Just for 2 seconds can we focus on the big breakthrough in womens maternity care

[~mamaspice~]

i hope you are right but knowing that these midwives will still work with in the policies of the hospital i hope they can still form th relationship required.. all fitted in 10minute appointments

Being that women would actually be hiring them and most likely paying more than the medicare rebate for their services, I would like to think that the midwife would be affording more than 10 minutes of her time per appointment.

And I guess looking at the positive aspect of these private midwives working under/being covered by the hospitals policies at least they will be playing a major role during the birth and also for women who have caesareans the IM they have hired under the new legislation would be able to be with mum in theatre and recovery and thus ensuring bub will be with mum in recovery too. Currently under the hospital system this is not always possible depending on staff numbers.
Also under the "current" system as independant midwives are not covered under hospital PI once a homebirth transfers to hospital the independant midwife can no longer be their clients active midwife as they aren't covered under the hospitals PI cover. This also includes a caesarean birth. The baby could only still be with mum in recovery if there is a hospital employed midwife present. Even if the IM is in recovery with the mother it's not acceptable as the IM is not covered by the hospital IYKWIM.
Just such a shame these private midwives will not be covered for homebirth too But I am hopeful this will change and that the buerocrats will eventually see sense.

[squidipa]

wow i think thats excellent,
me being a high risk patient im happy with that altho i wouldn't have the $$$ to hire one but good for other ppl

[~mamaspice~]

wow i think thats excellent,
me being a high risk patient im happy with that altho i wouldn't have the $$$ to hire one but good for other ppl

You never know Squidipa, with the medicare rebate an IM may not be too far out of your reach.

[fionas]

That's fantastic. One question - can you birth with that midwife in a private hospital or only public? Presume that in a private hospital you still have to have a designated (and paid for) ob - is that right?

And can you have both - so a midwife AND an ob (if you pay for it). Realise that sounds like overkill but I'd actually like both. Midwife to birth with me and ob to do any medical stuff that MAY be required. Would actually like to know both people before going to hospital and getting up the pointy end (so to speak).

[Salsa]

I am so pleased to hear this.
I found it very hard not having continuity of care with my last pregnacy. I dont think I saw anyone twice even the same ob! I was dealing with a vbac and continuity would have made a big difference to my stress etc.
having had my first baby in NZ I cannot believe how backwards Australia maternity system seems to be, so yes this is actually a big step forward! Yippee.

[~mamaspice~]

I am so pleased to hear this.
I found it very hard not having continuity of care with my last pregnacy. I dont think I saw anyone twice even the same ob! I was dealing with a vbac and continuity would have made a big difference to my stress etc.
having had my first baby in NZ I cannot believe how backwards Australia maternity system seems to be, so yes this is actually a big step forward! Yippee.

Thats exactly what has held me back from wanting to VBAC in the public system as there are no continuity of care options available in my region (apart from the birth centre which doesn't take on VBAC's). And that's why to me, the new legislation is so great

[~mamaspice~]

That's fantastic. One question - can you birth with that midwife in a private hospital or only public? Presume that in a private hospital you still have to have a designated (and paid for) ob - is that right?

And can you have both - so a midwife AND an ob (if you pay for it). Realise that sounds like overkill but I'd actually like both. Midwife to birth with me and ob to do any medical stuff that MAY be required. Would actually like to know both people before going to hospital and getting up the pointy end (so to speak).

Thats a great question Fiona,

I'd say you would definately still have to have your own OB.
Wouldn't it be great if you could have midwifery lead care at a private hospital though.

[fionas]

Yep, it shouldn't be toooooo much to ask to have TRUE continuity of care which in my book is having a relationship with everyone who is with you during labour and may deliver your baby. I wasn't very cluey last time so I went to a private obstetrician but now, I'm very, very happy with him and would trust him with my (and DS or DD's) life. But obviously he's not going to be there for the duration of the labour, hence I would also like to get to know a midwife. But I guess the best choice for me is a doula.

[~ Mylitta ~]

This sounds like a great improvement. I have Kyson in a private hospital and while my Ob was fantastic, I never once saw a midwife until I was in labour. It would have been nice to have known the people that were going to be with me while I was birthing my son, rather than a couple of strangers. That's not to say they weren't great, because they were, but it would have been nice to have known them beforehand.

[dust]

im classified as "high risk" yet i dont have the $$... im not also one who has all the tests, constant monitoring & appts etc. i dont see my preg as a illness and yes im lucky not to have had any probs or complications... im just saying that not everyone chooses to have a continous "Care" model. but its great news for those who do want it
altho bittersweet if this is going thru same day as law 2 make HB illegal.. *sigh*

[Sagres]

Wow, thanks so much for posting this! I have been trying to find more information about this since I didn't understand the wording of the original media release, but this has confirmed what I had thought.
This is a great advance! I think it will allow more women to see a midwife for a straight forward pregnancy (exactly what they are best equipt for), leaving obs to deal with the more complicated/surgical situations (exactly what they are best equipt for).

[Julie Doula]

I think it's brilliant that women will be able to access continuity of care with a self-chosen midwife, as per the NZ model. About time! This will be a real blessing for women who choose hospital care. BUT, this needs to include homebirth options as well as birth centre and hospital options. Not at the expense of independent home midwifery. We need an alternative to medically-managed birth, so we can choose which model suits us best.

[~mamaspice~]

I think it's brilliant that women will be able to access continuity of care with a self-chosen midwife, as per the NZ model. About time! This will be a real blessing for women who choose hospital care. BUT, this needs to include homebirth options as well as birth centre and hospital options. Not at the expense of independent home midwifery. We need an alternative to medically-managed birth, so we can choose which model suits us best.

I agree Julie, I just cannot understand why they cannot include HB services as part of the package. Especially with low risk women.

[Julie Doula]

Yeh, I don't like how they've appeared to give on one hand - but taken with the other.

I fear that even with the new continuity of care arrangements (which I think will be a great improvement - for mothers and midwives), if midwives are still controlled by rigid obstetric policy, they will still not be able to offer the true midwifery model as an alternative to the medical model. They'll end up functioning as obstetric nurses collaborating with a medicalised system. it will be very hard for them to really offer the midwifery model. I think they will not have much autonomy to function as professionals in their own right - just like most birth centre midwives are prevented by obstetric policy from offering women real midwifery care.

I think we need independent midwifery and independent birth centres so women can choose between the midwifey model and the medical model, and so midwives can choose to work within the obstetric framework or practice the midwifery model.

Continuity of care, although an improvement, won't help much if the midwives have their wings clipped by a hierarchy of medical control.

I know I'm saying this badly, but I do know midwives in NZ and UK have much more professional autonomy than here, and that midwives in USA are totally under the control of the medical hierarchy and are reduced to being obstetric nurses.

[SammyRo]

Prob a bit off topic, but I had this model in the public system with DD. I didn't get to choose my mw, but that didn't matter, as she was lovely and there was a great continuity of care - I had many of my appointments at home, and once my waters broke, she was happy to leave me for 4 days as long as she came over 2x a day, plus i montiored my temp (not that I needed it), I then gave birth to DD in the birth centre and was totally supported in our choices.

So its great that this model is going to be wider available...although, what i can't understand is, that if there is a fantastic option like this already available in the public system, why more women don't choose it. I obviously only know about my experience, but I felt that my mw whilst probably acting in line with policy, she was also acting in line with what we wanted - I know other hospitals will only let you go 24hrs after waters break, or only push for an hour before they intervene - my mw just let me go because whilst dd was taking her time, everything was fine (she finally appeared after 2 1/2 hours of pushing)