Midwifery care at home

Australian women currently have limited access to pregnancy, birth and postnatal services within their communities, outside the hospital. This is particularly concerning considering the current COVID-19 pandemic, where they must enter a hospital for all of their care putting themselves and their babies at risk. Those models of care that facilitate community midwifery care are either extremely restrictive in locality or the mother's health status, or require large investments of money. The goal of this campaign is to push for ministers to make recommended changes to Medicare and regulatory processes to enable maternity care at home to be more ...

Australian women currently have limited access to pregnancy, birth and postnatal services within their communities, outside the hospital. This is particularly concerning considering the current COVID-19 pandemic, where they must enter a hospital for all of their care putting themselves and their babies at risk. Those models of care that facilitate community midwifery care are either extremely restrictive in locality or the mother's health status, or require large investments of money. The goal of this campaign is to push for ministers to make recommended changes to Medicare and regulatory processes to enable maternity care at home to be more accessible and affordable in Australia. Continuity of community based midwifery care has been recommended in EVERY state and national review into maternity services, and the National Strategic Approach to Maternity Services. This needs to happen, NOW.

Please read through and edit the attached letter, enter your postcode to have this document sent to your local MP, add your own story and share widely on social media. Together, we can make a difference to the maternity system in Australia!

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We need continuity of community midwifery care

2,206 emails sent

By emailing your local MP and relevant politicians we can highlight how important it is that continuity of midwifery care, provided within our communities/at home, be supported by our government.

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Subject:

The maternity system in Australia is broken and the current COVID-19 situation exemplifies this. Many women who are booked to birth in Australian hospitals are currently seeking alternative antenatal, birth and postnatal care options to avoid the exposure of themselves and their babies to COVID-19; our maternity system provides few reasonable alternatives. While Midwifery Group Practices and Publicly Funded Homebirth Programs can provide in home/community based care, these are few and far between, hold heavy health and location restrictions and require early booking, so do not provide services for most Australian women. Privately Practising Midwives (PPMs) can be employed to provide in home antenatal, birth and postnatal care, but they are a rare commodity, often booked months in advance and are not publicly funded, so unaffordable for many.

The lack of access to and affordability of maternity care within our communities is driving women to go it alone, sometimes choosing freebirth - birth at home without a medical provider in attendance - in this instance not from a position of power, but from a position of fear; this holds substantial risks for both mothers and babies. By promoting and supporting continuity of midwifery care within the home setting, which improves outcomes for mothers and babies, the burden on the healthcare system and potential for disease spread could be eased during times of health crises, reducing risks for all.

In 2018 the MBS report (https://www1.health.gov.au/internet/main/publishing.nsf/Content/BEB6C6D36DE56438CA258397000F4898/$File/Report%20from%20the%20Participating%20Midwife%20Reference%20Group.pdf) and the National Strategic Approach to Maternity Services (https://consultations.health.gov.au/office-of-the-chief-nursing-and-midwifery-officer/national-strategic-approach-to-maternity-services/) recommended that:
- Continuity of community based midwifery carer be implemented nation-wide
- Rebates for intrapartum care provided by Privately Practising Midwives (PPMs) be included and accepted into Medicare, making homebirth more affordable for Australian women, and
- Appropriate regulatory changes be established to grow the pool of PPMs and enable PPMs to practice, providing easier access to PPMs and thus community based maternity (antenatal, birth and postnatal) services
These recommendations were due for approval in December 2019; None have been actioned.

We implore you to expedite the approval of continuity of midwifery carer and Medicare item numbers for intrapartum midwifery care at home, easing some of the financial burden placed on women seeking maternity care at home. Additionally, we ask that regulatory changes be promoted and put in place now so that the pool of PPMs can grow and provide specialised care to greater range of Australian women.

There are currently no reasonable pathways for midwives branching into private practice, PPMs must undertake 3 years of training before they can become endorsed, PPMs provide intrapartum care while uninsured and must be endorsed to provide intrapartum care at home, yet cannot do so without securing a collaborative agreement with another health practitioner or service, and two midwives are required at every birth. These barriers must be removed so that PPMs can provide specialised care to more Australian women, promoting access to community based midwifery services, particularly during situations like the COVID-19 pandemic. These recommendations must be sorted now to ensure that maternity care at home is made more affordable and accessible, not just now during the current pandemic, but also into the future.

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