What will become of our midwives as > this insurance "virus" spreads ? How can the public trust midwives with > birth if the 'powers that be' say they are a high risk group and remove them > from practicing? > >
There is potential for a very positive message to be put out about this crisis - and midwives and consumers need to lobby insurance companies as well as governments to understand that it is not childbirth itself which carries high risk, but the depersonalized medical model of care, in which women are often not involved in informed deciision-making about their care or the risks and benefits of alternatives. In NZ the college of midwives has successfully obtained another 3 years of full PI cover for its members, on the strength of a water tight case that insuring midwifery care is a low risk prospect for insurers. The same has successfully been achieved by the WA Community Midwives Program last year, where the argument was put to the WA Government's reinsurer that midwifery by its very nature is low risk, because women who develop complications are referred to specialists for care. Women are also supported by one-to-one midwifery care to take responsibility for their care and their decisions and to be well informed about their choices when complications do arise. The insurer was so persuaded of the merits of these arguments that they blocked moves by the King Edward Memorial Hospital to take over the CMP as a solution to the lack of PI cover for CMP midwives, saying that if the government merged the CMP with the hospital they would withdraw their cover for the Program!! It was the very autonomy of this midwife-led program which the insurer saw as it guarantee of low risk. The National Maternity Action plan (see www.communitymidwifery.iinet.net.au/nmap.html) outlines these issues and recommends that governments embrace the widespread adoption of community midwifery models of care as a major part of the solution to the indemnity crisis affecting maternity services. Obviously it will be necessary to have other measures too to support the continuation of obstetric services for the minority of women who actually need them. But the insurance crisis is a major opportunity for us all to put forward the argument that mainstream, publicly funded access to community midwifery care will go a long way towards addressing the spiraling litigation in obstetrics! Midwives need not and should not be tarred with the same brush as obstetricians! We need to get out there and market what midwives offer as a unique service which women value, which produces good outcomes, and which results in less exposure (of both women and insurers) to risk through greatly reduced rates of intervention. Barb. Dr Barbara Vernon National President The Maternity Coalition -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
