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Midwifery the ways we work


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This presentation discusses the ways midwives work in current workforce places/opportunities

Published in: Health & Medicine
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Midwifery the ways we work

  1. 1. MMiiddwwiiffeerryy:: wwaayyss wwee ccaann wwoorrkk DDrr BBeelliinnddaa MMaaiieerr MMaaiieerr..BBeelliinnddaa@@yyaahhoooo..ccoomm..aauu
  2. 2. iinntteerrnnaattiioonnaallllyy
  3. 3. 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. • Ad o p te d by the Inte rna tio na l Co nfe d e ra tio n o f Midwive s Co unc il m e e ting , 1 9 th July , 2 0 0 5 , Bris ba ne , Aus tra lia Sup e rs e d e s the ICM “De finitio n o f the Midwife ” 1 9 7 2 a nd its am e ndm e nts o f 1 9 9 0
  4. 4. AAuussttrraalliiaa 22001100……....
  5. 5. 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: • • 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.
  6. 6. • Expanding women's access to Medicare relatable midwifery services
  7. 7. NNaattiioonnaall aatttteennttiioonn ttoo wwhhaatt wwoommeenn wwaanntt?? • National Maternity Services Review – Commonwealth government response
  8. 8. 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.
  9. 9. 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
  10. 10. • 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 having differing values depending on where I work and how does that fit with our philosophy of midwifery – our woman centeredness?
  11. 11. 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 •
  12. 12. EEmmppllooyymmeenntt aass aa mmiiddwwiiffee • Public • Private • Self employed • Hybrids of all of the above • What else….?
  13. 13. MMyy ppaatthhwwaayy iinnttoo aanndd tthhrroouugghh mmiiddwwiiffeerryy 1998899 –– 2200133………… • Personal experience of birth and breastfeeding first • Hospital trained post nursing • Lactation consultant • Agency • Homebirth • Birth centre • Honours then PhD • South Australian Department of Health – Aboriginal and Torres Strait Islander antenatal guidelines • Research • MGP • Midwifery Advisor QLD • Project Manager MyMidwives
  14. 14. • My daughters will……
  15. 15. • Expect their dignity will remain intact regardless of where when how or with whom they give birth
  16. 16. • feature=player_embedded&v=K105F9o3H tU
  17. 17. HHoollllyywwooooddiissaattiioonn ooff bbiirrtthh –– lleessss ooff tthhiiss
  18. 18. MMoorree ooff tthhiiss……..
  19. 19. SSoo wwhhaatt aattttrraaccttss yyoouu,, wwhhaatt ssttiimmuullaatteess yyoouurr ppaassssiioonn ffoorr bbeeiinngg aa mmiiddwwiiffee??
  20. 20. ""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!!!!!
  21. 21. RRiisskk • Everything or nothing
  22. 22. • 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
  23. 23. RRiisskk iinn ccoonntteexxtt • Amniocentesis versus VBAC • Children drowning versus relocation for birth
  24. 24. Fundamentally wwhhyy iiss iitt eevveenn ookk ffoorr aannyyoonnee ttoo ddeecciiddee aannyytthhiinngg ffoorr wwoommeenn?? • Water birth • Pain relief • Homebirth • Cesarean section • Sex???????
  25. 25. •• TThhee cchhaalllleennggee nnooww iiss ttoo pprraaccttiiccee ppoolliittiiccss aass tthhee aarrtt ooff mmaakkiinngg wwhhaatt aappppeeaarrss ttoo bbee iimmppoossssiibbllee,, ppoossssiibbllee.. HHiillaarryy RRooddhhaamm
  26. 26. WWaayyss mmiiddwwiivveess wwoorrkk ffoorr wwoommeenn aanndd mmiiddwwiivveess • Advocacy • Lobbying • Government • Research
  27. 27. 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….