Saturday, April 19, 2014

The costs of institutional births



I would like to share this youtube video https://www.youtube.com/watch?v=7eZJqMhxD00 The Costs of Institutional Births: a wake-up call for obstetricians, presented by Dr Amali Lokugamage at the recent RCOG conference in India.

It's an excellent summary of the (growing) body of knowledge around birth place, the physiology of birth, birth ecology, sociology, economics, continuity of midwifery care, ... and quotes some of the great Australian research on these matters.

Please take a moment to watch the presentation, and share it with others who are committed to improving maternity care for mothers and babies.

Friday, April 11, 2014

MiPP review and restructure

The current membership of Midwives in Private Practice (MiPP) is 31 midwives, whose home addresses are predominantly across the Melbourne metropolitan area, and a few in rural Victoria.  MiPP is recognised within Victoria as a professional stakeholder, representing privately practising midwives.


MiPP has, since its inception in the late 1980s, functioned as a collective of privately practising midwives who provide primary maternity care in our communities.

Midwives who practise within caseload or group practice models of care are not able to predict their availability for meetings or professional development or even family birthdays!  The 'needs' of mothers and babies in our care, particularly around the time of labour and birth, take precedence in our lives.  Despite this obvious restriction, MiPP members have
  • attended MiPP meetings, usually bi-monthly, 
  • prepared submissions to relevant reviews by government, statutory and professional bodies, and 
  • provided occasional comment to the media on issues that concern our members. 
Decision-making is by consensus, and communication between meetings is by email.
Since the mid-1990s, MiPP has been a Participating Organisation in Maternity Coalition (MC). Recently, the MC management committee announced a review of its Constitution, in which MC intends to delete the category of ‘Participating Organsiation’ from its structure, and change its name to 'Maternity Choices Australia'. Under the new Constitution, MiPP would be able to become a Branch of MC.    This constitutional review has prompted MiPP to reconsider its organisational structure.

Another significant proposed change to the Constitution is in the Statement of Purposes:
change from:
“... a national (Australian) umbrella organisation made up of individuals and groups who share a commitment to improving the care of women in pregnancy ...” 
to:
“... a national (Australian) consumer advocacy organisation made up of individuals and groups who share a commitment to improving the care of women in pregnancy, birth and the postnatal period.”

The options that MiPP has at this time are:
1. Continue our organisational relationship with MC. Members are welcome to vote on changes to the Constitution.
2. Leave MC and set up an independent association
3. Leave MC and establish a new organisational relationship under another body
4. Other?




The following is a summary of responses to other questions in the survey:

The midwives 
  • Four of the 14 respondents have been members of MiPP for more than 11 years; three for 6-10 years; and seven for less than 5 years. 
  • These midwives report having attended 182 planned homebirths, as the primary carer (‘first midwife’) in the year 2013. 
  • These midwives report that in the year 2013, they attended 77 births in hospital after transfer of care from planned homebirth, and 73 planned hospital births. 
  • Additional midwifery services, apart from the primary caseload (for planned homebirth) include antenatal and postnatal consultations, lactation/breastfeeding consultations, counselling, and maternal and child health visits. 
  • Only two of those midwives who completed the survey are not eligible/endorsed, or working towards eligibility or endorsement to prescribe 

Comments 
Members value MiPP for mutual support, sharing, networking and professional contact with other privately practising midwives.

Since the federal government’s maternity reforms implemented in 2010, there have been significant changes in the way midwives are able to work in private practice, enabling Medicare rebates for clients, and as midwife prescribers.  Victorian midwives do not yet have collaborative agreements with public hospitals, one of the key promises in the reform package.




Your comments are welcome.