Australian College of Midwives - NSW Branch Incorporated

Contact: Media Spokesperson, Australian College of Midwives, Assoc Professor Hannah Dahlen 0407 643 943,  Executive Officer, Australian College of Midwives, Dr Barbara Vernon 0438 855 529,

26 August 2005 NSW Health Media Release
New credentials for midwives to maximise safety for low-risk births

Midwives working under midwifery-managed birthing models in NSW will now be credentialled under a new system aimed at ensuring the highest quality of care is provided to women accessing these low-risk services, NSW Health Minister John Hatzistergos said today.
Mr Hatzistergos said the new credentialling process, to be administered by the NSW Midwives Association, is the first of its kind in Australia.
“This new system of credentialling for midwives is a quality control mechanism that will optimise safety for women who opt for midwifery-managed antenatal, birthing and postnatal care.
“In the rare instance that a problem develops during pregnancy, labour, birth or the post-natal period, midwives working as primary care givers will need to make important decisions about the need to seek medical attention.
“The credentialing process will provide a further set of checks and balances to ensure midwives are competent and confident in providing this care to women in low-risk settings,” he said.
The NSW Health Credentialling Framework for Midwives is designed to allow midwives to individually assess their own needs and practice standards, identify any areas that may require additional attention, and when ready, seek to be formally credentialed.
“Midwives will then be reviewed by a panel of midwives and consumers who will assess a midwife’s competence and capabilities and ensure he or she is engaged in continuing professional development.
“The credential will be awarded for three years, at which time midwives will have to reapply. Midwives will have a 12-month transitional period from the date they commence work to attain the credential,” Mr Hatzistergos said.
Credentialling is available to any midwife wishing to formally demonstrate and be recognised for delivering high standards of midwifery care.
Scholarships to assist midwives working under midwifery-managed models of care will be available through the NSW Health’s Nursing and Midwifery Office for a transitional period of two years. After this time responsibility for scholarships will transfer to area health services.
Mr Hatzistergos said NSW midwives are at the forefront of midwifery care, with new midwifery-managed continuity of care models being implemented around the state.
“Since the successful establishment of the Ryde Midwifery Group Practice – now in it’s second year – similar midwifery models have been developed at Belmont Hospital, Shellharbour Hospital and plans are underway for a midwifery-managed model at Camden Hospital.
“Other states such as Victoria are now following our lead to provide more choice for women with low-risk pregnancies.
“In the past there have been few opportunities for midwives within the public health system in NSW to practice the full scope and role of the midwife as defined by the World Health Organisation.
“This new credentialling framework will offer midwives this opportunity while maximising the quality and safety of maternity care through a skilled and competent midwifery workforce,” Mr Hatzistergos said.
Dr Pat Brodie, President of the NSW Midwives Association (NSWMA), said this exciting new initiative would enable the public and care providers to have increased confidence in the range of services provided by midwives working in this way.
“For the first time, midwives have an opportunity to participate in a standardised quality process across the state.
“This will set the standards expected when midwives work to the full potential of their role throughout pregnancy, labour, birth and the early weeks after the baby is born,” Ms Brodie said.
The NSW Health Credentialling Framework for Midwives is endorsed by the Ministerial Maternal and Perinatal Committee.

NSW Health Media Contact
02 9391 9121 or 02 9214 9972
www.health.nsw.gov.au

Media Release from NSW Midwives Association
Announcing the NSW Midwives Association Annual State Conference
22nd 23rd September
Wagga Wagga

On the 22nd stand 23rd of September the NSW Midwives Association will host its annual State conference at the Wagga RSL Club in Wagga Wagga. Around two hundred midwives from NSW and other States are expected to attend the conference, which will have a distinctly rural theme.

“The conference will be a time for celebration and collaboration,” said Dr Caroline Homer, President of the NSW Midwives Association. “Midwives in NSW are leading the way in the provision of innovative models of care in this country. The release of the NSW Department Policy Directive for Public Homebirth Services in June this year is one example of changing attitudes to women’s right to choose their place of birth and care provider,” Dr Homer said.

Mary Moody, author and Gardening Australia personality, will be the keynote speaker on Friday 22nd. The title of her paper is Motherhood and Beyond – A generational view. On Saturday, Dr Sally Tracy will challenge midwives to question current maternity care practice where some of the highest intervention rates in the world are leading to compromises in safety and quality of care. Other midwifery speakers and consumers will talk on a variety of subjects, including research, models of care and innovative practice.

High on the agenda will be the Medicare item, 16400, recently proposed by the Federal Government to enable antenatal care to be provided by midwives, nurses, enrolled nurses and aboriginal health workers in rural and remote communities.

Dr Pat Brodie, President the Australian College of Midwives (ACM) said, “we are supportive of government initiatives that improve both access to, and quality of care available to people in rural and remote communities, particularly when this is delivered in a collaborative model. ACM and several other professional groups are concerned, however, about the safety and quality of care that would be provided under the proposed new item number”

“Safe and high quality antenatal care can only be provided by, or under the supervision of, a qualified health professional with appropriate education,” Dr Brodie said. “This includes qualified midwives, obstetricians and general practitioners with a diploma in obstetrics or equivalent qualifications. In the interests of the health and safety of women and their babies we do not support the inclusion of nurses or enrolled nurses without midwifery qualifications on the list of eligible care providers for the Medicare item number 16400 and we have asked the government that this be restricted to midwives and nurses with midwifery qualifications,” said Dr Brodie.

A consensus statement sent to the Federal Government regarding the proposed Medicare item number 16400 has been signed by: the Australian Nursing Federation; the Council of Remote Area Nurses of Australia; the Australian College of Midwives; the Association of Australian Rural Nurses; the Australian Practice Nurses Association; the Australian Nursing and Midwifery Council; the College of Nursing, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists

“Women and babies deserve the very best standards of care, wherever they live, and they shouldn’t be forced to accept second rate services based on geographic location. This is essentially proposing a two tiered system where the country gets one standard and the city another,” Dr Brodie said.

International Midwives Day - 5 May 2006
‘The world needs midwives – now more than ever’
This year, around 136 million births will occur worldwide and the professional most likely to be present, helping the mother, is a midwife.
On Friday the 5th of May, midwives will celebrate throughout the world, reminding everyone of the important and unique role they play in society. Midwifery is one of the oldest professions. Besides their own mothers, the first human touch felt by most people, came from a midwife.
“Where women are cared for by midwives during pregnancy and birth they experience less intervention and more positive outcomes, including greater satisfaction with their birth experiences,” said Hannah Dahlen, Secretary of the NSW Midwives Association.
“The world needs midwives, now more than ever. The world recognises that without you [midwives], there can be no safe motherhood,” said Dr Khama Rogo of the World Bank at the International Congress of Midwives in 2005. This statement comes at a time when the shortage of midwives is an international crisis.
In Australia, increasingly childbearing women are being looked after by nurses and enrolled nurses, due to the shortage of midwives. “This is not providing women with the best care,” Ms Dahlen said. “Surely Australian women deserve to have highly trained midwives caring for them during this life changing event? It does not say much about how society values pregnancy, birth and motherhood-indeed it does not say much about how we value women.”
World wide, midwives remain women’s first choice for a skilled attendant at birth. “The midwife is the only professional with the specialised skills to care for women from conception to early motherhood. Midwives are the biggest constant in childbearing women’s lives,” said Ms Dahlen. They are recognised internationally by the World Health Organization as, “the most appropriate and cost effective type of health care provider to be assigned to the care of normal pregnancy and normal birth, including risk assessment and the recognition of complications.”
Carol Chapman, President of the NSW branch of the consumer organisation Maternity Coalition said, “midwives change the way women experience birth for the better and birth changes the way women and their families experience life. The impact of one-to-one midwifery care is profound and life long.”
Today is a day for midwives to celebrate their enormous contributions to society-it is also a day to ask some serious questions in the hope that we address some of the causes of this workforce crisis. “Why is it that fewer than five percent of childbearing women in this country can access care from a midwife they know through the pregnancy, birth and postnatal period? Why is continuity of midwifery care almost non-existent for women living in rural communities? Why are we not using midwives’ skills to stem the tide of maternal and perinatal mortality in our Indigenous communities when we have the evidence to support this? Why are intervention rates in childbirth now some of the highest in the world? Why are midwives often prevented from practising to their full scope?” Ms Dahlen asks. “Midwives want to practice midwifery. If they can’t do this they won’t join the profession and they will increasingly leave it. Who will catch our babies then?”
“It is time to act! Women deserve a first class maternity service in this country and midwives are poised perfectly to deliver on this,” said Ms Dahlen. “Childbirth is the single biggest use of hospital beds nationally and midwifery care delivers great outcomes in a cost effective manner. It is time the government realised they need to nurtured the midwives, that nurture the mothers, that nurture the future of our country.”
On the 5th of May, remember Midwives Day!

Media Release
Wednesday 7 December 2005
The safety of small maternity units confirmed
in landmark Australian study
Low risk pregnant women can now be reassured that giving birth in small maternity units in Australia is safe, following the publication of a landmark Australian study, in the British Journal of Obstetrics and Gynaecology.
One of the study’s authors, Dr Sally Tracy said, ‘clearly all the scare mongering and shroud waving that goes on over the safety of small maternity units must stop. Unfortunately, strong biases and uninformed decision making have led to the closure of hundreds of these units across Australia in recent years.’
The study involved 750,491 women who gave birth over a three-year period in Australia between 1999-2000. Rates of intervention at birth and neonatal mortality for low risk women were examined in relation to hospitals with <100, 100-500, 501-1000, 1001-2000 and >2001 births per annum.
The study showed that for healthy women without identified medical problems, the risk of a baby dying in the first 28 days following birth was lower in maternity units with less than 2000 births than it was in units with more than 2000 births per year.
‘Size actually does matter when it comes to giving birth in Australia,’ said Dr Tracy, ‘but big does not necessarily mean better! Treating all pregnant women as high risk medical patients has to stop. It is time for a complete rethink about maternity service planning in this country.’
The study also found that low risk women having babies in maternity units with less than 100 births a year had significantly fewer inductions, epidurals, forceps/vacuum births, emergency caesareans and babies being admitted to a neonatal unit, compared with low risk women giving birth in maternity units with greater than 2000 births a year.
‘It is clear that in Australia, a lower hospital volume is not associated with adverse outcomes for low risk women and their babies’ Dr Tracy said, ‘in fact, it appears these women are better off. They have more normal births and lower levels of intervention in the birth. There is plenty of research to say this is a good thing.’
Closure of small rural hospitals has an undoubtedly negative effect on communities. ‘The maternity unit is often the heart of a community. It provides many women with the opportunity to give birth close to where they live without separation from their families and at no greater public cost’, said Professor Pat Brodie, National President of the Australian College of Midwives.
CONTACT
Researchers: Dr Sally Tracy 0404811357; Hannah Dahlen 0407643943
Australian College of Midwives: Dr Pat Brodie (President) 0417544824, Dr Barb Vernon
(Executive Officer) 0438855529

see full article

Press Release from NSW Midwives Association
Announcing the NSW Midwives Association Annual State Conference
“Midwifery by the sea: Riding the waves of change ”
21st and 22nd October 2005
Swiss Grand Hotel - Bondi

On the 21st and 22nd of October, 2005 the NSW Midwives Association will host its annual State conference at the Swiss Grand Hotel, Bondi. Around two hundred midwives from NSW and other States are expected to attend the conference.

“The conference will be a time for celebration and collaboration.” Hannah Dahlen, Secretary of the NSW Midwives Association said. “There has been a great deal of change in the last few years for midwives with the setting up of more midwife led care, the commencement of the Bachelor of Midwifery, the introduction of a Nurses and Midwives Act to replace the old Nurses Act, the introduction of credentialing for midwives and recent moves to obtain access to Medicare provider numbers for midwives. Midwives in NSW are now at the forefront of instigating change in the maternity service and are leading the way in innovative models of care” Ms Dahlen said.

Julia Gillard the Shadow Minister for Health will be the keynote speaker on Friday 21st October from 1100hrs to 1145hrs. Midwives are looking forward to hearing her outline her vision for midwifery under a Labour government. “We are very keen to know if she will be as receptive as Mr Abbott in considering Medicare provider numbers for midwives” said Ms Dahlen.

“Intervention in birth is at an all time high with close to one in three women having a caesarean section. There is an urgent need to recognise the benefits that come from midwifery care in reducing these unacceptable intervention rates,” Ms Dahlen said. “Continuity of midwifery care results in lower rates of intervention, excellent outcomes and women are more satisfied than with other forms of mainstream maternity care. This form of care also costs around $1000 less per woman than standard maternity.”

Ms Lisa Metcalfe a consumer from Maternity Coalition said, “continuity of midwifery care is safe and cost effective and it should be available to all women. Currently there is a view in this country that continuity of midwifery care is an indulgence rather than an essential right. This attitude has got to stop.” Ms Metcalfe said, “access to continuity of midwifery care in metropolitan areas is limited but in the rural areas of Australia it is almost extinct! This is simply unacceptable.”

Ms Dahlen said, “that while midwives recognise they have come a long way in their fight to be recognised as autonomous professionals they still have a long way to go to attain the same rights that many of their colleagues have in other countries. We will not cease fighting for this with women.” Ms Dahlen said “a society that does not respect birth and women’s right to choice reveals a sorry attitude to the value of women in that society.”

Ms Dahlen said, “home birth is almost extinct as women find it harder and harder to find a midwife who will attend them due to the lack of affordable insurance available to midwives since 2002. With the government willing to subsidise medical insurance to the tune of millions we see their lack of interest in doing the same for midwives as dismissive of the importance of our profession.”

The conference will give midwives the opportunity to enhance their knowledge, voice their opinions and set goals and priorities for the coming year.

For information and interviews please call Hannah Dahlen, Secretary of the NSW Midwives Association: 0407 643 943, Ms Lisa Metcalfe, Maternity Coalition: 42681675

NEWS RELEASE Friday February 10 2005
Contact: Pat Brodie 0404 468 224
Justine Caines 0408 210 273

Consumers, Midwives Business and Community Join forces to establish a safe and sustainable maternity Service in Camden

Businesses and the community of Camden have joined forces with local women and midwives to demonstrate the continued need for maternity services in the local area. Local businesses plan to close their shops on Saturday morning to show support for the mothers and babies of the town.

“The local community want the families and mothers to have their babies in Camden, this can happen with a midwifery program like the one operating in Ryde.” said Amanda McElhinney, local mother and Macarthur area spokesperson for the Maternity Coalition.

“Women of Macarthur want the support that a midwifery program offers. They are able to get to know who will care for them and this makes all the difference to the outcome, this is why it is so safe” said Ms Mc Elhinney.

“Don't close our maternity service down. Young, growing families spending in Camden is an important part of my business.” says Steve Wisbey, local businessman who will close his doors in support.

Last month over 300 members of the community – mostly mothers and women demonstrated their outrage at the suggestion the newly refurbished Birth Centre would be closed down.
“Camden and Campbelltown are very different areas, It is not cost effective to duplicate high level services, the majority of Camden women can be cared for by midwives with the potential to save money” says Ms McElhinney.

“With the current workforce shortages we cant afford to lose one single midwife” said Pat Brodie President of the NSW Midwives Association, the state branch of the Australian College of Midwives. Midwives want to work in units like this that allow them to use all of their skills and retain very high job satisfaction”

“This is another example of women across NSW being directed towards expensive and unnecessary highly medicalised intervention during pregnancy and birth by a failing health system” said Ms Caines, National President of the Maternity Coalition


Camden Community Rally 12 February 2005
11am outside the AH&I Building, Argyle St Camden
12 noon at Macarthur Park for speeches
Invited Speakers

* Dr Dianna Horvath – CEO, Sydney South West Area Health Service
* Ms Amanda Larkin – General Manager, Macarthur Health Service
* Mr Geoff Corrigan MP – Member for Camden
* Ms Peta Seaton MP – Member for Wollondilly.
Australia’s National Maternity Consumer Advocacy Organisation
www.maternitycoalition.org.au




NEWS RELEASE 30th August 2004

NSW Minister for Health abandons midwives at the twelfth hour

The NSW Minister for Health, Morris Iemma has abandoned midwives days before the new Bachelor of Midwifery course was to be announced.

The Bachelor of Midwifery is a very popular course internationally and indeed is the main route of midwifery education in industrialised nations. In Victoria and South Australia (where it has operated for 3 years) approximately ten women have been applying for every place in the course.

‘There are hundreds of potential midwives waiting to do the Bachelor of Midwifery in NSW,” says Hannah Dahlen, Secretary of the NSW Midwives Association. “The introduction of the Bachelor of Midwifery In NSW, through the University of Technology, Sydney (UTS) has been delayed now for two years as we waited for the new Nurses and Midwives Act to commence, and deliberations over who would insure these students for birthing practice continued.”

“The new Nurses and Midwives Act commenced as of the 1st August 2004, so there are no legislative obstacles to the introduction of the course. Midwives have until the 15th of September to convince the NSW Minister for Health to assist with insurance for these students or the course scheduled to commence in 2005 will be cancelled. The risk of litigation against these students is in fact miniscule because they are completely supervised by a registered midwife.”

“We have a workforce crisis in this State with a shortage of nearly 700 midwives out of a total workforce of 3782. This is untenable and frankly unsafe,” says Hannah Dahlen. “The average age of a midwife in NSW is forty and we are not replacing our workforce. The Bachelor of Midwifery with around 400 waiting list enquiries would have significantly improved this situation.”

Three or four Indigenous women are currently attending the Maternal and Child Health Course in order to enter the Bachelor of Midwifery next year. “Indigenous midwives will be key to reducing the maternal and perinatal mortality rate in this country,” Hannah Dahlen said. “The recent Maternal Deaths in Australia 1997-1999 showed three times as many Indigenous mothers are dying from pregnancy and birth related complications than non-Indigenous mothers.”

‘This is not rocket science. The safety of women will be compromised in this State if the Minister for Health does not act urgently.”

On the 5th of May 2004, International Midwives Day, Morris Iemma commended the Bachelor of Midwifery publicly and said he would insure all barriers were lifted. “We call on Mr Iemma to be a man of his word and not abandon midwives at the twelfth hour.”

For information contact: Hannah Dahlen, Secretary NSW Midwives Association 0407 643 943; Pat Brodie, President NSW Midwives Association 0404 468 224; Justine Caines Maternity Coalition 0408 210 273