[ozmidwifery] Queries re PI insurance

[Sue Cookson]

Firstly, there are BMid courses which allow students to attend with homebirth midwives - I'm in one and it's OK to do that. My insurance is covered by my uni. Secondly, I am concerned about a few aspects of this insurance deal - namely if I attend homebirths for women in categories where referral/transfer is recommended according to the ACMI National Midwifery Guidelines for Consultation and Referral - like VBACs, twins, postdates, breech etc- will the insurance company cover me for these births? Those who know Maggie's story - she was covered by PI insurance, but the insurance company found ways to withdraw from their obligations to her for various reasons. So I guess my question is about control of our practices. Will we have to notify the insurers of everyone we take on and their pregnancy histories etc for scrutinising, or will we only find these answers if and when problems arise? I'm happy to put my name down to look at these issues ... don't forget, we can only join up by choice... even as I say that, will it become 'illegal' to not join up if the majority do ... Food for thought, Sue Dear Lisa and All I agree Lisa we need to dispel fear around HB but to do that it needs to be accessible. Your experience of BMid students attending HB is a 1 off.  I don’t believe any other BMid course enable students to work with IPM’s doing HB. They also have trouble finding continuity models (and yes W&C in Adelaide is again different!). But what I want to respond to is the idea that insurance is just for midwives.  What about women?  I have had 6 children at home and I have NO FEAR!!! 2 with insurance and 4 without.  I understand the legal issues and I TAKE RESPONSIBILITY and would be very unlikely to sue, but this is not the point.  I do however believe that HB women must have the same rights as those accessing GP’s and Ob’s.  Insurance is seen as a consumer safety mechanism just as it is seen as a professional protection for midwives. This policy to me is very worthwhile as it allows for coverage on a per birth basis.  It will enable many more midwives wanting to ‘dip their toe in’ to private practice that chance.  It has the capacity to transform maternity services.  We can use the flexibility of this policy (and the business arrangements they offer) to recruit midwives who are currently reluctant to step outside of the system.  Private midwifery could actually be a mainstream option with women choosing where they give birth.  With PI ,midwives could be granted admitting rights and could therefore offer the marketplace a service in the home or hospital. I have spent 6.5 years advocating for women and midwives and 5 fighting for PI insurance.  I can safely say that politically midwives will get nowhere without PI. With 200 midwives we can sell 1-2-1 midwifery further than HB (although HB is my passion!!). Yesterday Manchester Unity refused to pay for a homebirth (even though they offer midwifery rebates) citing a lack of PI as the reason. HBA are also reconsidering and MBF has ceased paying out for HB’s for the same reason. I have never had private health insurance and never will, but this is not about the few, again this is about reaching many more women.  Private Health is well supported by the Fed Gov and it is a way to reach many more women.  Fear can not be easily dispelled by something that is so poorly supported (ie by public or private funding). With an influx of private midwifery there is a much better chance that Medicare will flow on to midwives in their own right (rather than the current idea re Medicare item number 16400 that requires Drs overseeing midwives). Lisa you cannot liken the UK to here.  Although I think team midwifery for homebirth is the pits, women in the UK have a legislative right to a public funded homebirth, even saying that in Australia would be considered reasonably outrageous. Unlike the UK,  Independent midwifery is the only option for the vast majority of Aust women wanting a HB. Barb Vernon is one very busy person who is pushed and pulled in many directions but like us she is working hard to achieve this. She is recording every e-mail etc received in the hope we get to 200 soon. I hope you appreciate the benefits of this policy in both per birth coverage and business structure; and whilst I acknowledge some IPM’s with established practices may have preferred that this was not a requirement I hope that they too can think with a world view as we consumers are. In solidarity Justine Caines Homebirth Australia Maternity Coalition For the homebirth movement to move forward here we need to dispel the fear that women have surrounding birth, no amount of insurance can do that. I don't think that because they are the only company offering insurance at the moment that is the main consideration at all.  Would you buy rotten fruit if it was all that was on offer ( not comparing rotten fruit with the offer at all you understand). At the uni of SA student's can attend homebirths in fact I had a birth this week with a student attending.  How is it that they are able to and others eg in South Aus Flinders Uni can't.  Maybe it has more to do with politics of birth than insurance. I am doing my best along with other independent's in this state to raise the profile of birth, insurance is not the only way to do this. I do get fed up when on the odd occasion I have been with a woman birthing at the hospital at the attitude of some (by no means all) but catching the baby isn't the be all and end all of my job.  Getting the woman the birth she desires is way more important and if that means advocating from the side line I swallow my pride and get on with it. All that said I would love as much as everyone else to have insurance as a rod to help me.  But it has to be right and open discussion is really important even before we blindly sign up to anything. Thanks for your input Lisa __________ NOD32 1.1454 (20060321) Information __________ This message was checked by NOD32 antivirus system. http://www.nod32.com