at home in lounge • 2000: Willow normal birth in water at home
  5. 5. • …a woman leaves her dignity at the door…?????????? • That’s the space that makes me a passionate midwife
  6. 6. • Dignity; is a term to signify that a being has an innate right to be valued and receive ethical treatment OR the quality or state of being worthy, honored, or esteemed
  7. 7. HHoollllyywwooooddiissaattiioonn ooff bbiirrtthh -- aarrgghhhhhh
  8. 8. SSoo wwhhaatt aattttrraaccttss yyoouu,, wwhhaatt ssttiimmuullaatteess yyoouurr ppaassssiioonn ffoorr bbeeiinngg aa mmiiddwwiiffee??
  9. 9. AGEING, C. D. O. H. A. 2008. National Consensus Framework for Rural Maternity Services. In: AGEING, C. D. O. H. A. (ed.). COALITION, M., (AUSTRALIA), A. & INC, A. S. O. I. M. C. M. W. 2002. National Maternity Action Plan: For the introduction of community midwifery services in urban and rural Australia. CREEDY, D. 1993. Postnatal depression: improving the experience of country women through professional and community awareness. Australian Journal of Rural Health, 1, 43-9. EVANS, R., VEITCH, C., HAYS, R., CLARK, M. & LARKINS, S. 2011. Rural maternity care and health policy: Parents' experiences. Australian Journal of Rural Health, 19, 306-311. FAHEY CM & JS, M. 2005. Australian rural midwives: perspectives on continuing professional development. . Rural and Remote Health 5, 468. GRZYBOWSKI, S., KORNELSEN, J. & SCHUURMAN, N. 2009. Planning the optimal level of local maternity service for small rural communities: A systems study in British Columbia. Health policy (Amsterdam, Netherlands), 92, 149-157. HOANG H, L. Q., KILPATRICK S. 2012. Small rural maternity units without caesarean delivery capabilities: is it safe and sustainable in the eyes of health professionals in Tasmania? . Rural and Remote Health, 12, 1941. IRELAND, J., BRYERS, H., VAN TEIJLINGEN, E., HUNDLEY, V., FARMER, J., HARRIS, F., TUCKER, J., KIGER, A. & CALDOW, J. 2007. Competencies and skills for remote and rural maternity care: a review of the literature. Journal of Advanced Nursing, 58, 105-115. KILDEA, S. Year. Risk and childbirth in rural and remote Australia. In: Presented at the 7th National Rural Health Conference: The Art and Science of Healthy Community - Sharing country know-how 2003 Hobart, 1-4th March 2003. KILDEA, S. 2006. Risky business: contested knowledge over safe birthing services for Aboriginal women. Health Sociology Review, 15, 387-396. KILDEA S, K. S., BARCLAY L, TRACY S. 2010. ‘Closing the Gap’: How maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women. Rural and Remote Health, 10, (Online) 2010. Available: http://www.rrh.org.au KORNELSEN, J. & GRZYBOWSKI, S. 2006. The Reality of Resistance: The Experiences of Rural Parturient Women. The Journal of Midwifery & Women’s Health, 51, 260-265. KORNELSEN, J. G., STEFAN ; IGLESIAS, STUART. 2006. Is rural maternity care sustainable without general practitioner surgeons? Canadian Journal of Rural Medicine, 11, 218-20. KRUSKE, S. & JONES, R. 2010. Summary Report on Consumer, Carer, and Stakeholder Perspectives on Maternity Care in Regional, Rural and Remote Queensland: . LUO, Z.-C. & WILKINS, R. 2008. Degree of rural isolation and birth outcomes. Paediatric and Perinatal Epidemiology, 22, 341-349. ROBERTS, C. L. & ALGERT, C. S. 2000. The urban and rural divide for women giving birth in NSW, 1990–1997. Australian and New Zealand Journal of Public Health, 24, 291-297. ROSENBLATT, R., REINKEN, J. & SHOEMACK, P. 1985. IS OBSTETRICS SAFE IN SMALL HOSPITALS? The Lancet, 326, 429-432. STRONG, K., TRICKETT, P., TITULAER, I. & BHATIA, K. 1998. Health in rural and remote Australia: The first report of the Australian Institute of Health and Welfare on rural health Australian Institute of Health and Welfare, Canberra TUCKER, J., HUNDLEY, V., KIGER, A., BRYERS, H., CALDOW, J., FARMER, J., HARRIS, F., IRELAND, J. & VAN TEIJLINGEN, E. 2005. Sustainable maternity services in remote and rural Scotland? A qualitative survey of staff views on required skills, competencies and training. Quality and Safety in Health Care, 14, 34-40. VAN TEIJLINGEN, E. R. & PITCHFORTH, E. 2010. Rural maternity care: Can we learn from Wal-Mart? Health & Place, 16, 359-364. YATES, K., KELLY, J., LINDSAY, D. & USHER, K. 2012. The experience of rural midwives in dual roles as nurse and midwife: “I’d prefer midwifery but I chose to live here”. Women and Birth.
  10. 10. 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. • Adopted by the International Confederation of Midwives Council meeting, 19th July, 2005, Brisbane, Australia Supersedes the ICM “Definition of the Midwife” 1972 and its amendments of 1990
  11. 11. EElliiggiibbllee MMiiddwwiiffee • What is an ‘eligible’ midwife? • An eligible midwife is a midwife who meets further professional criteria that enables them to work in private practice and may obtain a provider number. By having a provider number their private clients may access Medical Benefits Scheme and Pharmaceutical Benefits Scheme. • This is legislated under section 38 (2) of the National Law. • How do I gain registration as an ‘eligible’ midwife? • The standards are documented on the Nursing & Midwifery Board of Australia website, available at: • www.nursingmidiwferyboard.gov.au. • Summary of Requirements for Eligibility: • A 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 competencies 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 recognised prescribing course.
  12. 12. • So is a midwife a midwife or is there better midwives than others? • If I work in homebirth today, shift work model tomorrow, birth centre the next, public model or private model; has my midwife self been compromised? Am I of differing values depending on where I work and how does that fit with our philosophy of midwifery – our woman centeredness?
  13. 13. WWhhaatt aarree tthhee ooppttiioonnss aanndd wwhhaatt sshhaappeess hhooww mmaatteerrnniittyy ccaarree iiss pprroovviiddeedd ttoo wwoommeenn iinn AAuussttrraalliiaa?? Why do Australian women have different options to New Zealand women or Dutch women or Italian women…? •Political imperatives •Patriarchal medical dominance •History •Culture •Assumption of equity – – Aboriginal and Torres Strait Islander women and babies – Rural and remote women •
  14. 14. EEmmppllooyymmeenntt aass aa mmiiddwwiiffee • Public • Private • Self employed • Hybrids of all of the above
  15. 15. NNaattiioonnaall aatttteennttiioonn ttoo wwhhaatt wwoommeenn wwaanntt?? • National Maternity Services Review – Commonwealth government repsonse
  16. 16. National MMaatteerrnniittyy SSeerrvviicceess PPllaann •Five year vision • Maternity care will be woman-centred, reflecting the needs of each woman within a safe and sustainable quality system. All Australian women will have access to high-quality, evidence-based, culturally competent maternity care in a range of settings close to where they live. Provision of such maternity care will contribute to closing the gap between the health outcomes of Aboriginal and Torres Strait Islander people and non- Indigenous Australians. Appropriately trained and qualified maternity health professionals will be available to provide continuous maternity care to all women.
  17. 17. NNaattiioonnaall RReeffoorrmm • Scope of practice • Professional identify • Private practice • Access for your clients to have MBS/PBS rebates • Models of care – High risk, low risk, all risk • Woman centered
  18. 18. ffuuttuurree • Greater access to visiting rights, indemnity insurance, credentialing… • Negotiated contracts…. • More public models… • More rural and remote models that utilise midwives to full scope of practice…. • Rural/remote midwives with maternal child health, sexual health and immunisation qualifications….
  19. 19. "TThhee ppeerrssoonnaall iiss ppoolliittiiccaall" • Are we living in an enlightened and equal society? • Risk has become the norm even normal is only normal because there is as yet an absence of risk!!!!!
  20. 20. RRiisskk • Everything or nothing
  21. 21. • Why is it ok to assume medicine or midwifery can determine what is good or bad for women? • When did it become ok to take women out of their personal context and frame everything for them in a medical context
  22. 22. RRiisskk iinn ccoonntteexxtt • Amniocentesis versus VBAC • Children drowning versus relocation for birth
  23. 23. Fundamentally wwhhyy iiss iitt eevveenn ookk ffoorr aannyyoonnee ttoo ddeecciiddee aannyytthhiinngg ffoorr wwoommeenn?? • Water birth • Pain relief • Homebirth • Cesarean section • Sex???????
  24. 24. •• TThhee cchhaalllleennggee nnooww iiss ttoo pprraaccttiiccee ppoolliittiiccss aass tthhee aarrtt ooff mmaakkiinngg wwhhaatt aappppeeaarrss ttoo bbee iimmppoossssiibbllee,, ppoossssiibbllee.. HHiillaarryy RRooddhhaamm

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