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Denise
I need to correct your info about Mareeba model of
care. We do not have a birth centre as such. Our unit is part of the
hospital but is like birth centre in that we have family rooms so that partners,
children or significant others can stay with the woman throughout her stay
in hospital. All women are allocated to or choose a particular midwife's
clinic at booking and she sees that midwife throughout the antenatal
period. Most women will see a doctor once during their pregnancy for a
general medical assessment but otherwise are under midwife care. Whilst we
cannot guarantee the same midwife at birth, we do have a fairly small team and 2
midwives on a shift mean one to one care in labour. The women have usually
met the birth midwife at some stage during her pregnancy as the
antenatal clinic is conducted within the unit. Our model of care has
evolved over the last 10 years by committed midwives striving to improve
the birthing services available to all women in our community. We have had
some fairly difficult hurdles to overcome and tough battles to fight to
gain the ground that we have...but we are only
able to provide the service we do because we have a couple of wonderfully
supportive doctors who are happy to play the supportive role rather than the
traditional "starring" role of the doctor "in charge".
We carry the constant nagging fear that if these
doctors move on or there are none willing to take on this supportive role
then we will face closure as we have seen occur in many small units around the
country in recent times.
We do need to be working and talking about the
issues on as many fronts as possible. It is reassuring to see some of the
activism that is occurring through people on this list.
At the Qld Nurses Union Annual conference in July
the Mareeba branch put up a resolution "That the QNU
support the rights and the health of families in the rural areas by lobbying the
government to resist the growing trend to "rationalise/centralise" (birthing)
services away from these communities." The resolution was passed
unanimously.
I think the NMAP should be brought to
the attention of the ANF(Australian Nursing Federation) state branches and
wonder if anyone has sought endorsement by them as yet. I know there has
been nurse vs midwife struggles in the past but the nursing unions being
majority female organisations should have a strong interest in birthing issues.
Nurse unions are becoming more politically strong/active. There are a
couple of QNU councillors on the State ALP Health Policy Committee. I will
pass the NMAP on to them. The Federal Office of the ANF is now located in
Canberrra and is well placed to be a positive voice. The ANF Federal
Secretary Jill Iliffe I think has a history of midwifery and community nursing
and may well prove to be a useful advocate.
The more places this is being discussed and the
more unified the voice the better chance small units like Mareeba will have of
staying operational. All women deserve to have the safe care of a midwife
in or near there homes before, during and after childbirth.
Sandra Eales
--- Original Message -----
Sent: Wednesday, August 21, 2002 1:36
AM
Subject: [ozmidwifery] Aust
Midwfery
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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