Background mountains glorious challenging treacherous magnificent up down up down
Safety Quality Continuity
There are no right or wrong answers if the woman is at the centre and her dignity remains intact No one can answer to the type of midwife you are and become – no one can make you inflict indignities on women you can collude
Women are both personally responsible and separated from the personal in the immediate space of being at risk. This exposes a discourse of medicine based on the separation of mind and body, the mechanistic framing of the maternal body. It is also the fragmenting and isolation of women’s bodies into functional and dysfunctional parts, cervix, placenta and uterus for example. This pathologic body is identified in specific ways, (always at risk), therefore screened, managed and treated. This is a powerful way to maintain the discourse of medicine and excluding other discursive constructions.
What it means to be a midwife inc national reform july 2013
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• 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
• 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
• 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
• Current competencies to provide pregnancy,labour, birth and post natal care to women and their
• 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
• Formal undertaking to complete, within 18 months of recognition as an eligible midwife, or the
successful completion of recognised prescribing course.
• 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
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…?
•Patriarchal medical dominance
•Assumption of equity –
– Aboriginal and Torres Strait Islander women and babies
– Rural and remote women
EEmmppllooyymmeenntt aass aa mmiiddwwiiffee
• Self employed
• Hybrids of all of the above
NNaattiioonnaall aatttteennttiioonn ttoo wwhhaatt
• National Maternity Services Review –
Commonwealth government repsonse
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.
• Scope of practice
• Professional identify
• Private practice
• Access for your clients to have MBS/PBS
• Models of care – High risk, low risk, all risk
• Woman centered
• Greater access to visiting rights, indemnity
• 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
"TThhee ppeerrssoonnaall iiss ppoolliittiiccaall"
• Are we living in an enlightened and equal
• Risk has become the norm even normal is
only normal because there is as yet an
absence of risk!!!!!
• 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
RRiisskk iinn ccoonntteexxtt
• Amniocentesis versus VBAC
• Children drowning versus relocation for