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spot on Kathleen, I totally agree and
somewhat get annoyed with new programs or services that don't go all the way in
providing "continuity of carer", sure it may not suit all but I believe it
should be part of baseline services everywhere then you can let the women and
their families choose. I think we are often selling ourselves short when
we can't even offer this as a baseline service, roll on NMAP.
yours in midwifery pete
malavisi.
Dear Denise,
It may be that all the models that you have below use a midwifery
philosophy to underpin the service. It may be that active birth is
encouraged in these models. But if you ask the questions which
health services provide funded continuity of midwifery care, how many are you
left with?
It is good to see the definition of a midwifery model of care which was
developed by a working party of midwives for Qld Health. It should read
"The midwife provides continuity of care as the primary care
provider.....
I know not everyone agrees that continuity is important but for me it
is.
This means THE midwife (or a very small team of 2-4). It cannot
include large teams of 8-20 or more. It is vrey difficult to form
trusting relationships with strangers. In large teams there can be no
continuity of carer and lots of disjointed care where women have to meet lots
of strangers and tell their story (sometimes including DV and sexual abuse,
over and over).
Kathleen
--------------------------------------------------------------
Kathleen
Fahy
Professor of Midwifery
Head of School of Nursing and
Midwifery
Faculty of Health
The University of Newcastle
University
Drive,
Callaghan, 2308
Ph 02 49215966
Fax 02 49216981
>>> [EMAIL PROTECTED] 08/21/02
01:36am >>>
Dear All
Below my latest summary list of models of funded
midwifery care available in Australia at the moment
if you want it as an attachment email me off list
please notify me if you know of any other additions or
deletions
Denise Hynd
FUNDED AUSTRALIAN MODELS OF MIDWIFERY CARE.
A MIDWIFERY MODEL OF CARE; is based on Primary Health Care Principles
whereby the midwife provides continuity or the majority of care as the primary
care provider through the antenatal, intrapartum and postpartum period. The
midwife aims to work in partnership with the woman and collaboratively with
other members of the health care team to provide a pattern of care within this
framework.
FUNDED; Operating costs are predominantly borne by sources other than the
consumer or individual practitioner (as per most Midwife in Private Practice
cases), either by government, private companies or health funds.
The following information was gathered from participants of the Ozmidwifery
mailing list by Denise Hynd (updated 19/8/02).
QUEENSLAND
- The Royal Women's Hospital, Brisbane Birth Centre
has a waiting list
of upto 80 clients/month.
- Selangor Private Hospital (Health Care of Aust) has no routines,
each woman is an individual.
- Cairns Base
Hospital uses a team basis for all midwifery care.
- Mackay Birth Centre and Hospital had admission rights for
MIPPs
.
- Mareeba
Hospital offers a range of models of midwifery care,
including a Birth Centre.
AUSTRALIAN CAPITAL TERRITORY
The Canberra Hospital has a Birth Centre and Community Midwives
Caseload based program.
SOUTH AUSTRALIA
There are Birth Centres attached to The Women's & Children's,
Flinders, Lyell McEwan, and Queen Elizabeth public hospitals each with
different criteria including/excluding water birth and physiological third
stage options.
A 'Team Midwifery Project' operates at The Queen Elizabeth
Hospital Woodville.
- The Northern Women's Community Midwfery program
was ABS funded
since January 1989.
NEW SOUTH WALES
Team Midwifery projects operate at Westmead, King George v, Royal
Women's, Hornsby, Gosford, Broken Hill, Canterbury, Royal North Shore and
Wyong hospitals.
- St George Hospital, (Kogarah) has a St
George Outreach Midwifery
Programme (STOMP) and a RAP (Risk Associated Pregnancy) team
providing continuity of care for women who develop problems late in
pregnancy. The women maybe seen through a Day Assessment Unit (DAU).
- John Hunter (Newcastle)
Team Midwifery project closed.
- King George V, Hospital (Sydney) has a Birth Centre which
holds
Prenatal clinics at weekends or evenings, has homeopathic and herbal
remedies on hand; they also have 100% support for their woman-focused
natural birthing policy from the staff specialist in Obstetrics. The
accredited Visiting Midwives scheme ceased, but KGv is working to
develop other means so private midwifery clients can use the birth centre
and other facilities under the care of their chosen midwife.
- Camden and Nepean birth centres have closed,
- Birth centres
operate at Blacktown, St George, John Hunter and Royal
Women's hospitals,
- Royal Women's
Birth Centre, has a 1% episiotomy rate, 70% intact
perineum rate, and has a 25% waterbirth rate and did offer accreditation
of MIPPs.
- Liverpool Hospital's
Primary Health Midwifery Practice has
closed.
VICTORIA
Team Midwifery Programmes operate at Monash Medical Centre and Royal
Women's (Melbourne), Williamstown, Angelis and Ballaratt hospitals.
Birth Centres operate at the Royal Women's, Angelis and Monash
hospitals.
Birralee Maternity Unit (Box Hill) has caseloading programme
with a midwives clinic.
Midwife Care Project in Wangaratta originally ABS funded, offers a
modified caseload for up to 12 women per month. Three streams - Midwife Care
Only (MCO), Shared Care with Obstetrician (SCO) and Obstetric Care Midwife
Support (OCMS). Each midwife can order pathology tests, ultrasounds and all
women are admitted to the hospital under the midwives bedcard - Community
Midwife Program (CMP) focus has outreach clinics in 2 other towns, with home
based antenatal care an option for women in remote areas.
Mitcham Private hospital (Melbourne) did offer admission rights
to MIPPs. .
Bendigo Hospital, Victoria Team Midwifery ceased in
2001.
The freestanding private Hawthorn Birthing Centre (Melbourne)
with an international reputation for its waterbirth and other midwifery
options, operating since 1998 has closed.
TASMANIA
"Know your midwife scheme" operate at the Queen Alexandra (Hobart),
Burnie/North-West Private and Queen Victoria (Launceston) and a partial
version operates at Mersey North-West hospitals.
- Freestanding Community run Birth Centre in
Launceston
WESTERN AUSTRALIA
The Fremantle now Community Midwifery WA scheme covers all Perth
metro region.
Denmark District Hospital has a Home Birth Programme operating
from the hospital since April 1995 funded by the hospital for women living
within a 25km radius. Entry criteria to the service as the nearest hospital,
which can do a LUSCS, is 50 km away.
King Edward Memorial Hospital has an initially lotteries funded
Family Birth Centre where midwives work in 2 teams of 4. Entry criteria
limit for healthy "low risk" women and active management of third stage,
proscribes waterbirths, still bookings are at/near capacity (1,000 pa).
King Edward Memorial Hospital has 2 Team Midwifery projects.
Swan District Hospital (Perth) Birth Centre has closed.
The ABS funded Mandurah Birth Centre has closed
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