RE: homebirth policy

[Johnston]

Hi Belinda
Your question < Does any one out there know if ACMI has a homebirth policy?>
is of interest to me, as I am closely involved in ACMI in Victoria (employed
20 hours per week as ACMI Vic Professional Officer) and I am a midwife who
attends women for homebirth.

I don't know if you are a member of ACMI, so if you already know these
things they may be of interest to others who do not.  All new members
receive a set of documents which include the Constitution, by-laws,
Philosophy and Position Statements, and the ACMI Competency Standards for
Midwives.

In the ACMI Philosophy and Position Statements, under the heading Midwifery
Ethos, you will find the definition of a midwife, which clearly states that
the midwife "may practise in hospitals, clinics, health units, domiciliary
conditions or in any other service."  Everything that follows must be
consistent with this definition, and that leaves no doubt in my mind as to
the sphere of practice of a midwife.  This definition 'belongs' to the
International Confederation of Midwives, and has been ratified by the World
Health Organisation and the International Federation of Gynaecologists and
Obstetricians, so it is a very important statement.

The ACMI Competency Standards for Midwives apply to all midwives, without
distinction as to place of practice.

There may be some disagreement as to which midwives are competent to attend
a woman for homebirth.  Is there some requirement for advanced skill?  If
you read the definition the person who bears the title midwife is required
to attend births, and do all the other midwife stuff "on her own
responsibility".  Within the various collectives of homebirth midwives there
seems to be a mentoring of a 'new' midwife who wants to go into private
practice.  The ACMI has a process of accreditation for independently
practising midwives, and I know there are some on this list who have that
accreditation and may wish to comment further.

I hope I have shed some light on the matter in answer to your question.

Joy Johnston
Midwife and lactation consultant
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Belinda & Tom
Sent:   Friday, 2 July 1999 19:34
To: ozmidwifery
Subject:homebirth policy

Does any one out there know if ACMI has a homebirth policy? So far I
have been told no but I just thought I would double check this. Belinda

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Maternity Coalition Dinner, 5 August

[Johnston]

If you think you can interest someone in this important event, or place this
information on a notice board, please print this page.


The Maternity Coalition  DINNER
5 August 1999,  from 6 pm
to celebrate its birth a decade ago!
'Changing the image of childbirth: the role of the media

The evening event includes pre-dinner drinks at 6pm, a 2 course dinner and
discussion: MC launch of new web page, a video on current TV birth images
introduced by childbirth educator, Bronny Handfield and panel of journalists
leading the discussion.
Cost $48 (waged) or $30 (unwaged).
For further information/inquiries contact
Rhea Dempsey 9562 8592 or Kerreen Reiger on 9439 7852 .
Please complete and mail registration details as below:

--
I wish to register for ' The image of childbirth in the media' on August 5.

Name:Phone:
  Address: 
   P CODE:
Enclosed is cheque/money order for $48 (waged), or $ 30 (unwaged)
Please make payment out to the MaternityCoalition Inc., and mail to the
MaternityCoalition Inc, PO Box 48 Brighton, 3186 ASAP, and at the latest by
29 July.
Receipts will be issued at the dinner


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free public forum in Melbourne, 5 August

[Johnston]

If you think you can interest someone in this important event, or place this
information on a notice board, please print this page.
INVITING YOU TO AN IMPORTANT FORUM

Best Practice Maternity Care:
what have we got and what do we want?

at the Cato Conference Centre, YWCA, 489 Elizabeth St, Melbourne at 3-5pm on
5 August

Women from all political parties, major women's organisations and networks
are invited to a free public forum to discuss current problems in maternity
services.

Panel Speakers are midwives, Maria Nethercott on antenatal care, Vanessa
Owen on birth, and Maternal and Child Health Nurse, Frances Bettenay, on
postnatal issues. To encourage debate about a vision for the future,
midwife, Patrice Hickey will speak about NZ developments, and social
researcher,  Kerreen Reiger will outline the Mother Friendly Childbirth
Initiative in the US and the Australian Midwifery Action Project. In
discussion time, members of the audience will be asked to prioritise
suggested action strategies.

This forum is being sponsored by the Best Practice in Maternity Care
Committee formed by the ACMI (Vic Branch), the Maternity Coalition Inc, the
ANF (Vic), the Midwives' Action Group and the Maternal and Child Health
Special Interest Group.


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RE: spirituality

[Johnston]

Trish, this is a big ask.
I am not really sure what academics mean when they use the ' post-modern,
post-positivist' talk, because I haven't been conditioned very much within
the hallowed walls of universities.  But I am not one to shy from a
challenge, so I'll have a go at giving an opinion.
You said < my spiritual sense was well aroused
by the connectedness I feel with women, particularly while in the birhting
year, and within certain situations where connections are so strong due to
empathy and resonance, such as during times of trial and triumph.>

My understanding of spirituality, which seems to be experienced by people of
all groups and persuasions, can only be explained (in my mind) by the
Judeo-Christian concept of being created in the image of the all powerful
creator.  That image must transcend physical features.  The teaching that
God the creator is a Spirit is something that I accept without being able to
fathom.  Being in the image of God means that the creature is like the
creator, and that's where spirituality fits in.
It doesn't bother me that I can't describe or understand spirituality.  It
is not surprising, within this system of thinking, that an athiest, or a
believer in another religion, should share a similar sense of connectedness
with all creation.  That's the way we are, and is independent of our mental
response to religious claims.

You are a brave woman to seek comment on matters of faith in a public forum
such as this one - and I hesitate to say much about my beliefs, although
they are strong and very real to me.
Warmly
Joy Johnston

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Trish David
Sent:   Monday, 5 July 1999 17:18
To: [EMAIL PROTECTED]
Subject:spirituality

Dear Listners, this is an interesting subject in a post-modern,
post-positivist world.  (apologies to those who think academics have too
much of a say, here.  I'm on a little exploring mission)

I've jsut been given a review copy of Jean Watson's (celebrated nursing
theorist) new book titled "Postmodern Nursing and Beyond"  1999 Churchill
Livingstone.  I've only had aflip through looking for material for third
year subject, Nursing as a Profession.  A particular quote caught my eye:
'Since the 19th Century, over 250 published empirical studies have appeared
in the epidemiological and medical literature in whihc one or more
indicators of spirituality or religiousness, variously defined, have been
satistically associated in some way with aprticular health outcomes'
(Levin, 1993 in Watson, 1999: 119).  This holds regardless of how
spirituality is defined or measured (bizarre thought!).  This put me in
mind of a question a colleague once asked me, how do you as an atheist
define spirituality.  I responded that my spiritual sense was well aroused
by the connectedness I feel with women, particularly while in the birhting
year, and within certain situations where connections are so strong due to
empathy and resonance, such as during times of trial and triumph.  I don't
know if it was satisfacoty to my colleague, who is a Christian.  But I
wonder what other midwives and wise women out there think.  Is it different
for us becuase we have such a connection with the life-continuum?  Or am I
romanticising/fantisizing?

What does spirituality mean when we have deconstructed and critiqued
god/goddesses out of existence?

All replies read with interest.

Cheers, Trish, oh and some other great stuff in Watson, too, but a bit 'new
age' for me just yet!
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FW: help

[Johnston]

Dear all
This message came to me (from the USA, I assume) and the writer has asked
that I send it out to y'all in case anyone is able to help her locate her
friend.
Please reply directly to Paula.
Joy Johnston

-Original Message-
From:   [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent:   Saturday, 3 July 1999 8:11
To: [EMAIL PROTECTED]
Subject:help

Hi Joy,

I'm looking for a friend with whom I have lost touch.  She was a midwife in
Australia but I don't know if she still is.  Her name is Rowena cooper
Harrison.  If you know her, could you give her my email address or send me
her address?
Thanks for any help.
Sincerely,

Paula Durbin Blair

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new midwifery appointment

[Johnston]

This week's midwifery news:
Julie Collette has been appointed to a Clinical Director position at the
Mercy Hospital in Melbourne, to begin in August.  Julie is the Hon President
of ACMI Vic, and has recently overseen the establishment of the Birrallee
Maternity Unit at Box Hill, which I have written about previously on this
list.
Congratulations Julie!
Joy Johnston
Professional Officer, ACMI Vic
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm

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RE: ACMI Accreditation requirements.

[Johnston]

Mary I am glad you have asked these questions.  I have to say from personal
experience that it is very discouraging when one goes through the
application process, only to be rejected.  I empathise with the WA midwives
who have not 'met the criteria'.  (sounds like the criteria for birth
centres, doesn't it?)

I and other independent practitioners in Victoria who belong to the MIPP
collective would say that we meet the criteria, although I can't say whether
we would pass the test.  Those of us who are reasonably articulate would
probably be able to express what we do in a way that satisfies the censor.
Other midwives who do a wonderful job may not have the same skill in
writing.  The word 'formal' bothers me.  How formal?   Perhaps Trish will
comment on that.
1. Articulate formal quality assurance initiatives.
MIPP members and other homebirth midwives in Vic have gathered statistics on
our births, and looked at the evaluation forms that our clients have filled
out.  Jenny Parratt is presenting a couple of papers at Hobart in September.
2. Articulate formal self-evaluation. eg reflective practice journal
Yes, many of us write our stories.  I doubt that this could be called
formal.  And how deeply I reflect on a particular issue depends on my
sensitivities at the time.  I am not only a midwife - there  are all the
other life things happening at the same time.
3. Articulate formal processes of peer review.
A few midwives have on occasion got together for coffee to review a
particular 'case'.  Most of the time it's telephone and e-mail.  In writing
about our experiences on this list I believe we are engaging in peer review.
But it's not formal.

MIPP meetings occasionally have peer review, or case presentations.  However
you can imagine that even in a small State like Vic, it's not easy to get
together.  We usually meet in Brunswick, and usually every 2 months.  People
travel several hours to be there.  Sometimes it's only 4 or 5 of us.  So
it's very patchy.  The midwives in Mildura who are members of MIPP don't get
to meetings.  We might see them at ACMI conferences.

I understand that the WA midwives need the acmi accreditation in order to
access public funding for homebirth.  In Vic there are no such funds, and no
other benefits to being accredited.

I hope these thoughts have added to the wider understanding of the issues.
Homebirth midwives make easy targets, and there is a high attrition rate.
If the community and the profession want to keep the choice of homebirth
open, there needs to be support and protection for homebirth practice.
sincerely
Joy Johnston
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Mary Murphy
Sent: Wednesday, 7 July 1999 19:05
To: midwifery mailing list
Subject: ACMI Accreditation requirements.


Dear All,
I am writing on behalf of some W.A. midwives who have not met the
criteria in the following areas:
1. Articulate formal quality assurance initiatives.
2. Articulate formal self-evaluation. eg reflective practice journal
3. Articulate formal processes of peer review.
Use the cues "Plans/Process/Outcomes"  "evaluation tools"

Now I know I have been in private practice for 16 years and kept my nose
clean and done lots of other worthy things in life, however I have never
been able to make head nor tale of those requirements when I see them on an
application form.  It seems that we have none of those processes in place
and would like to have some advice from those midwives who successfully
articulate/demonstrate the above.  I am particularly interested in midwives
who practice autonomously and therefore have no-one directly observing or
evaluating their practice, and those who have obtained ACMI accreditation by
successfully demonstrating/articulating the above to the satisfaction of the
accreditation panel.
Yours in anticipation, Mary Murphy


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RE: senate inquiry

[Johnston]

Here's my hand up - Yes, we do all need to work on this one.
Sally wrote;


I (JJ) am preparing a submission with the Executive of ACMI Vic Branch, a=
nd
it will be quite comprehensive.  A lot of what we have prepared for the
recent round of State reviews under the Competition Policy Agreement also
applies to this inquiry.
The notes to assist in the preparation of submissions tell us that the
submission:
may be a letter, or a substantial paper
may contain facts, opinions, arguments and recommendations.
may cover all points raised by the committee, or selected ones.
where possible should be typed on A4 paper.  If written, should be
legible (!)
If there are parts of a submission that the author would prefer not b=
e
made public, this can be kept confidential, and there are protections of
parliamentary privilege.  (If you need this I suggest you check details)
authors may be asked to give oral evidence before a committee.
A couple of points that someone may be able to shed light on:
(i) the adequacy of information provided to expectant mothers and their
families in relation to the choices for safe practice available to them; =
and
Is there anyone out there (esp consumers) who has tried to get informatio=
n?
A letter about this would be very useful.  Anyone in Vic can send it to m=
e.
I understand that it's easier to get info from the NSW Midwives Data
Collection than it is in Vic.  The Vic Perinatal Data Collection Unit sen=
ds
the individual statistical reports to the hospitals (hospital profiles), =
but
doesn't give the details to other inquirers.  It seems that most of the
hospitals aren't keen to give out their information.  Homebirth is
considered a 'hospital' for the purposes of data collection, and we
independent midwives receive a copy of the homebirth statistics.  To date
this has only covered babies born at home, not those who planned homebirt=
h
and transferred to hospital.  However that information will be available =
in
the next report, as it is now being collected.  what happens in other
States?  If someone from each State could respond to the list, I will
include it in our submission for comparison.  Thanks
(j) the impact of the new Medicare rebate provided for complex births,
including the use of the term =91qualified and unqualified neonates=92 fo=
r
funding purposes, and the impact that this has had on improved patient ca=
re
and reduction of average gap payments.

Does anyone have evidence of births becoming 'complex' since this rebate
came in?  Has anyone been able to look at statistics before and after?
Babies in some hospitals get their own UR number, for funding purposes,
whereas others are with the mother unless they are 'qualified'.  Can anyo=
ne
provide any evidence or information on this?

I believe we have an opportunity right now to effect lasting change.  Let=
's
all give it our best shot.  We are building on the good work of many who
have laboured on these matters in previous years, some of whom are burnt
out, or have been sidelined by restrictive and anti-competitive systems.
sincerely
Joy Johnston
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Sally Tracy
Sent: Tuesday, 13 July 1999 19:44
To: [EMAIL PROTECTED]
Subject: Re: senate inquiry


Cathy and Nigel
i agree it would be very good for ozmidwifery to submit a response to
the inquiry, and I am happy to co-ordinate responses on behalf of ozmid.
Everybody's  contribution would have to reach me by the 3rd August and I
will put them together. Doesn't matter how small the offfering is..it
all counts...just remember to reference  work submitted.
It would also be useful for peole to offer on the line what area they
are proposing to work on and 'advertise' for help!
At the moment i am encourageing every mother who has the energy to
write, addressing parts "e" and "i". Also working on a few of the others.
There are lots of organisations presenting submissions.and every =
bit
counts ...
enclosing the terms of reference again for those who inadvertently
deleted them!
sally t
Senate Community Affairs References Committee

  INQUIRY INTO CHILDBIRTH PROCEDURES
 The Senate has referred the following matter to the Senate
Community Affairs References Committee for  inquiry and report by 30
December 1999.

 Childbirth procedures, with particular reference to:
(a) the range and provision of antenatal care services to ascertain
whether
interventions can be minimised through the development of best practi=
ce
in antenatal screening standards;

(b) the variation in childbirth practices between different hospitals
and different states particularly with respect to the level of interventi=
ons
such as caesarean birth, episiotomy and epidural anaesthetics;

  (

RE: Canberra Midwifery Program and Birth Centre Info

[Johnston]

Jenny and Gill
Thanks for sharing this information on the CMP.  Do you have any recent
statistics or qualitative reports, any papers published?  Do you have a
paper to present at the Hobart conference?
I think it's very important to tell our stories.  Someone reading your post
may say "we could do that" and a dream is born.  With a bit of encouragement
and planning, the vision can be extended.
Warmly
Joy Johnston
Midwife and lactation consultant
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Jenny Browne
Sent:   Wednesday, 14 July 1999 17:16
To: [EMAIL PROTECTED]
Subject:Canberra Midwifery Program and Birth Centre Info


Dear All

Gill Hall, a Community Midwife in Canberra, is here with me and wants to
clarify the issues around Canberra's Community Midwives and the Birth
Centre.  Hope it helps!

AUSTRALIAN CAPITAL TERRITORY

The Canberra Midwifery Programme (CMP) formerly known as the Community
Midwives Program began in March 1999 when the existing community program
which was a team of six full-time midwives merged with the Birth Centre
midwives to provide one uniform service.  Previously the two services had
run parallel but relatively separately.

Currently there are two teams of six FTE (seven) midwives who provide care
for approximately fifty women per month - twenty five women per term.  The
teams are North and South, the women being allocated geographically with
some flexibility to keep bookings\workload even between the teams.  Women
usually book with the program at approx. eight weeks gestation or whenever
they 'find us' providing we have space for the month they are due.  All
their antenatal care is provided by their team of midwives except for one
visit with a staff doctor at about twenty weeks.  This is done as a clinic
in the Birth Centre with the senior obstetric registrar who is sympathetic
to our model of care.  The women can be referred back to see this doctor if
there are any concerns in the pregnancy or if they are overdue.

In labour the women are attended by one of their team midwives, birthing in
the Birth Centre (or Delivery Suite depending on circumstances).  If they
need to transfer their team midwife continues care.  A second team midwife
may take over depending on the length of labour, time of day, number of
women labouring etc.  Once they have birthed the women have three choices:
they can go home four or so hours after birth, they can stay O/N in the
Birth Centre provided they have another adult with them as there is no
midwife rostered over night.  After this first night or if needed after
birth they can go to the postnatal ward.

Once home their team provides postnatal support for approx. two weeks.
Visiting every day until day 4 or 5 then another 3 or 4 visits spread over
the next week or so.

For more information please phone Rose O'Donnell Director of Nursing
Women's and Children's Health or the Programme coordinator Roz Rebbeck at
the Birth Centre.  Please note the listed phone number was incorrect, it is
:  02 62443145I am also happy to talk to interested midwives, phone 02
62824814.

Thanks Gill Hall (North Team)






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RE: new to the list

[Johnston]

Welcome to the list Rachel.
I know many midwives on the list will appreciate your opinions, as a woman,
mother, and potential direct entry midwife.

Since the ACMI Vic Public Forum on Bachelor of Midwifery held in Melbourne
last August there have been a considerable number of women like you who have
enquired about becoming midwives without first becoming nurses.  The
Discussion Paper on the introduction of the Bachelor of Midwifery into
Victoria is in its final draft stage, and will be available in the near
future.

There was a meeting recently at Monash University to discuss the
introduction of a 4 year double degree, BNBM.  The clear message from the
practitioners at that meeting was that the BM as a degree in its own right,
without being linked to BN, is not only desirable but essential if the
universities are to provide for current international and local professional
requirements.  There is no objection to a double degree, as long as each of
the component degrees can be taken independently.  This is the usual process
when universities offer double degrees.

Thanks for introducing yourself.  Are you able to tell us about The Birthing
Womb and the Cyber Circle of Motherhood?

warmly,
Joy Johnston
Professional Officer ACMI Vic
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Rachael Colley
Sent: Sunday, 18 July 1999 0:46
To: [EMAIL PROTECTED]
Subject: new to the list


I've finaly found you! I have heard about you and looked for your
address and now I'm here, cool. Well, my name is Rachael. I am an aspiring
midwife, mother of 3 and am at the moment watching midwifery training models
very closely to see what's happening and what I feel I want to do.
Does anyone here have experiance as a traditional/lay midwife/birth
attendant? I am very interested in this path, even if it is just so I can be
of service to myself and family. I have a real belief in the midwife
inherent in each woman.
Looking forward to hearing from you all.
Is there anyone I know on the list? Barb?
p.s. I'm a terrible speller!
Rach
The Birthing Womb and the Cyber Circle of Motherhood.
http://www.ozemail.com.au/~rscolley

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FW: New WABA Breastfeeding, Women and Work Website

[Johnston]

-Original Message-
From:   Ted Greiner [mailto:[EMAIL PROTECTED]]
Sent:   Wednesday, 21 July 1999 8:08
To: tedh
Subject:VB: New WABA Breastfeeding, Women and Work Website



Breastfeeding, Women and Work Website
The World Alliance for Breastfeeding Action (WABA), would like to invite you
to visit its new website at http://www.waba.org.br/working.htm and click the
button for "ILO Campaign."
WABA, the International Baby Food Action Network (IBFAN) and other
organizations have formed a coalition to work on strengthening the
breastfeeding rights of working women. The most important normative
documents that influence national laws in support of this right are the
International Labor Organization Convention 103 and Recommendation 95. ILO
is currently revising these and we would like to alert you about this. You
can obtain detailed information on what has happened so far at the first ILO
Conference to deal with these revisions in Geneva in June 1999.
Unfortunately, ministries of health, who these days usually recommend
exclusive breastfeeding for 4, 5, or 6 months, are not being consulted with
in this ILO process. One important contribution in many countries would be
to suggest to ministries of health that they contact the ministry of labor
and call for a
formal consultation to harmonize national policy on this issue. The
coalition
hopes to work also at regional and national levels in the coming years to
encourage this kind of harmonization at least at the level of national
legislation. Let us know also if this is something you would like to work
practically with in your country.

Your country will comment on the latest version to the ILO by November. The
next ILO Convention in June 2000 will vote on the new convention and
recommendation. If you would like to know what you can do in your country to
influence your delegates (government, labor and/or employers), please read
the information in the website first, and then write to [EMAIL PROTECTED] or
[EMAIL PROTECTED] We look forward to your support!
Ted Greiner, PhD
Coordinator, WABA Research Task Force
Webmaster (with Denise Arcoverde) of the WABA "Breastfeeding, Women and
Work" Website

P.S. Your email address is on a large mailing list used by WABA strictly
breastfeeding-promotion purposes. If you would like to be removed, simply
hit "reply" and write "remove" on the subject line.



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a midwife in Canada

[Johnston]

This message came to me via a couple of intermediaries, so I forward it on
to you.
Joy Johnston
Midwife and lactation consultant
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm
-Original Message-
From:   Maureen Minchin [mailto:[EMAIL PROTECTED]]
Sent:   Friday, 23 July 1999 21:46
To: [EMAIL PROTECTED]
Subject:Fwd: Please send Birthday wishes to midwife!

>X-POP3-Rcpt: minchin@merlin
>From: Catherine Young <[EMAIL PROTECTED]>
>Subject:  Please send Birthday wishes to midwife!
>Date: Wed, 21 Jul 1999 22:15:42 -0400
>MIME-Version: 1.0
>
>Dear Friends of True Midwifery:
>
>Wendy Clemens is a competent, capable, intelligent, compassionate and
>spiritual midwife who devoted her adult life to midwifery. Her statistics
are
>better than the lowest statistics around the world in hospital or home.
>
>A couple of heavy-handed letters were written by health care
>professionals in Wendy's community to stop her from practicing,
>and as a result, she was suspended, had to defend herself against
>these allegations and is still on a course to gain legitmacy and
>registration in British Columbia.
>
>She has not been allowed to practice midwifery for two years.
>She has been jumping through hoops for the B.C. College of
>Midwives and the medical establishment who sit in judgement
>on legalization of midwifery in B.C.
>
>Wendy is taking required courses, re-mortgaging her home, cleaning
>people's houses to make ends meet, trying to keep her head down and learn
>what life is teaching her. She is at a very low point in
>her career, in her life. She feels abandoned by her peers in
>midwifery; worthless for all the work she has done in her
>life. Her good work, excellent statistics  and the glowing comments from
her
>clients count for nothing against the College of Midwives disapproval.
>
>Her birthday will be Friday, July 23rd.  She will be 54.
>Contact her here:
>
>Wendy Clemens
>3312 Beach Avenue
>Roberts Creek, B.C. VON 2W0
>Canada
>
>tel. (604) 885-2950
>
>Or email me and I'll pass your message on:
>
>Caitlin Hicks
>Playwright/Performer
>SINGING THE BONES
>[EMAIL PROTECTED]
>

Maureen Minchin, PO Box 1221, St.Kilda Sth, Vic. 3182 Australia.
Book orders: [EMAIL PROTECTED]


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dates to remember

[Johnston]

Has anyone else noticed that the first week of August looks busy?
Friday 6 August - submissions to the Senate Inquiry


Anyone within reach of Melbourne please note:

* Thursday 5 August: 3pm - 5 pm  FREE public forum 'Best Practice Maternity
Care' at the YWCA, 489 Elizabeth St, Melbourne.  No registration required.
See you there!
* Thursday 5 August - from 6 pm:  MATERNITY COALITION dinner 'Changing the
image of childbirth: the role of the media'  Contact Rhea Dempsey to
register 03 9562 8592
* Saturday 7 August - ACMI Vic State Conference and AGM 'WOMEN'S WAYS'.
Registrations are coming in daily.  Don't delay with your registration if
you are planning to come!  If you don't have a reg form, call acmivic 03
9349 1110, or e-mail [EMAIL PROTECTED]  Credit card payment
available.

There are a lot of midwives and consumers who are eager for the sort of
changes that are often talked about on this list.  I heard on the radio
today that the State Premiers are calling for an overhaul of health funding.
All those who have been writing submissions about competition policy, be
encouraged.  Those simple messages may be taken up - the safety of midwifery
care, the collaboration of midwives with other professionals when needed,
the acceptability of midwifery care, and particularly where continuity of
carer is an element.
Remind all who will listen that 'birth is not an illness'.  I will copy the
Fortelesa Declaration (WHO 1985) below so that you can quote it.  I suggest
you use it as a handout, make posters, and generally do all you can to
spread the good news, just in case someone in your community is unaware of
these facts.
Now back to writing that submission.
Joy Johnston
Midwife and lactation consultant
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm

BIRTH IS NOT AN ILLNESS
Recommendations from the World Health Organization

These recommendations are taken from a report on Appropriate Technology for
Birth published by the World Health Organization in April 1985, and are
known as the Fortelesa Declaration.  The recommendations are based on the
principle that each woman has a fundamental right to receive proper prenatal
care; that the woman has a central role in all aspects of this care,
including participation in the planning, carrying out, and evaluation of the
care; and that social, emotional and psychological factors are decisive in
the understanding and implementation of proper prenatal care.


* The whole community should be informed about the various procedures in
birth care, to enable each woman to choose the type of birth care she
prefers.
* The training of professional midwives or birth attendants should be
promoted.  Care during normal pregnancy and birth, and following birth
should be the duty of this profession.
* Information about birth practices in hospitals (rates of caesarean section
&c) should be given to the public served by the hospital.
* There is no justification in any specific geographic region to have more
than 10 - 15% caesarean section births.
* There is no evidence that a caesarean section is required after a previous
transverse low segment caesarean section birth. Vaginal deliveries after
caesarean should normally be encouraged wherever emergency surgical capacity
is available.
* There is no evidence that routine fetal monitoring during labour has a
positive effect on the outcome of pregnancy.
* There is no evidence for pubic shaving or pre-delivery enema.
* Pregnant women should not be put in a lithotomy position during labour or
delivery.  They should be encouraged to walk during labour and each woman
must freely decide which position to adopt during delivery.
* The systematic use of episiotomy is not justified.
* Birth should not be induced for convenience, and the induction of labour
should be reserved for specific medical indications.  No geographic region
should have rates of induced labour over 10%.
* The routine administration of analgesic or anaesthetic drugs that are not
specifically required to correct or prevent a complication in delivery
should be avoided.
* Artificial early rupture of the membranes, as a routine process, is not
scientifically justified.
* The healthy newborn must remain with the mother, wherever both their
conditions permit it.  No process of observation of the healthy newborn
justifies a separation from the mother.
* The immediate beginning of breastfeeding should be promoted, even before
the mother leaves the delivery room.
* Obstetric care services that have critical attitudes towards technology,
and that have adopted an attitude of respect for the emotional,
psychological and social aspects of birth should be identified.  Such
services should be encouraged and the processes that have led them to their
position must be studied so that they can be used as models to foster
similar attitudes in other centres and to influence obstetrical views nation
wide.
* Governments should consider developing regul

RE: direct entry

[Johnston]

Thanks for those comments Sally.
Anyone on the list who would like to receive a copy  of the ACMI Vic
Discussion Paper on the introduction of Bachelor of Midwifery (direct
entry ) programs please send your snail mail address to
[EMAIL PROTECTED]  All full members of ACMI Vic Branch will receive a
copy, and a group of people identified as key stakeholders.
The paper is to be ready for distribution shortly.
Joy Johnston
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Sally Tracy
Sent: Saturday, 24 July 1999 11:49
To: [EMAIL PROTECTED]
Subject: direct entry


dear list
In response to the discussion re the nature of direct entry education.
No, it does not need to be obstetrically based ...in fact the ideal is
for obstetrics to remain the domain of study for obstetricians and other
tertiary level practitioners. The direct entry degree course for midwives
would ideally educate a midwife in the primary care model as a 'watchful
attendant ' to the woman in childbirth as opposed to a 'medical caregiver'.
To get a better idea about the areas of study, they are closely related to
courses presently taught in the departments of public health, Women's
Studies, biological sciences and sociology. The aim of training midwives in
this system is to educate midwives in the phenomenom of birth as a
physiological event based in the sociological context of the family. This of
course contrasts strongly with the notion of birth as a medical procedure
attended by nurses and doctors who are trained in the pathology of birth and
assess birth in terms of risk.The midwife  must be trained to recognise
danger signs, but the difference is she is not educated to be fearful of the
process, but to be patient and confident in women's innate ability to give
birth.
Sheila Kitzinger puts it far more eloquently than I can when she says
"In childbirth midwives touch the two worlds of the instinctual and the
cultural, bringing them into harmony. Such a calling requires not domination
and control, but careful observation and sensitive awareness. It needs
patience and a willingness to wait for the unfolding of life. It requires
skill in helping the labouring woman to have confidence in herself and the
power of her uterus." Sheila Kitzinger The Midwife Challenge, 1991.Pandora.
For a closer look at the subjects and the course of study for direct
entry midwives have a look at the Christchurch (NZ) course which is up on
the web at www.midwives.org.nz/college.html
And remember..(I know I sound like a stuck record!). It was
mainly women who made the differeence in new Zealand. Without women
(consumers) midwives are nothing! So go out and demand your midwife should
be better educated in the art and science of midwiferynot
obstetrics.
sally t

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baby friendly news

[Johnston]

Dear list friends
I am sure you will join me in congratulating the Royal Women's Hospital, in
Carlton Vic, on their successful reassessment as a Baby Friendly Hospital.
Heather Harris who many of you know is chief LC there.

This is the first hospital in Australia to be reassessed.
Joy Johnston

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midwifery and GST

[Johnston]

Someone asked me recently if self-employed midwives will have to pay GST on
our earnings - and thus charge extra.  I don't know.  Does anyone on the
list have an authoritative word on this?
I will ask my accountant when I take my tax, but my guess is that he won't
know either.

Thanks in anticipation.
Joy Johnston
Midwife and lactation consultant
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm

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RE: Direct entry

[Johnston]

Dear Elaine and list,
This issue of midwives needing to be nurses is one that we all have to look
at carefully.  It's not only rural and remote - even in some metropolitan
and regional hospitals midwives are often expected to work in general wards
when maternity is quiet, or the other side particularly busy.
As long as mainstream midwifery is linked to hospital shifts, this will
continue to be a problem.
When you link the midwife to the woman, and start asking what is appropriate
maternity care, the issues are seen in a new light.  There will always be
jobs in hospitals for some midwives, but I think many could be better
employed as practitioners who provide continuity of carer within small teams
or groups.
A small town that has the potential for 30 - 40 births annually could be
serviced for maternity care by 2 midwives, each taking a caseload of 15 to
20 women, for prenatal, intranatal and postnatal care, and covering each
other for time off.  A third midwife, who was perhaps less able to take her
own caseload (most of us have our own children at some stage in our
journey), may cover for annual leave and sickness.  These midwives would
attend only 1 or 2 births a month, and if that was not enough work to keep
them busy, they could do nursing shifts at the hospital.  Women who develop
complications that require a higher level of care than can be accessed
locally are referred to the larger centre.
One of the problems we are frequently reminded of in smaller communities is
the deskilling of midwives, due to the small number of births. Some small
hospitals find it is impossible to have a midwife employed on every shift.
Does this mean that the hospital can no longer safely provide care for the
women in birth?  I hope not.

When there are midwives who are not nurses these issues may become more
clear.  I don't think we should wait until that time.  Let's bring in
changes to the system so that midwives can practise woman-centred midwifery.
And let's do all we can to keep midwifery alive in each town and district.

Sincerely, Joy Johnston

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Dietsch Family
Sent:   Wednesday, 28 July 1999 20:24
To: midwifery@ace
Subject:Direct entry

While I agree that Direct Entry would be a wonderful opportunity for women
choosing to be midwives and for many birthing women. I do have a concern
that I would like to share with the list.

My concern is for women choosing to give birth in small country towns all
over Australia.  Rural (let alone remote) Australia is having incredible
difficulty recruiting midwives to practice and as a result maternity
services all over the country are being closed and women are being forced
to larger centres, often many hours away to give birth (A homebirth midwife
is only a  fantasy!). Direct entry may help in encouraging more women to
midwifery.  But, in these small towns the reality is that midwives also
double/triple as accident and emergnecy nurses, gerontology nurses, etc. As
an idealist, I agree that this is awful and plays a role in discouraging
qualified midwives from practising and the health service should realise
this and do something.  As a realist, I must admit (and nearly choke as I
do so) they are - they continue to close down birthing opportunities for
rural women - it makes great sense economically - it is a tragedy for
women, their babies and their families.

My concern is that birthing opportunities for rural women will be even
further reduced if Direct Entry were to be accepted and midwives cannot
also function as nurses in rural hospitals.



Elaine  Dietsch
11 Willow St
Leeton NSW 2705
02 69 533 272
[EMAIL PROTECTED]
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a woman's right to choose midwifery care

[Johnston]

I want to share a situation with you, colleagues, caring people, and
possibly some who would oppose what I am doing.
I am not prepared to identify the hospital concerned, and even if you think
you know to which hospital I refer, believe me, it could be one of several.

A woman whose baby is due in a couple of months has booked for care at a
public hospital.  This hospital does not have an antenatal clinic, and
requires women to be seen in the rooms of the doctors who provide obstetric
services in that hospital.

The woman is not a health professional.  She has made it her business to
find information about birth and evidence based models of care.  She decided
she wanted continuity of care from one midwife, so she phoned the maternity
unit at the hospital.  The midwife she spoke to said the hospital did not
offer that option, but directed her to independent midwives.  After
discussion with me the woman decided that she would like to have me provide
pre-, intra- and postnatal care.  She wants to have her baby in the
hospital, and go home within a few hours of the birth.  I explained that I
do not have a visiting arrangement with the hospital concerned, meaning that
when in hospital she would be under the care of another midwife from the
hospital as well as me.
(I'm sure you get the picture - the hospital uses the word 'support person',
and although support is a marvellous thing, and one of the things I aim to
do, I am and will continue to be, a midwife, whether or not the hospital
acknowledges me as such!)

The woman phoned the doctor's receptionist to cancel her next appointment,
and to inform the doctor that she would only be coming back to him if she
required specialist care.  She was informed that she was not allowed to
change to a midwife's care.  The woman phoned the hospital, and was told
that it 'not medically possible' for her to keep her booking at the
hospital, and have the model of care that she had chosen.

The woman has written a letter of complaint to the CEO of the hospital.

This sort of medical monopoly and anti-competitive behaviour is very
offensive to me, and to those who seek my services.  According to the Trades
Practices Act, it is the purchaser and not the seller of a service who
should determine what is the best product.  I offer a service for which I am
qualified, and which is my livelihood.

Having just completed a submission to the Senate Inquiry (as have quite a
few others on the list) I am acutely aware of the inappropriate
medicalisation of well women in pregnancy and birth.  We cannot afford to be
complacent about this.  WE have a better option.  I have told this story to
remind myself and others that coming generations of women will be subjected
to unnecessary tests, surgery, self-doubt, depression, and many other
unpleasant sequelae if we do not change the delivery of care in mainstream
maternity services.

Sincerely
Joy Johnston
Midwife and lactation consultant
[EMAIL PROTECTED]
www.aitex.com.au/joy.htm

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midwifery campaign

[Johnston]

Dear list
yesterday the Vic premier announced a State election.

yesterday another campaign was also launched - the VICTORIAN MIDWIFERY
CAMPAIGN

you are among the first to hear about it.  Could I ask all Victorians to
watch this space, and contribute and work with this initiative.  ALSO,
perhaps other State groups of midwives and consumers will consider forming
similar cooperative groups to make the campaign nation-wide.  Hear are a few
details of this campaign:



We are preparing letters to politicians and candidates, press releases, and
other strategies.

This is evidence that midwives and consumers are working together to achieve
reform in childbirth.
Joy Johnston

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RE: midwifery campaign

[Johnston]

Arwa
The message is, that each woman needs the right to choose a midwife as her
primary caregiver through the pregnancy and birthing continuum.

This option is currently out of reach of most women (and midwives) as a
result of the medicare funding monopoly, and other anti-competitive
practices within the health care system.

That's the simple, basic message - whether in Canberra or Cairns.
Joy Johnston

-Original Message-
From: sunnah haid [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, 25 August 1999 14:47
To: [EMAIL PROTECTED]
Subject: Re: midwifery campaign


Dear joy
i applaude all the efforts...can we do anything here in canberra...there are
some good politicians (women) that i can talk to directly...what would you
have me say..
awaiting in eagerness
arwa


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RE: Why can't we practise as midwives in hospitals?

[Johnston]

Dear Kathleen and all
Midwives in Victoria have, since 1996, our excellent Code of Practice.  The
ICM Definition of a Midwife is its central statement, and everything else is
consistent with the Definition.
There are a couple of statements in the Code that are relevant to your
question:
<4.2  midwives are responsible and accountable for their own practice.  Each
midwife acts within the sphere of midwifery practice and is expected to
maintain the competence necessary for contemporary practice.
The midwife employed by a healthcare facility must practise within the
policies and procedures of that facility.  Where a midwife is afforded
clinical responsibilities by a healthcare facility through an appointment
mechanism there must be a documented agreement between the midwife and the
facility.  However, it should be noted that practising within a guideline or
policy of an employer, any organisation or professional group does not
relieve the midwife of responsibility for personal acts.>

I expect some will see the Code as restrictive.  However there is a new
paragraph that has been added recently (the 1999 review), which I really
like.
<5.  Professional responsibilities: Each midwife has a professional
responsibility to identify policies, procedures or practises that are
restrictive and/or  may be detrimental to the standard of midwifery practice
and woman-centred care.  In identifying these issues, midwives must act to
ensure that they are brought to the attention of the relevant authority.>

I read this as covering all those issues we talk about on this list, and
much more.  Midwives in every Victorian hospital should be carefully
reviewing policies and procedures and guidelines from a midwifery
perspective, and following through with deputations to the hospital
management.  And I know it's easy for me to say what those in the acute
system should be doing - and I don't want to see midwives being victimised
because they stick their necks out.  But the Code says that 'each midwife
has a professional responsibility ...'  We all need to support each other in
this.  We in Victoria have a long way to go before we can claim that
midwives in mainstream maternity care are practising according to the Code.

all the best
Joy Johnston


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Kathleen Fahy
Sent: Thursday, 26 August 1999 12:18
To: Ozmidwifery
Cc: Cath Rogers-Clark
Subject: Why can't we practise as midwives in hospitals?



This question may seem naive but I really can't get a clear answer?

What policy or legislation requires hospital midwives to follow medical
protocols?   For example:  where do midwives stand if they don't do regular
VEs, avoids using oxytocins or keep descriptive notes rather than use a
partogram?

I can find no legislation in Qld (which doesn't mean it doesn't exist but it
is not in the nursing act and I'm told it is not in the health services
act).

A midwifery administrator tells me that the only way in which midwives are
required to follow medical protocols is that if they don't they will not be
covered by the hospital's vicarious liability insurance.

Does anyone know anymore?


Dr. Kathleen Fahy
Associate Professor
Midwifery Co-ordinator
University Southern Queensland
07 46312377
[EMAIL PROTECTED]

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RE: Fundal Pressure

[Johnston]

Mandy and all
I have not seen fundal pressure in 2nd stage labour used in Australia, but
when I visited a few hospitals in NW China in 95 I saw it used liberally.
Most mothers in China are Primiparae, and the routine medical procedures
that were dished out to those women made me shudder.  Fundal pressure was
used to augment vacuum extraction which seemed to be standard unless
something more drastic was 'required'.

Care in Normal Birth: a practical guide (WHO 1996) states that "In many
countries the practice of fundal pressure during the second stage of labour
is common.  It is meant to expedite the delivery, is sometimes performed
shortly before delivery, and sometimes from the beginning of the second
stage.  Apart from the issue of increased maternal discomfort, there is
suspicion that the practice may be harmful for the uterus, the perineum, and
the fetus, but no research data are available,  The impression is that the
method is at least used too often, with no evidence of its usefulness."

A further comment from me is that the physiological arguments used against
sustained directed pushing - Valsalva - would surely also apply with this
manoeuver.  The woman would be required to lie on her back, which is
contraindicated, and the increased pressure on the uterine fundus would
increase the potential to compress the aorta, and reduce the blood flow to
the baby.

The psychological impact of such management must be overwhelming to the
woman.

What a world of difference there is between this image, and the woman giving
birth in the position she has chosen!

Joy Johnston

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Mandy O'Reilly
Sent: Sunday, 29 August 1999 11:46
To: [EMAIL PROTECTED]
Subject: Fundal Pressure


I would dearly love to hear responses and opinions regarding the use of
fundal pressure during the second stage of labour.

To define what I mean by fundal pressure: It is pressure applied to the
fundus of the uterus by the open palm of the hand in second stage of
labour, in order to assist the delivery of the infant. Some of the
versions I have seen require that the women is lying flat so that the
angle of the pelvis is correct.

Fundal pressure appears to be acceptable or common in certain countries.
Have seen its use in Indonesia. Women have reported to me that it was
used on them in previous births in Germany and Japan.

A review of the literature revealed the following:  There appears to be
very little research done on either neonatal or maternal outcomes
relating to the use of fundal pressure. In the USA 2 studies found gross
under-reporting in the women's notes regarding the fact that fundal
pressure had been applied. There appeared to be a fairly high incidence
of use. This was by both obstetricians, nurses and midwives. It appears
to be a fairly common phenomena in certain birth settings there.

A pilot study by Costner (journal of nurse-midwifery) revealed no
adverse neonatal or maternal outcomes, in fact apgar scores in the two
groups were similar. What she did find was that the fundal pressure
group had a mean length of second stage of labour twice that of the
control group. Reasons cited for the use of fundal pressure in this
study were, foetal distress, maternal exhaustion and prolonged labour.

A Swedish study warned of the danger of  embolism (pulmonary ?). If I
remember  correctly that actually documented cases where this had
occurred.

Adverse outcomes extrapolated regarding the use of fundal pressure
include: uterine inversion and haemorrhage. Increase in perineal trauma.
Neonatal outcomes: concerns have been expressed regarding neonatal
adrenal damage and haemorrhage, liver damage, impacted shoulders with
the use of this manoeuvre.

This procedure has been justified a less harmful alternative to vacuum
extraction by one obstetrician that I have personally discussed it with.

I have also witnessed one case where the head appeared to asynclitic
this baby needed resuscitation and developed what appeared to be a TTN
on day 3. I also think I have seen more jaundice in the babies that have
had this procedure used on them - not able to substantiate it. Maternal:
one or two of the mothers complained of a sore diaphragm for a few days
afterwards. Equally some of the women did not seem to be distressed by
the use of this procedure on them and did not complain of any
pain/discomfort.

Elizabeth Davis in her book "Hearts and Hands" advocates for the use of
fundal pressure if the second stage is prolonged.

This is obviously a very controversial procedure and I have to admit
bias after seeing it in action. I would dearly love to debate this one
and would be happy to hear opinions from lots of folk. My impression is
that in certain countries this would just not be considered acceptable
practice and could even lead to disciplinary action.

Comments please.

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RE: Fundal Pressure and fees

[Johnston]

Dear list
I wonder if there is a strong correlation between practises such as fundal
pressure, and the colonial history of an area.  Where did the medical
practices come from?
The left lateral position for birth is another one.
Some women choose L lateral, and I am very happy to work in that way.  She
may hold her own leg up or have someone support it.   But when I was  a
student (1972 at the Royal Women's, Carlton) they had an awful pole with a
strap attached, so that the woman's right leg could be suspended out of the
way.  L lateral was seen as an excellent teaching position.  You put the
woman's face on one side of the bed, and a midwife there to administer the
gas.  that, in my opinion, effectively removed the woman from what was
happening.  The rest of the team stood on the other side of the bed, at the
business end of things.  It didn't seem to matter how many onlookers there
were, or how many pairs of hands were used to do what the woman could have
done herself if given half a chance.

Mandy asked me to give her an idea of fees I charge.  I wonder if anyone
else would like to contribute to this discussion.
I have worked out my fee as a proportion of my annual potential earnings if
I was able to book a full caseload (40).  This doesn't happen - some months
I have to turn people away, and other months I have no bookings at all.

I charge $1600 for the 'package', which includes prenatal consultations at
my home office; a birth planning meeting at about 36 weeks at the woman's
home; attendance for labour, birth and 3-4 hours after; postnatal visits,
usually daily until day 4, then as needed; and a follow up consultation at 5
or 6 weeks at my home office.  A second midwife fee is usually $400-500, and
may include attending the birth planning visit.  If the woman does not want
to employ a second midwife, other options are a student midwife or a friend
who is there as helper.

A woman who lives more than 50K from my home will also be charged for
travel.

The details are on my website www.aitex.com.au/joy.htm
Joy Johnston

-Original Message-
From: Mandy O'Reilly [mailto:[EMAIL PROTECTED]]
Sent: Monday, 30 August 1999 10:46
To: Johnston
Subject: Re: Fundal Pressure







Dear Joy

Have never figured what their actual logic is in wanting the women to
lie flat - the mutter something about the angle of the curve.

What I really found fascinating was the no documentation esp from the
USA. That tells me something. Have never seen it in Australia either or
in South Africa.

On another topic are you able to give me input regarding the fees you
are charging for the various services you provide. I would be really
grateful. I need to do some comparisons

I presume you are going to Hobart. I am envious, but if you are enjoy.

Kind Regards

Mandy O'Reilly






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RE: MSES

[Johnston]

Rob, it's really heartening to read what you have written.
I am off to Hobart tomorrow, and will be back Saturday evening.  Without
people like you who are prepared to be passionate about what sort of opti=
ons
you want for maternity care, midwifery would go nowhere.  Thanks.

Vanessa Owen has been elected (yesterday) National President of ACMI, and
Trish David as Vice Pres.  Vanessa is in the process of moving to a new j=
ob
(at Werribee Mercy), and moving house.  As soon as she is back on line I'=
m
sure she will be in touch with the list.  In the meantime any messages of
support can be sent to Vanessa at [EMAIL PROTECTED]

WOMEN AND MIDWIVES ~ POWER IN PARTNERSHIP

Let's do all we can to support and strengthen each other.
Joy Johnston
  -Original Message-
  From: Tony Payne [mailto:[EMAIL PROTECTED]]
  Sent: Tuesday, 31 August 1999 10:51
  To:
  Subject: MSES


  Following the rally we had last week ( the success of which depends on
what you call success!!) I am continuing to raise the issue in the public=
's
eye about my concerns about MSES and accountability of funds.  I have tri=
ed
to precis below what the issue is as I see it.  Perhaps my concern is
unjustified, the whole point is, without some sort of accountability, how=
 do
we know?  I would really love to hear from Victorian midwives who share m=
y
concern about this money and how its being spent and what difference they
think MSES is going to make.  When you think of what we could do with $61
million bucks if it was directed toward primary midwifery care and
women-centred care - its a crying shame to think it might all get pxx@@##=
 up
against the wall and no one ever questions it.  If they're doing
good -great.  If they're not, we must expose it.

  The Victorian Government, as part of the Maternity Services Enhancement
Strategy (MSES) has allocated $61 million to enhance maternity services.
  The money is only available to hospitals even though part of the brief =
is
to be expanding women=92s choices in models of care and the development o=
f
"information" about pregnancy and childbirth.
  At a workshop held on the 10th June 1999 by the Department I raised my
cynicism about
1.. what incentive did hospitals have to develop choices outside thei=
r
own perspective of maternity care?
2.. the development of information should be independent and not
attached to the provider of services
3.. how is the consumer to know that the money is being spent in
accordance with the strategy?
  I was told not to worry and that the Reference Group that was being
established will act an accountability body to ensure that money is spenT
within the terms and spirit of the strategy.

  To date, over a year into the strategy and no such group has been
convened.  I have written to the minister and the department expressing m=
y
concerns and asking when this group will be convened. I have received no
response to these questions.

  There are some good initiatives coming out of the strategy which I
acknowledge. However I have also since heard anecdotally from talking to
some midwives working in the units that money has been received by the
hospitals but has simply gone to making up the already existing budget
deficit from previous years. In other instances I have heard of funds bei=
ng
spent inappropriately (cars; EFM machines) all for antenatal care which i=
s
what the first year=92s funding was targeting. I have heard too that the
department are also concerned and doing some "internal" questioning.

  If the Department really wants to know what=92s happening they should b=
e
conducting confidential interviews with midwives working in the units.
Midwives are too fearful for the job security to question their superiors=
 on
what is happening or to speak out. However they know exactly what is
happening with that money.

  The Department must convene that Reference Group which must include
consumers and all receivers of funds under the strategy should be
accountable to that group.

  I will continue to write to the Department and the minister and write
letters to all newspapers and would encourage anyone else who could imagi=
ne
the things we could do with $61 million to improve maternity services in
this state, to do the same.

  Please contact me for more information - Robin Payne 9380 2863.

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conference

[Johnston]

Dear all
I have just returned home after the National ACMI 'Hearts, Hands and Minds'
conference in Hobart.  I would love to be able to go on to Byron Bay for the
Homebirth conference, but that's not possible.  The babies that are due have
waited for me to return, but I doubt they'll wait much longer.

I was acutely conscious at the conference of many of the midwives who I have
met through this list, and who I met face to face for the first time.  These
are people who have shared their wisdom and passion through this list.
Many of us commented on whether the person (in the flesh) was what we
expected from the online meetings.

I believe that the open communication that this list has facilitated has
been significant in a growing sense of expectancy in midwifery.  We are
expecting big changes.

Tomorrow (Monday) the Senate Inquiry into childbirth procedures is hearing
submissions in Melbourne.  I expect to be there.  ACMI Vic is presenting at
11-11.45 am, Maternity Coalition 1.30-2 pm, and the Obstetricians 4-5pm.

Joy Johnston



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senate inquiry in Melbourne

[Johnston]

ttending the hearing.  The changes we seek are really worth pursuing.
Let's all work together, and use every opportunity to ensure that women of
future generations are able to give birth with a known midwife, in the place
of the woman's choice, with respect and joyful intimacy.

Joy Johnston

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RE: senate inquiry in Melbourne

[Johnston]

Hi Marina.  I don't know how long it takes to get the transcripts up.
Is there a particular one that you want to see?
Joy

-Original Message-
From: HomeMidwifery Association [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, 7 September 1999 13:58
To: [EMAIL PROTECTED]
Subject: Re: senate inquiry in Melbourne


Joy,

I've had a look but there is nothing yet for this enquiry. Was it indicated
to you at the hearing exactly when the transcripts will be posted?

Marina

Transcripts of the evidence taken at hearings are available on the internet
at http://www.aph.gov.au/hansard
The report will be available in mid December at
http://www.aph.gov.au/senate/committee/clac_ctte/index.htm

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RE: Senate Inquiry

[Johnston]

Dear Sally and all
I can't answer either of these questions.
The Age medical reporter Victoria Button got a piece about the Inquiry into
page 3 of today's paper (Tues).  She gave particular focus to Jane Fisher's
claims that caesareans are linked to an increased incidence in certain
psychological disorders, and that subsequent pregnancies  may reactivate the
condition.
The article reported that:
"The Australian College of Midwives called for a funding reform to allow
midwifery at all births."

I have written to Victoria Button with the following comment:



:

  -Original Message-
  From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Sally Tracy
  Sent: Tuesday, 7 September 1999 9:55
  To: [EMAIL PROTECTED]
  Subject: Re: Senate Inquiry


  dear Joy
  many thanks for this briefing. I am going to represent AMAP on the 14th
Sept in Sydney. I need some feedback on two points.
a.. Does anybody have the latest reference for the spending on
ultrasound technology as part of the maternity budget? I have several
references but I want to be absolutely sure...they all look so
unbelievably high!
a.. what constitutes 'early discharge' in the majority of practices? I
have conflicting definitions to hand. And when is a woman eligible for
visits by a community midwife, after discharge from hospital?
  Many thanks in anticipation
  sally


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RE: Senate Inquiry VERY IMPORTANT

[Johnston]

Hi Marina,
I would suggest that as a voice for the  consumer you could make a strong
issue that the current funding does not allow the woman an equal choice
between the standard medical / hospital models and other evidence based and
appropriate models.  The monopoly of medical care prenatally - because of
medicare funding, and hospital care for the birth, followed by patchy bits
and pieces of services for those who can access care - does not in many
cases provide best care for the woman and baby.
The only way I can see out of this is that the policy makers look at it from
first principles.  Birth is not an illness.  Maternity services require a
unique, purpose built process.  Each woman who is pregnant should be
entitled to a basic service, which is adequate for primary care, and to
which realistic funding is attached.  This is where that woman has choice.
She should choose, as New Zealand women do, the model of maternity care, and
a lead maternity carer.  That carer either follows through with the total
provision of care (as midwives are able to do for well women and babies) or
accesses the services of other professionals.  If a doctor is the lead
carer, and does not wish to provide personal continuity of care through the
birthing episode, the doctor pays the midwife an agreed sum.   If
complications develop there would be additional funding which can be
accessed, as in the current medical system.
I understand that there were early funding problems in NZ, in that some
people were doubling up on services - midwife and doctor when this was not
necessary.  There may be some NZ people on the list who could give us more
information.  This has been stopped, but the word got out about the funding
blowout in NZ.  Carol mentioned this double dipping in her submission.
Women who 'choose' a service that charges more than the public funding
allows would pay the extra themselves.
Another funding issue that should be tackled by the Senate committee is the
excessive use of public money for obstetric ultrasound.  Why is this
allowed, when there is no evidence that outcomes are improved?  If every
woman had the 'right' to one funded ultrasound (I don't agree that every
woman needs one, and I am not sure that it is a safe procedure), and any
subsequent referrals for ultrasound had to be supported by indications from
an agreed list, the budgets would certainly be more readily kept in control.

The ACMI Fellows Forum (which is a fancy word for a bunch of committed
midwives) has asked me to lead a group looking at funding issues and
hospital visiting access for midwives, and Kate Cook from WA is helping me.
Please help us as much as you can by putting your ideas and suggestions to
this discussion, on the list.  This generates a broad overview, and the
comments of  people coming from different perspectives are very valuable.
So thanks in anticipation

Joy Johnston
-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of HomeMidwifery
Association
Sent:   Thursday, 9 September 1999 13:00
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject:Re: Senate Inquiry VERY IMPORTANT

Hi folks,

I'm totally lost on the issue of public funding but willing to pass on the
info during our 40 minutes if someone can provide the necessary details.

Marina


Original Message Follows
From: "Carol Thorogood" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Subject: Re: Senate Inquiry VERY IMPORTANT
Date: Wed, 8 Sep 1999 18:58:58 +0930

Dear all

Have just returned from the Senate Select Committee hearing. I represented
the WA ACMI. There's no doubt the committee has read the submissions and are
thinking about issues. Most of my questions came from Sue Knowles and
Rosemary Crowley. I found it difficult at times to separate the me hat from
the ACMI hat. This was harder when some of the questions were What is your
opinion of... and the ACMI doesn't have a stock/united policy.

VERY IMPORTANT After the hearing it was suggested to me that we midwives
must present to the Senate models which show how Federal money can best be
used to fund services - sort of like the ABSP.  I just can't do it  at the
moment. Maybe we need a joint submission. I get the impression that the
Committee wants ideas about finding sources of money and then ways of using
it. Can this be done by the next hearing?  The crux of it is that they want
us to do the work! We've done it all before so can we do it again?

The rest of this post is about my/ACMI (WA) submission.

  In my five minute blurb I concentrated on the need for maternity services
that reflect womens' expressed needs etc etc. I used a primary health care
model to show that not all women have services that are equitable,
accessible, appropriate affordable etc etc. I then gave three examples of
this ie homebirth, only two birth centres in WA and none in the rural areas,
inadequate or even absent ser

RE: Senate Inquiry & Age

[Johnston]

Hi Felicity
As I understand it the submissions and the hansard recording of the meetings
will be put up on the government website - I don't know how ling it takes
for this to happen.
Joy

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Felicity Croker
Sent:   Wednesday, 8 September 1999 16:50
To: Johnston; [EMAIL PROTECTED]
Subject:RE: Senate Inquiry & Age

Joy,
Your response to the news item should hopefully clarify 'midwifery care'.
All the best with the Senate Inquiry.
Do you think it would be a useful resource to have the senate submissions
on the OzMid or ACMI websites? They are well researched and could provide a
useful resource to midwives and consumer groups seeking evidence based
information.
Cheers
Felicity


At 06:04 PM 09/07/1999 +1000, you wrote:
>Dear Sally and all
>I can't answer either of these questions.
>The Age medical reporter Victoria Button got a piece about the Inquiry into
>page 3 of today's paper (Tues).  She gave particular focus to Jane Fisher's
>claims that caesareans are linked to an increased incidence in certain
>psychological disorders, and that subsequent pregnancies  may reactivate
the
>condition.
>The article reported that:
>"The Australian College of Midwives called for a funding reform to allow
>midwifery at all births."
>
>I have written to Victoria Button with the following comment:
>
>will attempt to briefly explain why.
>
>All (or almost all) women giving birth in Australia probably do have
>midwifery care. The problem is that the woman (consumer) is not able, under
>current funding arrangements, to choose a midwife. Very few women are
>attended by a known midwife. The concept of partnership between each woman
>and her known midwife is central to the woman centred philosophy of
>midwifery. Birth is not an illness. A midwife is not a nurse.
>
>Funding for both public and private midwifery care is available only
through
>hospitals - which are controlled by doctors who do not understand midwifery
>care. Public funding for all births includes a 'medical' component, but the
>midwifery care is treated as part of the service. Antenatal care is
>frequently provided in the community by doctors, and the funding is through
>Federal government Medicare. Most of these doctors do not have anything to
>do with the birth. Those who are involved in the birth do so through the
>private hospital system, and rely on midwives to attend their clients
>through labour, and call them in time to catch the baby. Of course, if
there
>are complications, that specialist is called to provide expert care.
However
>there is evidence that the involvement of specialists as primary carers may
>indeed be a factor in increasing the likelihood of medical intervention.
>This is one of the main issues that the Senate committee is attempting to
>address.
>
>Ten years ago New Zealand changed from a system of hospital based maternity
>funding, similar to ours, to a system over which the woman has choice and
>control. The woman may choose a lead maternity carer, either a GP doctor, a
>specialist obstetrician, or a midwife, and this is covered by government
>funding. The committee was particularly interested in the changes in
>maternity care in New Zealand. A recent report quoted in our submission,
>Maternity Care Provider and Outcomes, NZCOM 1998, in which the perinatal
>mortality rate (number of babies who die) for births under a midwife lead
>maternity carer was 3.6/1000, compared with 11.5/1000 for GP/midwife
shared,
>and 14.9/1000 for O&G/Midwife shared, was given a lot of attention. This
>evidence suggests that it is extremely safe to choose midwifery care. The
>only midwives in our country who work with a similar degree of independence
>to our colleagues in NZ are homebirth midwives, and perhaps a few in birth
>centres.
>
>Women are eager to maintain control over their bodies and lives, especially
>at a time of personal intimacy such as the birth of a baby. You did not
stay
>for the presentation by Maternity Coalition, but I would encourage you to
>read their submission. I wish you every success in your efforts as a
medical
>reporter, that you will be objective, and present a true picture of the
>issues you address.
>
>Yours sincerely
>
>Joy Johnston>
>
>:
>
>  -Original Message-
>  From: [EMAIL PROTECTED]
>[mailto:[EMAIL PROTECTED]]On Behalf Of Sally Tracy
>  Sent: Tuesday, 7 September 1999 9:55
>  To: [EMAIL PROTECTED]
>  Subject: Re: Senate Inquiry
>
>
>  dear Joy
>  many thanks for this briefing. I am going to represent AMAP on the 14th
>Sept in Sydney. I need some feedback on two points.
>a.. Does anybody have the latest reference for the sp

RE: funding for births

[Johnston]

That's exactly what I'm looking for.  Thanks Trish.
Joy

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Trish David
Sent:   Thursday, 9 September 1999 16:23
To: [EMAIL PROTECTED]
Subject:funding for births

Dear Joy,
I haven't thought this through very well, but I would like to see all
births funded through normal channels, but the choice of where to birth
would be the woman's.  How I see this happening might be that midwives are
employed by government bodies (such as hospitals or health departments) to
be the lead maternity carer regardless of place.  S/he then follows the
woman wherever she goes.  The salary of the midwife thus is guaranteed, and
the woman has a funded choice of either public, private, birth centre, home
or the highway in between.

Any extra above the medicare rebate is a matter for the woman and her
private health insurer.  An obstetrician is a separate entity, separately
contracted by the woman after referral from the midwife.  We will still
need obstetricians for the pathological contingencies, and they should be
remunerated accordingly.  And after all, no matter who she goes to as a
doctor, she will still need her midwife.

A small pool of midwives are maintained on a shift work basis in hospitals
for the obvious reasons, and antenatal care and the bulk of postnatal care
takes place in the woman's home by her LMC midwife (and her partners).
Does this make sense?  This would then open the gates to either fully
employed by agency midwives or privately practicing midwives to work in all
sorts of ways but the woman chooses.  What do you think?

Thus we do away with the bulk of shiftwork, the bulk of infrasturcture
costs, the bulk of on costs, etc.  We put these midwives on a salary.
Create a separate award, register and Act of Parliament. We put them into
their own community to serve their neighbours within teams of midwives who
integrate with other services and use their underused buildings (eg Family
and child health clinics, gp offices, school buildings, etc) anything to
get them out of the big centres and out to where the women are.

Well, that's all probably more than you asked for.  Cheers, Trish

Trish
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RE: anf and direct entry

[Johnston]

Dear Jen
Thanks for this.
I have forwarded your message on to Anne Marie Scully at ANF, who is a
member of the Bachelor of Midwifery Taskforce which prepared the 'Reforming
Midwifery' discussion paper.
Also to Diane Cutts who chaired the taskforce.

Let's all remember that it is the responsibility of the midwifery profession
to define midwifery.
Joy Johnston

-Original Message-
From:   [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Jen Byrne
Sent:   Friday, 10 September 1999 15:48
To: [EMAIL PROTECTED]
Subject:anf and direct entry

Dear list.
As most of you may be aware the University of SA and Flinders University
are collaboratively developing a  three year undergraduate midwifery degree
(Direct Entry) to be offered in 2001.  We  have appointed a project
officer.  One of our aims is to coordinate a national collaboration. We
would be pleased to hear from any interested universities.

This letter has been sent to the University of SA and Flinders University
from the ANF SA Branch following a number of letters sent to them asking
them to review their policy on direct entry when they had their annual
state delegates conference in August.

I QUOTE(I had great difficulty in writing this even though it is a quote -
referring to midwifery as nursing!! )
"...delegates voted overwhelmingly to maintain ANF's curent policy position
regarding midwifery including opposition to direct entry programs.

The ANF has a national policy which oppose direct entry education programs
for specialist areas of practice such as midwifery and mental health
nursing.  The basis for this is that we believe that it is necessary for
nurses to undertake a broard-based undergraduate program and to specialise
at postgraduate level.  This is particularly relevent in the contemporary
environment where clients' needs are so diverse and nurses must be able,
more than ever before, to respond to the full range of needs.  Further
more, there continue to be chronic shortages of specialist nurses in rural
and remote areas particularly of midwives and mental health nurses.
Employers in these areas continue to assert that direct entry courses will
not address these shortages.

Consequently we wish to reiterate our concerns about the university's plans
to introduce a direct entry midwifery program, as we do not believe it is
in the best interests of the community or the nursing profession."
END OF QUOTE
There was some debate at the ACMI conference in Tassie around the issue of
should we just ignore ANF.  As ACMI does not have an industrial arm we have
nowhere to go for industrial issues execpt ANF.  In SA the professional
officer is supportive of Direct Entry and understands midwifery is a
separate profession, however we are up against a national policy.

What does the list think about this issue?
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RE: Fundal Pressure

[Johnston]

Hi Genevieve
This is interesting.  I assume it is in response to the discussion on the
ozmid chat line, so I will send it on there.  I don't remember the
discussion getting into shoulder dystocia.
Joy Johnston

-Original Message-
From:   Genevieve Lilley [mailto:[EMAIL PROTECTED]]
Sent:   Friday, 10 September 1999 23:28
To: Johnston
Subject:RE: Fundal Pressure

Try having a look at Coates, T. Manoeuvres for the relief of shoulder
dystocia, Modern Midwife, 7(5), September 1997, which is cited in an
article in Open Line, which reads: "A five year review conducted in Totonto
found that fundal pressure, when used without other manoeuvres, was
associated with a high rate of neurological and orthopaedic damage. In
addition, it has been suggested that fundal pressure is associated with
uterine rupture and premature separation of the placenta."


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homebirth and initiation of breastfeeding

[Johnston]

Goodmorning!
I am planning to write a paper on this topic, and will be using stories
(case studies), as well as brief questionnaires to midwives who attend
homebirth, and to women who have planned homebirth in the past 3 years.

The questions that the mothers and midwives will be asked are similar to
those asked in an assessment of a maternity unit for Baby Friendly
accreditation.

I would really appreciate the input of ozmidwifery midwives and mothers.
Anyone who participates will not be identified.  Stories/case studies should
be up to 250 words in length, and should not use names or other identifying
features.  I am doing this as an individual, and not as part of any funded
project or course of study.

Please reply to me if you would to participate, or if you have questions.

Many thanks
Joy Johnston

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mainstream midwifery services

[Johnston]

Dear all
You may recall that I asked recently for comments on how we can change the
current system to allow midwives to provide woman centred care within the
mainstream health system.
The following comment came from Jan Robinson, and I wonder if anyone would
like to discuss this proposal.  It sounds excellent to me.  I would be
interested in contracting a caseload of say 2 per month at a local hospital,
and retaining my own private caseload.  The 'contracted' bookings would be
for planned birth in hospital, and I would expect the hospital to encourage
a midwife or student midwife who wanted to be mentored into independent
practice to work alongside me in some way through the care.  I envisage that
some women who accessed this service would actually decide that they wanted
to give birth at home, and that would be OK by me.

I now have 'shared care' provider status for antenatal care with Birralee
Maternity Service, Box Hill, and my first client who was booked there
birthed at home last Monday.  Of course this arrangement does not have any
funding linked to it - the next step, which fits in very well with Jan's
proposal:

QUOTE
Re your request for ideas on the ozmidwifery chat line... I feel the way
forward is for all midwives capable of providing a comprehensive service to
women be offered a redundancy package by their employers and then invited to
tender for contracts with the Area Health Authority to independently
contract to service a set number of healthy women each year. The midwives
would provide and maintain their own vehicles and communication equipment as
well as insurance and contract to take a permanent student load to enable
them to experience caseload working conditions. There would be benefits to
all parties but the most benefit to the women who would now have their own
midwife and hopefully offered a choice of birth venue within the program.
The women would not have to pay any midwife contracted with the area health
authority.

It all seems so simple to me but I'm sure all parties would see complexities
superimposed on each aspect of this suggestion.
Hilary and I have submitted such proposals to one of our local health areas
on numerous occasions and although the CEO is interested the buck stops when
the nursing administration tells him 'we don't have the budget for this'.
What they really mean is that they don't have the midwives with the skills
or inclination. Hillary and I offered to skill-up their midwives so that we
could bow out of the scheme after one year and their midwives could take
over. No way!

There must be some employed midwives with the skills and enthusiasm
somewhere in Australia who would like to privatise and start working as
autonomous, professional business women. The Kalgoorlie midwives surely
would go for something like this. Once one hospital does it, others see the
advantages and go for it.
END QUOTE

Any comments will be recorded in the file I have started on funding and
visiting access for midwifery services.

Many thanks
Joy Johnston

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RE: revolutionary stuff

[Johnston]

Dear 
everyone
I would like to second 
some of Carol's comments below.  I also went to Hobart, and could not 
afford time or funds to go to Byron.
A conference has many 
things happening at once, and I did not perceive the same degree of division 
that you speak of Carol.  I heard passionate debate, and I was truly 
saddened that some perceive an elitist mentality amongst those who have 
made a determined effort to demonstrate their commitment to the midwifery 
profession through 'Fellowship' (flawed though the word is).  Is it just 
the tall poppy syndrome?
I have come to the 
conclusion that ACMI will move ahead when members at the local level find 'jobs' 
that they can do, and get on with them.  A small group of Victorian mothers 
and midwives, and some branch executive members, siezed the opportunity to work 
together a few years ago, and I believe have begun to change the course of 
midwifery.  There was no time to go through the lengthy processes of 
national ACMI executive decisionmaking.  There was no need to.  Even 
at a Branch level there was agreement in principle, but most of the work took 
place outside the meetings, and by committed volunteers who had very little 
preparation for what they set out to do.  I won't go on with that story 
here.
 
I am concerned that too 
much responsibility is dumped on the ACMI executive, creating a huge load that 
would overwhelm any such group.  This culture can be seen as control from 
the top, and some criticise the executive for this.  But there is no need 
for branches and sub branches to accept disempowerment.  It's quite similar 
to the power relationships in birth.  If the national executive has too 
much 'power' it's because we, the members, give it to them.  If the 
constitution is defective, then let's get to work and change 
it.
 
A couple of people have 
asked where Vanessa is.  She has just moved house and she told me on Monday 
night that her computer was being connected to the internet this week.  
Then she will have to link up to ozmidwifery, so it's likely to take a few 
days.  Started the new job this week too.
 
sincerely
Joy 
Johnston

  -Original 
  Message-From: [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]]On Behalf Of Carol 
  ThorogoodSent: Wednesday, 15 September 1999 10:34To: 
  Midiwifery mailing listSubject: revolutionary 
  stuff
  Dear all
   
  I went to Hobart too and unfortunately 
  couldn't get to Byron Bay as well (piggy bank's empty). Several things came to 
  mind at the time. We have some of the ACMI, non-member midwives (and some 
  consumers/activists) all pulling in different directions and until we all move 
  forward together I doubt we'll achieve much at all. I know, I know I've spent 
  a fair bit of time criticising the slowness of the 
  ACMI too. But, I was appalled at some of the antics of my midwifery colleagues 
  who seem intent on white anting midwifery, birthing and the ACMI for their own 
  agenda and political benefit. Some of the people who complained the loudest 
  didn't have the best interests (in my opinion) of birthing families or the 
  ACMI at heart. And they never, ever have a plan to make things better. 
  
   
  As Freire said (before he died that is) - 
  there are none so oppressive as the oppressed. There seems to be no point in 
  destroying the ACMI and each other unless there is something more useful to 
  put in its place. I've not seen any worthwhile replacement yet. Some of our 
  behaviours in Hobart were even more horrific and in my opinion unethical and 
  disgusting than that of the average politician. 
   
  There is a new Executive of the ACMI. I had the distinct 
  impression that the new Pres hears the calls for change and movement loud and 
  clear.   I really do feel more positive about the ACMI for the first 
  time for ages. So, I reckon we (that's all of us) might do better to volunteer 
  to assist Vanessa and co.and keep the Exec. on the path of 'our righteousness' 
  at the same time. Nigel et al I'm wondering if you could perhaps harness some 
  of your boundless energy and enthusiasm and skill by joining the ACMI Exec. 
  (maybe as an ex-officio member) and helping with the huge tasks ahead. For the 
  first time in Hobart there was a real move for consumers to be given voting 
  and membership rights. That is a break through. Not all the ACMI think it is a 
  good idea. So the Exec will have to put it into the constitution, placate 
  those that think it shouldn't happen and placate those who think that  it 
  isn't happening fast enough.
   
  Please let's give them a go - If it doesn't work then up go 
  the revolutionary banners!. Yoo hoo Vanessa are you there? You have my 
  support. 
   
  Carol
   
   

RE: Independent Midwives hosting ACMI branch meeting

[Johnston]

Dear Anne and 
all
this sounds like an 
important gathering.  Please someone put up your hand to be 'reporter' 
and give a summary of discussions to the list.  I and many others will 
be very interested.
 
It has occurred to 
me that if we get the changes we so desperately desire, there may be an 
acute shortage of suitably prepared practitioners ready to take up a personal 
case load, and act as a midwife on her/his own authority in any 
setting.
 
Joy 
Johnston

  -Original 
  Message-From: [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]]On Behalf Of 
  CSent: Monday, 13 September 1999 21:28To: Midwifery List 
  (oz)Cc: Vicki Chan; Ruth Casey; Marie Barton; Lynne Staff; Lisca 
  Hoy; Jenny Gamble; Heather McCosker; Cathy & Nigel 
  BrockSubject: Independent Midwives hosting ACMI branch 
  meeting
  Dear Colleagues,
  AN INVITATION TO ALL 
  MIDWIVES
   
  I have organised a Brisbane branch meeting for the 
  ACMI that will be sponsored by some Independent Midwives.  We need 
  as many Midwives Independent or not, as well as student midwives to 
  attend this meeting.  
   
  This gathering will enable Midwives and future Midwives 
  to gain insight into Independent Practice.  There will be ample 
  opportunity to discuss current issues impacting on Independent Practice in 
  Southeast Queensland.
   
  Lisca Hoy will be our guest speaker.  Lisca is 
  presently completing her PhD on sudying Independent Midwives around the 
  world.
   
  I urge as many of you to attend this meeting.
   
  When:        Thursday, 23rd 
  September, 1999
   
  Where:        Queensland 
  Health Bld.,
              
          3rd Floor
     Charlotte 
  Street,
              
          Brisbane.
              
          You will be required to 'sign in' at the 
  reception on arrival.
   
  Time:        
      7pm-9pm
   
  Free parking can be provided under the Queensland Health 
  Bld.  If you require parking, contact me with your name and car rego. 
  number by 19th September, 1999.  OR there is plenty of parking stations 
  in Charlotte street at a reasonable cost.
   
  If you would also like to help set up or bring some munchies 
  it would be greatly appreciated.
   
  If you require any further info. please contact me either by 
  E-mail or phone 07 3300 3579.
   
  See you there.
   
  Anne Clarke
   
  'Birth is as safe as life 
  gets!'
   
   

RE: Homebirths in Peril and Midwifery Insurance

[Johnston]

I hope someone is able to answer Sue's questions.
ALSO - I have heard that in New Zealand midwives and doctors are covered by 
a different type of insurance, like Third Party property, that is linked to 
their registration (ie all midwives have the same insurance).  Does anyone 
on the list know about this?  What other options are there?

I was strongly considering moving my insurance to Guild, when this 
withdrawal was announced.  I have kept membership with ANF (Aust Nurses 
Federation) which give a $5 million PI Insurance to all members.  There are 
a lot of issues between midwives and ANF, and some may consider midwives 
who belong to ANF to be running with the hares and hunting with the hounds. 
 However for me it was/is a financial decision - about half the cost of 
Guild.  I won't bore you with my personal story, but every $ counts. 
 Market forces apply in this as in other fields.

As long as the small numbers of midwives who practice outside rostered 
hospital employment are expected to provide insurance above what is needed 
for the rest of the profession, it will be uneconomic to insure us. 
 Recently Maine Health has taken over ownership of some Vic private 
maternity hospitals, one of which is Mitcham.  I and a few others have had 
shared care visiting access at Mitcham, which means that women can book 
with a midwife of their choice, as well as the obstetrician (who has the 
bed rights).  The other midwives also employed in the unit, were taking 
private bookings.  Maine now requires $10 million PI Insurance for 
midwives, so the service has come to an abrupt halt, as none of us have 
that amount.  Guild was selling up to $10M, but that's off now.

I feel really sorry for those midwives who have had to withdraw their 
services - they will be really hurting.  Also those women who were booked. 
 The options for them will be significantly reduced.

Where to from here?  I'm all ears.
Joy Johnston
-Original Message-
From:   Sue Cookson [SMTP:[EMAIL PROTECTED]]
Sent:   Sunday, July 08, 2001 6:25 AM
To: [EMAIL PROTECTED]
Subject:Homebirths in Peril and Midwifery Insurance

Hi All,
On page 2 of today's Sydney Morning Herald is an article by Julie Rowbotham
about the decision by Guild Insurance from Sydney to withdraw indemnity
cover from independent midwives. Apparently the midwives were given 28 days
notice of the intent to withdraw the cover, and Emma Baldock from the ACT 
is
quoted as informing her 12 pregnant clients to make alternative
arrangements.

I must have missed much of the discussion around this issue, but what are
the midwives who choose to have insurance cover going to do now??

Is this insurance company the only one offering such cover (at affordable
rates)?
Insurance cover is a requirement for midwifery accreditation to the ACMI -
how will this issue be addressed??
Are the midwives employed through the government funded programs (WA and 
SA)
still able to work if they can't find indemnity cover?

The article was titled "Home births in peril as midwives lose insurance
cover". It keeps sending out that same message about fear, danger and
litigation around birth.

What do homebirth midwives intend to do??

Sue Cookson
Homebirth Australia

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RE: Homebirths in Peril and Midwifery Insurance

[Johnston]

Denise asked
 
I have a letter dated 6 July from Hannah Sellers, Assistant Secretary ANF 
Victorian Branch, "The $5m PI Insurance you receive as part of your ANF 
membership remains available to you as a Nurse in Independent Practice."
[This 'nurse' vs 'midwife' issue is always there.  I argue that as long as 
midwives are required to register under the Nurses Act, the benefits 
available to nurses are also available to midwives.]
The insurer is David Marshall at MCA Insurance, phone 03 9819 9700.

I will cc this correspondence to the ACMI.  It is to be hoped that some 
emergency arrangement can be made on behalf of midwives who have been left 
high&dry by Guild.
Joy Johnston


-Original Message-
From:   Denise Hynd [SMTP:[EMAIL PROTECTED]]
Sent:   Sunday, July 08, 2001 3:51 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject:Re: Homebirths in Peril and Midwifery Insurance

Is Leive on the list at the moment??

Perhaps she/others can tell us who insures midwives in Belgium and the 
Dutch
midwives?
How much are the premiums??

Joy
Who  underwrites the ANF PI and are you sure it covers you as a MIPP?

My understanding is that the Guild coverage of all private practitioners 
has
been dropped (not just MIPPs) - remember the deal with the ACMI was part of
a package with the RCN, A&NZ Mental health nurses Ass. as well.
Nothing has been said about that in the articles in the papers -does any 
one
know fi this is true or have midwives been dropped on their own as per the
implication of the article??

If the ANF covers MIPPs for PI  why hasn't the ACMI done a deal with their
insurance co/underwriters to take on the MIPPs out in the cold from Guild??

Is Vanessa Owen on the list?

Or Alana Street or some other ACMI Nat Exec person in the know about the
ACMI's efforts to find a replacement  for Guild for their members??

Also perhaps some one on the list has had some feedback from ACMI they can
share with MIPPs on the list??
What is ACMI doing for their members and australian families in this fix??

Similarly does anyone know??

Who underwrites the NZCOM??
What are their premiums like??
Would that company take on the Australian MIPPs  from Guild??

As this does limit the options for Australian Women & families is this some
thing for the ACC??

Denise
- Original Message -
From: "Johnston" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Saturday, July 07, 2001 6:36 PM
Subject: RE: Homebirths in Peril and Midwifery Insurance


> I hope someone is able to answer Sue's questions.
> ALSO - I have heard that in New Zealand midwives and doctors are covered
by
> a different type of insurance, like Third Party property, that is linked
to
> their registration (ie all midwives have the same insurance).  Does 
anyone
> on the list know about this?  What other options are there?
>
> I was strongly considering moving my insurance to Guild, when this
> withdrawal was announced.  I have kept membership with ANF (Aust Nurses
> Federation) which give a $5 million PI Insurance to all members.  There
are
> a lot of issues between midwives and ANF, and some may consider midwives
> who belong to ANF to be running with the hares and hunting with the
hounds.
>  However for me it was/is a financial decision - about half the cost of
> Guild.  I won't bore you with my personal story, but every $ counts.
>  Market forces apply in this as in other fields.
>
> As long as the small numbers of midwives who practice outside rostered
> hospital employment are expected to provide insurance above what is 
needed
> for the rest of the profession, it will be uneconomic to insure us.
>  Recently Maine Health has taken over ownership of some Vic private
> maternity hospitals, one of which is Mitcham.  I and a few others have 
had
> shared care visiting access at Mitcham, which means that women can book
> with a midwife of their choice, as well as the obstetrician (who has the
> bed rights).  The other midwives also employed in the unit, were taking
> private bookings.  Maine now requires $10 million PI Insurance for
> midwives, so the service has come to an abrupt halt, as none of us have
> that amount.  Guild was selling up to $10M, but that's off now.
>
> I feel really sorry for those midwives who have had to withdraw their
> services - they will be really hurting.  Also those women who were 
booked.
>  The options for them will be significantly reduced.
>
> Where to from here?  I'm all ears.
> Joy Johnston
> -Original Message-
> From: Sue Cookson [SMTP:[EMAIL PROTECTED]]
> Sent: Sunday, July 08, 2001 6:25 AM
> To: [EMAIL PROTECTED]
> Subject: Homebirths in Peril and Midwifery Insurance
>
> Hi All,
> On page 2 of today's Sydney Morning Herald is an article by Julie
Rowbotham
> about the decisio

RE: Homebirths in Peril and Midwifery Insurance

[Johnston]

Tina, you are SPOT ON.  I don't think you have lost the plot - you are very 
right.
I agree that the action of Guild and other insurers in refusing to insure 
midwives is an insult to the whole midwifery profession, as well as 
slanderous to the reputations of the midwives concerned.  ACMI should put 
aside less important issues and act to protect midwifery in Australia.
Joy Johnston


-Original Message-
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Sunday, July 08, 2001 10:26 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]; [EMAIL PROTECTED]; 
[EMAIL PROTECTED]
Subject:Re: Homebirths in Peril and Midwifery Insurance

In a message dated 7/07/01 12:30:35 PM AUS Eastern Standard Time,
[EMAIL PROTECTED] writes:

<< The article was titled "Home births in peril as midwives lose insurance
 cover". It keeps sending out that same message about fear, danger and
 litigation around birth.

 What do homebirth midwives intend to do??

 Sue Cookson
 Homebirth Australia
  >>

Hi all ozmider's.

This situation distresses me greatly. As I see it, the problem is the huge
lack of recognition and respect for midwifery as an autonomous profession,
which I believe has far reaching implications for ALL women and midwives -
not just MIPP and the homebirth community. The homebirth movement here is
still considered a radical, questioning and an independent movement outside 
of medical control and its always been a thorn in the obstetric side and
subject to a great deal of attention, scrutiny and anticompetitive 
behaviour.

Historically we know that many of the improvements in maternity care have
been born from the homebirth movement. So for all other midwives to then 
hide
their heads in the sand on this issue and to shrug it off as something that 
only affects homebirth midwives and their clients is a HUGE mistake.
Homebirth needs to exist for the benefit of ALL, not just the few that 
choose
it, because out of this movement we have another model by which to compare
the obstetric model, and measures by which to demand greater accountability 
from medical men and their machines and evidence for continued improvements 
for mainstream maternity care. Once you recognise this it becomes apparent
that the withdrawal of professional indemnity insurance from MIPP is just 
the
tip of the iceberg and actually represents the largest assault on the
autonomy of midwifery this country has seen and THIS THEN AFFECTS ALL
MIDWIVES AND ALL WOMEN - NOT JUST THE HOMEBIRTH COMMUNITY.

Midwives please open your eyes and look 'outside of the square you live in' 
and see the bigger picture !!! By insurers denying/refusing to insure
midwives in private practice, is to effectively, slam the door shut on
midwifery as an autonomous profession in this country, relegating midwifery 
to be forever controlled by the medical fraternity. This has ripple effects 
into EVERY other facet of midwifery practice. It will eventually effect 
EVERY
MIDWIFE in her capacity to work as a midwife 'with woman' as it effectively 
undermines EVERY midwife's status and claim to autonomous practice as the
health care professional that she is, irrespective of where she provides
midwifery care. Further more,  while the majority of midwives may work in
hospitals and have their liability underwritten by state governments, many
midwives also choose to have PI outside of this as well - independent of
their employers interests! So to argue that this is an issue that just
effects 80 midwives and the 1% of women who choose to birth at home in this 
country is just ridiculous and will surely then see the demise of midwifery 
in this country.

This issue needs to be brought to the forefront and dealt with once and for 
all. The ACMI needs to gather ALL its constituents together with their
greatest allies - women - and demand to be heard in the halls of 
parliament,
news and media until the powers that be listen and  cotton on to the great
conspiracy that is denying Australian women and their families the right to 
choose for themselves how, where and with whom they birth their children.
Furthermore, midwives need to put their money where their mouths are and 
get
serious about their professional representation. This is not meant to be a
criticism of the ACMI as it stands, but rather to say that, it can only do 
so
much with the resources and limited personnel that it has. The College 
needs
funds to invest in a good lawyer who can research these issues from the 
point
of law and justice, and funds to undertake through risk analysis of 
providing
midwifery care. How can the College continue to argue for what is right and 
just - without the evidence to support it. Insurance companies would find 
it
difficult to refuse policy applications or charge outrageous premiums, if 
the
evidence was there in black and white to sink their arguments that 
midwifery
is "a highly 

RE: ACMI Constitution

[Johnston]

I have been doing some work on the Draft 2 constitution, and as responses 
have to be in fairly soon, I will put up a small matter for discussion here 
- a matter that I think is of particular interest to this list.
A couple of points that may be worth considering:
* What is the difference between a 'consumer member' and an 'associate 
member' except that the former has voting rights, the latter does not?
* Re: The consumer and the student on the executive committee - it appears 
that these people are appointed by the executive. The other members of the 
executive are delegates from each of the Branches.  Delegates report back 
to their branches, and there is a definite system of representation and 
being accountable.  To whom do the consumer member and the student member 
report?  How are they selected? Are they representing bona fide consumer 
and student concerns, or are they simply representing themselves?  What's 
the point of having isolated and unconnected people on a national execut  
ive?
I think there is wide agreement that a strong consumer voice is desirable 
in setting the direction for the midwifery profession.  There seems to be a 
real attempt here to do this.  However it's important in putting together a 
new constitution that we do our best to get it right.  Perhaps those on 
this list who have consumer interests at heart would look at the draft and 
put some thought into how the goal can be achieved.
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


-Original Message-
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Monday, July 09, 2001 1:44 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; 
[EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; 
[EMAIL PROTECTED]
Subject:ACMI Constitution

Hi all,

just letting everyone know that the 2nd draft of the ACMI Constitution is 
up
on the ACMI website and is open for comment. You can find it at:

http://www.acmi.org.au/ACMI_Constitution_Draft2.pdf

The document provides for interesting reading. I encourage all to read it
carefully and to make comment. The College is seeking feedback and or
amendments to the draft document by 24th July 2001. The Final Draft 
document
to be published in the August edition of the ACMI newsletter, before being
ratified at the National ACMI Conference in Brisbane in September.

I am delighted to see that the 2nd draft constitution includes nomination 
for
membership for "consumers" and for midwifery students  -"open to those
undertaking or wishing to undertake pre registration midwifery education".

It is important that ACMI members and other interested parties contribute 
to
open honest and meaningful discussion on these issues and arrive at an
outcome that ultimately reflects the codependant nature of the relationship 
between women and midwives - Partnership.

I look forward to hearing what others have to say on this potential
monumentous step forward in the history of Australian midwifery.

Yours in birth,
Tina Pettigrew
Birthworks
Independent CBE and aspiring B.Mid Midwife.
Convenor, Aust B. Mid Student Collective.

" As we trust the flowers to open to new life
   - So we can trust birth"
Harriette Hartigan.
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FW: midwife in Brisbane

[Johnston]

Is there a midwife in Brisbane who would be able to follow up this request please?
Joy

-Original Message-
From:   Lou Walker [SMTP:[EMAIL PROTECTED]]
Sent:   Thursday, July 12, 2001 11:45 AM
To: '[EMAIL PROTECTED]'
Subject:

Hello Joy.
Inq on how do I go about getting a midwife I live in south side of Brisbane and I am 
into my 18th week of pregnancy.
Thanks 
Lou Walker

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Professional Indemnity (PI) Insurance for midwives - for distribution

[Johnston]

***The person who sends this should add their own contact details if they 
are prepared to speak to the politician or media or whoever it is sent to.
A joint statement by consumer and professional groups: The Maternity 
Coalition Inc, Australian Society of Independent Midwives, and the 
Association for Improvements in the Maternity Services.
PRESS RELEASE
14 July 2001
Re: Professional Indemnity (PI) Insurance for midwives
Midwifery practice and the options women have for birth have been thrown 
into chaos by the crisis caused by the withdrawal of Guild Insurance from 
midwife PI Insurance policies.  This is an issue that will affect all 
midwifery.  The impact of this crisis will be to disadvantage women and 
their families across the country, as midwifery services will be withdrawn 
and further marginalised.

We seek immediate intervention from both federal and state governments, to 
enable midwives to continue practising. Many concessions have been made in 
recent months to obstetric models of care, encouraging pregnant women to 
give birth in private hospitals, and promising to reduce the gap in rebates 
for doctors' fees.  At the same time the basic option of continuity of care 
from a known midwife - THE model that is strongly supported by research 
evidence - is being withdrawn.  This is totally unacceptable.  It defies 
logic, removes the midwife's livelihood, is not in the interests of the 
consumer, and is causing great distress to women who have made plans to 
give birth in the care of a midwife.

Signed by
Joy Johnston, a midwife representing the Maternity Coalition Inc [Tel: 03 
9808 9614]
Robin Payne, a consumer representing the Maternity Coalition Inc [Tel:03 
9380 2863]
Jan Robinson, a midwife representing Australian Society of Independent 
Midwives [Tel: 02 9546 4350]
Toni Cannard, a consumer representing Association for Improvements in the 
Maternity Services [Tel: 03 3265 4137]

Fact sheet:
* Birth is not an illness.  Internationally accepted best practice 
standards for optimal maternity services promote care by a known midwife 
during pregnancy, birth, and early parenting.  This is fundamental to the 
definition of a midwife: one who provides primary care for women throughout 
the pregnancy and birth, and who collaborates with other practitioners 
(such as obstetric specialists) when a woman requires specialist or 
secondary levels of care.
* The focus of the midwife's care is the woman, as an individual.  The 
wellbeing and safety of the woman and her baby are paramount, and data from 
Australian and international reporting support midwifery care as protecting 
the safety of the woman and child.
* Australian women have very limited access to the optimal standard of 
care.  This is due to many social and professional factors, including the 
progressive medicalisation of pregnancy and birth over many years, together 
with the government funding monopoly that supports medical primary care and 
excludes most midwifery options of care.
* A recent Australian Society of Independent Midwives (ASIM) survey of 
members revealed most of the membership was insured with Guild; two have 
been without insurance since their policies expired recently, and the rest 
will gradually become uninsured as their policies expire.  A small 
proportion of ASIM midwives are insured with ANF (Australian Nursing 
Federation) Victoria and so far they are unaffected.  There were five 
members who carried no professional insurance whatsoever.
WHAT HAPPENS WHEN INSURANCE RUNS OUT?
For those midwives no longer insured, there are two alternatives;
* cease their private clinical practice, thereby requiring the women booked 
with them to make other arrangements, as well as the midwives losing their 
livelihood.
* continue to practice without PI insurance ...
this will mean that midwives who did have visiting/admitting rights in 
hospitals will no longer be able to attend their clients in hospitals and 
therefore reduce women's choice of birth venues to homebirth only.
If an Independently Practising Midwife (IPM) always acts as a reasonable 
midwife would in any situation then they are unlikely to be a victim of a 
malpractice suit. However, the person who ultimately suffers when there are 
adverse outcomes is the woman who has a damaged baby and if there is no 
insurance the woman has little hope of any financial assistance for the 
rest of her baby's life.
* We seek immediate action to address this crisis.  Despite the best 
efforts of competent professionals in all settings (hospitals, birth 
centres and home), the unpredictable nature of birth, and of life itself, 
means that there may be adverse outcomes.  We recommend government 
insurance arrangements that are made available to all who experience the 
dreadful cost of birth trauma!  Women (and their families) deserve support 
through public insurance if they are the victim of bad outcomes from 
encounters with any health professionals.

midwives' insurance - lobby tally

[Johnston]

To everyone who is sending letters and press releases, please keep 
ozmidwyfery informed of who has received information.
I will copy the wording of the press release that is being sent jointly by 
Maternity Coalition, ASIM and AIMS at the end of this message.
The current tally that I know about stands at:

* Sydney Channel 7
* ACT TV stations
* Guild Insurance


Press Release Faxed or emailed to
* Health & Aged Care (commonwealth)
* ACMI
* DHS (Vic) - Nurse Practitioner committee
* Nurses Board of Vic
* Nursing Review
* Radio National
* The Age (vic)
* Herald Sun (vic)
* Health Dept magazine (vic)

Melbourne TV and radio stations (I have a list which I am about to work on 
now)
A joint statement by consumer and professional groups: The Maternity 
Coalition Inc, Australian Society of Independent Midwives, and the 
Association for Improvements in the Maternity Services.
PRESS RELEASE
14 July 2001
Re: Professional Indemnity (PI) Insurance for midwives

Midwifery practice and the options women have for birth have been thrown 
into chaos by the crisis caused by the withdrawal of Guild Insurance from 
midwife PI Insurance policies.  This is an issue that will affect all 
midwifery.  The impact of this crisis will be to disadvantage women and 
their families across the country, as midwifery services will be withdrawn 
and further marginalised.

We seek immediate intervention from both federal and state governments, to 
enable midwives to continue practising. Many concessions have been made in 
recent months to obstetric models of care, encouraging pregnant women to 
give birth in private hospitals, and promising to reduce the gap in rebates 
for doctors' fees.  At the same time the basic option of continuity of care 
from a known midwife - THE model that is strongly supported by research 
evidence - is being withdrawn.  This is totally unacceptable.  It defies 
logic, removes the midwife's livelihood, is not in the interests of the 
consumer, and is causing great distress to women who have made plans to 
give birth in the care of a midwife.

Signed by
Joy Johnston, a midwife representing the Maternity Coalition Inc [Tel: 03 
9808 9614]
Robin Payne, a consumer representing the Maternity Coalition Inc [Tel:03 
9380 2863]
Jan Robinson, a midwife representing Australian Society of Independent 
Midwives [Tel: 02 9546 4350]
Toni Cannard, a consumer representing Association for Improvements in the 
Maternity Services [Tel: 03 3265 4137]



Fact sheet:
* Birth is not an illness.  Internationally accepted best practice 
standards for optimal maternity services promote care by a known midwife 
during pregnancy, birth, and early parenting.  This is fundamental to the 
definition of a midwife: one who provides primary care for women throughout 
the pregnancy and birth, and who collaborates with other practitioners 
(such as obstetric specialists) when a woman requires specialist or 
secondary levels of care.
* The focus of the midwife's care is the woman, as an individual.  The 
wellbeing and safety of the woman and her baby are paramount, and data from 
Australian and international reporting support midwifery care as protecting 
the safety of the woman and child.
* Australian women have very limited access to the optimal standard of 
care.  This is due to many social and professional factors, including the 
progressive medicalisation of pregnancy and birth over many years, together 
with the government funding monopoly that supports medical primary care and 
excludes most midwifery options of care.
* A recent Australian Society of Independent Midwives (ASIM) survey of 
members revealed most of the membership was insured with Guild; two have 
been without insurance since their policies expired recently, and the rest 
will gradually become uninsured as their policies expire.  A small 
proportion of ASIM midwives are insured with ANF (Australian Nursing 
Federation) Victoria and so far they are unaffected.  There were five 
members who carried no professional insurance whatsoever.
WHAT HAPPENS WHEN INSURANCE RUNS OUT?
For those midwives no longer insured, there are two alternatives;
* cease their private clinical practice, thereby requiring the women booked 
with them to make other arrangements, as well as the midwives losing their 
livelihood.
* continue to practice without PI insurance ...
this will mean that midwives who did have visiting/admitting rights in 
hospitals will no longer be able to attend their clients in hospitals and 
therefore reduce women's choice of birth venues to homebirth only.
If an Independently Practising Midwife (IPM) always acts as a reasonable 
midwife would in any situation then they are unlikely to face a malpractice 
suit. However, the person who ultimately suffers when there are adverse 
outcomes is the woman who has a damaged baby and if there is no insurance 
the woman has little hope of any financial assistance for the rest of her 
baby's life.
* We seek imm

RE: Research Critique??

[Johnston]

Jackie the first rule of research is to compare like with like.
Comparing rates of rupture for those who laboured with those who didn't 
labour makes no sense.  It's like comparing the number of times a child 
falls off a bike when trying to learn to ride, with the number of times a 
kid who never gets on a bike falls off.

JJ

-Original Message-
From:   Jackie Mawson [SMTP:[EMAIL PROTECTED]]
Sent:   Saturday, July 14, 2001 6:07 PM
To: Ozmidwifery List
Subject:Re: Research Critique??

> I am concerned at this report in the BMJ it is contrary to so much other
> research and expereince of those who have done VBAC's
> Can anyone see how such contradictory findings can be disputed ??
> I have to go back to my files to relearn research critque analysis 
skills!!
> Denise
>
> http://bmj.com/cgi/content/full/323/7304/68
> Vaginal delivery after caesarean section triples risk of uterine rupture
> Deborah Josefson San Francisco

ICAN (International Caesarean Awareness Network) sent me this request. Any
response would be appreciated.

-- Forwarded Message
From: "Connie Banack" <[EMAIL PROTECTED]>
Date: Sun, 8 Jul 2001 21:06:21 -0600
To: "Jackie Mawson" <[EMAIL PROTECTED]>,
Subject: VBAC-lash in the media

Hello ICAN Advisory Board members,
Most of you, especially in the US, have probably heard or even seen the New
England Journal of Medicine study just released on uterine rupture
statistics. The media has been, for the most part, portraying the "great
risk" of VBAC vs ERCS based on this study, while the true nature of it was
to prove the increased risk of induction with VBAC (which it did). We sent 
a
quick press release (if any of you have not received it, please let me 
know)
to the media last week outlining our stance on the subject.

I would be honoured if any of you could send me quotes, your own
articles/media releases, and/or thoughts on this study as we continue to
enlighten and educate regarding the safety of VBAC vs ERCS. Thank you each
and every one of you for your support of ICAN and it's work.

Warmly,
Connie Banack, president
International Cesarean Awareness Network, Inc. (ICAN)

-- End of Forwarded Message


Birthing Beautifully,
Jackie Mawson.

Convenor of Birthrites: Healing After Caesarean Inc.
Visit our Website at: http://www.birthrites.org
Email: [EMAIL PROTECTED]
Phone: 61 08 9418 8949

Please note I am not a Professional Healthcare Provider, and all opinions
given in this email are not to be taken as medical, or legal, advice. 
Please
seek such advice from the relevant professional service.

Email me your postal details for a FREE copy of our quarterly magazine, if
you live within Australia - Overseas postage costs are above budget, sorry!

Too many Gods;
so many creeds,
Too many paths
 that wind and
 wind,
When just the art
 of being kind
 Is all the sad
  world needs...
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RE: midwives' insurance - lobby tally

[Johnston]

Once a Press Release has been published, it can be sent to as many people 
as anyone likes.  The more ways the message reaches a particular point, in 
various forms (including phone calls and hand written letters from people 
who are affected), the more likely it is to be noticed.

As with everything else in the Midwifery Campaign, this is grass roots 
stuff.  Noone has any funding to do what they are doing, and there is no 
central office or mission control.  Each committed person has to identify 
what she/he can do, and do it to the best of their ability.

Joy Johnston

-Original Message-
From:   Elizabeth McAlpine [SMTP:[EMAIL PROTECTED]]
Sent:   Sunday, July 15, 2001 4:08 PM
To: [EMAIL PROTECTED]; ozmidwifery list (E-mail)
Subject:Re: midwives' insurance - lobby tally

Joy,
Its not clear, should everyone be sending the press release to whoever they
choose??
Has it been sent to Senator Crowley who thinks that birth issues are a
national concern or Michael Wooldridge??
Please clarify.
Liz McAlpine   [EMAIL PROTECTED]



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midwives and PI insurance in the media

[Johnston]

Dear all
There are a couple of articles coming up, that you may be able to look out 
for.
Melbourne's Sunday Age is doing a health feature this week, on Sunday - 
interviewed me and a client, Monica, and got good pics of Monica and her 
(first) baby Lois who is 10 days old, born in a private hospital in 
Melbourne.
Nursing Review responded to the faxed press release, and have done an 
interview.  I don't get this paper, so if anyone sees it, please put the 
message out through the list.

Somebody asked me if there is any point in sending letters out, when the 
press release has already been sent.  All the advice we have is YES.  Use 
your own words, write about your own situation and why you are outraged by 
the situation that restricts midwives from practice in hospitals, and 
restricts women from choosing their own midwife.  The joint Press Release 
and other information that has been posted on this list can help everyone 
to focus on the real issues.  Use the Press Release if you don't have the 
confidence to write your own statement. The key strategic people for each 
one of us to contact are:
* The members of parliament (State and Federal) for the electorate in which 
you live
* The Ministers for health (State and Federal)
* Other politicians with an interest in women's policies, community issues
* Newspaper reporters, particularly health

As I have said before, this is an issue for ALL midwifery, and ALL 
women/consumers.  Please act on this.  Don't try to offer a solution, just 
demand that a solution be found!

Joy Johnston

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Vicki in Melbourne

[Johnston]

Vicki Chan met with a diverse group of committed women (mothers & midwives) 
last night at my place.
We had a very valuable time of sharing from the different perspectives that 
each of us brought to the gathering.  I believe this type of gathering can 
only strengthen the maternity reform movement, as each one is takes courage 
and strength from her sisters.  We will be preparing a report from the 
meeting and that will be published in Birth Matters in due course.  The 
strong belief that I have come to is that it's not enough to be activists - 
we need to be achievers!  Noone has time or energy or skill to do it all, 
but together we can become a force to reckon with.

Today (Sat) (2-4pm) Vicki will be speaking at the Mount Waverley Primary 
School  Helen Ireland is organising this event, 'Meet a midwife' - and has 
had a good article in the local newspaper.  (To speak to Helen, call 03 
9803 7476).

I want to encourage all who are able to make a priority of meeting Vicki as 
she travels - Geelong, Warrnambool, Adelaide, Mildura, and further ... see 
website ... www.travellingmidwife.com for the details.
Joy Johnston

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RE: Independent Midwives

[Johnston]

I want to add my support to this call for bridge-building and closer 
co-operation/mutual respect/support between the various professionals 
involved in birthing services.

I have chosen not to engage any further in the current debate with the 
Senator, even though I wish I had a way of saying something that would 
clearly present what I believe to be the truth.  You see, although we have 
the WHO statement about the midwife being the most appropriate primary 
carer, although we have the ICM Definition of a midwife, which is endorsed 
by both the International Federation of Gynecologists and Obstetricians, 
and WHO - yet there is a strong belief in our society that obstetric 
management is better/safer/more appropriate than any other option.  As long 
as a person such as Senator Eggleston believes that, he would be going 
against his personal integrity to support anything else, ESPECIALLY a 
service that her honestly believes is inferior.

As long as this perception is held, Senator Eggleston and millions of other 
professionals and consumers in this country will continue to support a 
system that is based on a very shaky foundation.  AND they will believe 
they are acting in the best interest of the public they are committed to 
serve.

It is therefore obvious that education to change the mindset, that midwife 
primary care is no less safe than medical management, is urgently needed. 
 A few years ago I was at a meeting, at which Prof Marc Kierse (of 
Effective Care) was asked a question about who looks after pregnant women 
in Holland. He replied very quickly to the effect that an obstetrician is a 
specialist, and doesn't want to waste his/her time with well women.  That's 
the midwife's job, and the midwife sends women to him if they need to see 
him.  That's collaboration, cooperation, and professional respect in 
action.

Joy

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FW: motherInc poll re unpaid work & the census

[Johnston]

A message to pass on:
When you fill out a census form Aug 7, please write the words UNPAID  WORK  SHOULD  
COUNT on the form.


-Original Message-
From:   Women's Action Alliance [SMTP:[EMAIL PROTECTED]]
Sent:   Monday, July 23, 2001 9:20 PM
Subject:motherInc  poll re unpaid work & the census

 UNPAID  WORK  SHOULD  COUNT
Write these words on your census form on August 7th

Dear WAA members & friends,
 
MotherInc. have now put on their website (motherInc.com.au) the poll about unpaid work 
and the
census about which we gave you early notice. Don't be put off completing it by the 
questions
asking you to record the hours you spend on various activities. Just estimate 
approximately. It
will be highly educated guess. No-one knows as much about your daily life as you do! 
You will
also see on their website their statement of support for the WAA "Unpaid Work Should
Count"census campaign.
 
We will be grateful for your assistance to the endeavour of another supportive women's
organisation. The results of the poll will be used to support our campaign during 
census week -
presuming they come out as we anticipate. If not we will all be sent off to have 
another think!
 

Kind regards 

Pauline Smit,  National Secretary 

Women's Action Alliance (Australia) Inc 
Suite 6, 493 Riversdale Road 
Camberwell Vic 3124 
Tel (03) 9882 8809 Fax (03) 913 4048 
Website www.womensactionalliance.com.au 


Get your FREE download of MSN Explorer at http://explorer.msn.com






UNPAID  WORK  SHOULD  COUNT
Write these words on your census form on August 7th







Dear WAA members & friends,
 
MotherInc. have now put on their website (motherInc.com.au) the poll about unpaid work and the census about which we gave you early notice. Don't be put off completing it by the questions asking you to record the hours you spend on various activities. Just estimate approximately. It will be highly educated guess. No-one knows as much about your daily life as you do! You will also see on their website their statement of support for the WAA "Unpaid Work Should Count"census campaign.
 
We will be grateful for your assistance to the endeavour of another supportive women's organisation. The results of the poll will be used to support our campaign during census week - presuming they come out as we anticipate. If not we will all be sent off to have another think!
 
Kind regards 

Pauline Smit,  National Secretary 

Women's Action Alliance (Australia) Inc 

Suite 6, 493 Riversdale Road 

Camberwell Vic 3124 

Tel (03) 9882 8809 Fax (03) 913 4048 

Website www.womensactionalliance.com.au 

Get your FREE download of MSN Explorer at http://explorer.msn.com

RE: gathering facts around Prof. Indemnity Issue

[Johnston]

There have been many messages around this project.  Well done everyone, and 
don't give up.  There has to be a way to ensure that women can access best 
practice midwifery care, and that midwives can practice midwifery.  My 
thoughts are with those who meet in Sydney tomorrow.

Remember there is no law that enshrines a right to choice. (the notion of 
choice in maternity services has been promoted as what women want, along 
with control and continuity of care - Changing Childbirth in the UK.  Women 
have to demand what they think is appropriate.) The law recognises a 
competent person's right of refusal of medical treatment, but not a right 
to dictate what a provider should do.

However there is a longstanding ethic of doing good and not doing harm.  We 
can argue that the evidence for midwife primary care and against the 
Australian obstetric model should compel providers of maternity services to 
promote (not just offer) midwife primary care.

Our Commonwealth government has put in place the Competition Policy 
Agreement, and the ACCC as the watchdog body.  Prof Fels and his colleagues 
have acted decisively on many other matters. Statements about competition 
and health care - that it should be the consumer's choice, and not the 
judgment of the provider, what services are available UNLESS it can be 
clearly demonstrated that people will be harmed by removal of restrictions 
to competition - these need to be taken seriously.

Last night on the ABC (3LO) radio program about midwives, Sandy Gray from 
the NZCOM stated that New Zealand now has evidence of falling rates of 
neonatal mortality in the decade since 1990.  That's very supportive 
evidence, and I want to get my hands on it!

I have counted all the signatures that have come it for the Midwifery 
Campaign petition. We are well over 1200.  Please continue to collect these 
signatures.  You can download a petition form from the website 
www.maternitycoalition.org.au   The petition will support our claims when  
 we speak to the policy makers.

Keep up the good work everyone, and keep a clear vision of the goal
Joy Johnston


Ps I have been told by a reliable person that RCNA is very unhappy about 
the Guild decision about midwives.  Guild has sent the letter of notice 
that they will not renew policies to midwives who are not even in clinical 
practice, as well as the IPMs.

-Original Message-
From:   Jan Robinson [SMTP:[EMAIL PROTECTED]]
Sent:   Thursday, July 26, 2001 6:48 AM
To: Sally Tracy
Cc: [EMAIL PROTECTED]
Subject:Re: gathering facts around Prof. Indemnity Issue

 << File: ATT0.htm >> << File: Meeting_Agenda.doc >> << File: 
ATT1.txt >> Dear Sally

Questions asked of ASIM members revealed most of the Victorian
members were insured with ANF so I don't know about payouts from them.

ALLEGED PAYOUTS
The only payout I heard of was in SA where they was a very small
payout (after 4  years of investigating) from an IPM where a woman
alleging she was in part responsible for her post-natal depression.
(the midwife stated she had borrowed money for the payout).There was
a payout from the hospital and the doctor involved as well. The
payout was given in order that the woman took her complaints no
further.

As far as I can gather there have been numerous complaints against
midwives from medicos (mostly through the AMA). Both Hope Island and
Guild have had to pay their lawyers to investigate these claims.
That is why the PI funds are running low. (no payouts though)

STATE HEALTH DEPARTMENTS
I have contacted both the office of the Minister and the Chief Nurse
to be informed they are aware and 'working on this issue'. Both the
Minister, the Chief Nurse, the Executive Director of the Dept of
Health (or their representatives) have been invited to the meeting at
Dundas on Friday evening.

THE FINAL STRAW
All ASIMNSW IPMs who are insured have agreed to tell their clients
they will no longer be able to support them after their insurance
runs out and they will have to seek care at their local hospital.
This has bought on an outcry which I hope will be heard at the
meeting Friday evening.

Sally, you would be most welcome to attend the meeting, it has been
remiss of me in not inviting you before this. The stress of all this
alongside practice pressures has been put a great strain on the brain
cells, so your presence and support at the meeting would be
appreciated.

Attached is the amended agenda for the midwifery insurance meeting.

It will be held from 7pm to 9pm on Friday, 27 July 2001.
The venue will be:

Valhalla Room
Dundas Valley Rugby Union Football Club
35 Quarry Road, Dundas Valley (9638 4589)
Tea and Coffee will be $1.50

RSVP to Virginia Miltrup at [EMAIL PROTECTED] or 02 9477 2740.





>Apart from the negotiations the College (ACMI) is involved in .
>
>Does anybody have any info on payouts - large or small  - for
>midwi

PI Insurance - advice

[Johnston]

To those on the list who are interested in the politics of PI Insurance for 
midwives [this advice pertains specifically to Victoria]:
I have had a meeting with Anne Marie Scully, Professional Officer for ANF 
Victorian Branch.  This message is my own notation after the meeting, and 
is not formal advice from ANF.  The ANF insurer is due to review PI cover 
for members of ANF in September.

* The crux of the PI Insurance issue is that the person is NOT AN EMPLOYEE 
(ie not covered by a hospital's vicarious liability) at the time under 
question.  They may be an employee at other times.
The issue that midwives are facing now should be understood as an issue 
that also affects any registered nurse who is working outside an employment 
structure (hospital, other agency).  These nurses include a nurse who 
assists a surgeon, and goes to hospitals to work alongside the surgeon. 
 Victorian Nurse Practitioner legislation will be in effect in November. 
 Midwives, Nurse Practitioners, and practice nurses are all able to do what 
they are professionally qualified to do, regardless of whether they are 
employed by a hospital, or not.  I expect ANF will be taking this global 
position rather than looking at what the member does specifically.  This 
gives strength in numbers, and proven strength in industrial relations.

* As long as midwives have to be registered as nurses in Australia, 
midwives can use whatever provisions are set up for nurses.
* The title 'midwife' is protected in the Nurses Act 1993.  The role and 
scope of practice has been defined by the NBV in the Code of Practice.
* "Each midwife should ensure that there are satisfactory arrangements in 
place for their professional indemnity insurance" (Code of Practice for 
Midwives in Vic.  Other States have similar statements)

I have put a cc to Anne Marie.

Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


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RE: comment

[Johnston]

Barb asked

I don't want to get side-tracked from the real issues with this one, but it 
does deserve a comment.
To my knowledge most of the independent midwives in Vic have been long-term 
ACMI members, and some of us have held branch executive positions.  But we 
make up the tiny minority of the profession.  It's in the mainstream that 
the problem exists.  There are unit managers and senior midwifery staff in 
many hospitals who don't belong to ACMI - they are unlikely to encourage 
new and existing staff members to join the professional body.  They are 
unlikely to support midwives who want to go to acmi-run study days, and pay 
the attendance fees from the unit's budget.

Joy Johnston
-Original Message-
From:   Mary Murphy [SMTP:[EMAIL PROTECTED]]
Sent:   Thursday, August 02, 2001 11:08 AM
To: Ian & Andrea Quanchi; Barb and Greg; Oz Midwifery
Subject:Re: comment

I know that there are about 10 mipp MEMBERS IN w.a. wE HAVE A POSITION ON 
THE sTATE eXEC. (mipps rep)  I have been a past President.(sorry about 
the Capitals.)  in a hurry , MM
  - Original Message -
  From: Ian & Andrea Quanchi
  To: Barb and Greg ; Oz Midwifery
  Sent: Thursday, August 02, 2001 8:17 AM
  Subject: Re: comment


  I am
  Andrea Quanchi

  Barb and Greg wrote:

One thing to be careful in this current debate on PI, rallies, media 
etc is that separatists with other agendas could easily hijack this 
legitimate forum to further their personal beliefs on 'midwifery'. Why is 
it that so few of midwives belong to ACMI? I ask how many of our vocal 
participants on this list are members of ACMI ? Barb Cook

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FW: Birth Pools

[Johnston]

Terry I have forwarded your query to Michelle Carrucan.  Michelle and Annie 
Sprague have a few pools, and recently had 2 made new.  This model is very 
sturdy, made with steel pipes that form a frame (and that come apart for 
transporting), and a pool liner.
Joy

-Original Message-
From:   Child Birth Information Service [SMTP:[EMAIL PROTECTED]]
Sent:   Friday, August 03, 2001 1:16 PM
To: Ozmidwifery mailing list
Subject:Birth Pools

 Hi every one,  The Childbirth Information Service wish to obtain a new 
 birth pool, ours is getting old.  The company we originally got the pool 
from has gone out of business and we need some new contacts to enable us to 
get a new one.
Please send any information to Terry: [EMAIL PROTECTED] or 156 Warwick 
Street, West Hobart 7000 Tasmania
Phone 03 62310633
Thanks all Terry













Hi every one,  The Childbirth Information 
Service wish to obtain a new  birth pool, ours is getting old.  The 
company we originally got the pool from has gone out of business and we need 
some new contacts to enable us to get a new one.
Please send any information to Terry: [EMAIL PROTECTED] or 156 Warwick 
Street, West Hobart 7000 Tasmania 
Phone 03 62310633
Thanks all Terry
 
 
 
 
 
 
 
 
 

the campaign

[Johnston]

Dear ozmid team
I want to congratulate everyone who has been involved in the rallies, and 
the lobbying, and getting media coverage &c&c.  I am proud to be one of us.

Some of you may have heard Vanessa Owen (ACMI national president) on Radio 
National thismorning (Mon 6/8) at about 8.15 am. She spoke very well, 
insisting that the PI issue affects all of midwifery - not just independent 
midwives.
The news from the ABC was that the matter of PII for midwives has been 
referred to the Health Ministers Working Party on Professional Indemnity, 
chaired by Penny Gregory.  I think this is a good step.  Whereas we need to 
get cover immediately to enable midwives to continue meeting their 
commitments, the same thing could happen again if there is another monopoly 
situation of only one insurance company for a small number of midwives.  We 
still have a lot of work to do arguing the legitimacy of midwifery practice 
(without medical 'supervision') and the legitimacy of a woman's choice of 
place of birth.
The perception that this is going to result in more harm (and therefore 
more claims on insurance) than the 'standard' model is a huge obstacle.  We 
need published reports from community midwifery projects in WA and SA.  We 
need Sate birth data for homebirths and birth centres.  We need articulate 
consumers and midwives who will become well informed.  We can't just be 
true believers - facts and strong arguments have to be relied upon.

Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm




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midwifery campaign petition

[Johnston]

Signatures are coming through via the online petition from 
www.maternitycoalition.org.au and are being recorded and added to the total 
tally (around 1500 at present)
Most of the names are not familiar to me, meaning that people who access 
this information and sign the petition are outside the 'network' - this is 
good.

For those who are not familiar with the Petition, which was launched in May 
this year, here it is:

To the Ministers for Health (State and Federal). We the undersigned 
petition you to provide access for all women to choose a midwife as their 
primary caregiver during pregnancy and birth within the health system 
(public and private) whether in the community or hospital.
This is the goal of the Australian Midwifery Campaign, with wide support of 
organisations and individuals in all Australian States and Territories. The 
current health funding system throughout Australia is anticompetitive 
towards midwives, and restricts the choice of women who seek the services 
of a known midwife. Changes similar to those made in New Zealand (Nurses 
Amendment Act 1990) to maternity service provision would not place extra 
demands on health funding, but would remove the current monopoly which 
supports medical management of pregnancy and birth, and unfairly 
disadvantages midwives and women who are attended by midwives. 
International evidence and best practice standards support midwives as 
primary caregivers throughout the childbearing continuum.

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book launch invitation Thursday 6 September 2001 at 5pm

[Johnston]

To all who are interested in childbirth, you are invited to:
Maternity Coalition's FORUM and LAUNCH of KERREEN REIGER'S NEW BOOK
'OUR BODIES, OUR BABIES'
The Maternity Coalition in conjunction with the absolutely women's health 
program invites you to a forum and book launch.
THE CHILDBIRTH REVOLUTION:
STALLED OR STOPPED?

A panel of speakers who have been active in changing childbirth in recent 
decades will consider what has and has not been achieved. Their lively 
discussion will be facilitated by Andrea Robertson of Birth International.
Thursday 6 September 2001 at 5pm
Committee Room First Floor
Royal Women's Hospital
Cardigan Street (Emergency) Entrance
Carlton
Following the forum you are invited to celebrate the publication of
OUR BODIES, OUR BABIES:
THE FORGOTTEN WOMEN'S MOVEMENT
By Kerreen Reiger
Published by Melbourne University Press
to be launched by
Rhonda Galbally of ourcommunity.com.au
With the support of the Royal Women's Hospital, light refreshments will be 
catered for by 'Mary and Steve'. A donation to the Maternity Coalition of 
$10 (or $5 MC members/unwaged) is requested to defray other costs and to 
continue the work of making childbirth 'woman-friendly'.
  

* As numbers are strictly limited please RSVP by 30 August 2001 to:

The Maternity Coalition
PO Box 73
Brunswick South VIC  3055

Please make cheques payable (tax deductible donations) to The Maternity 
Coalition.
Receipts will be available at the forum.
Inquiries to
Robin Payne
tel: 9380 2863
or
absolutely women's health
tel: 9344 2199


Please find enclosed my payment for
the forum 'The Childbirth Revolution:
stalled or stopped?' and the launch of
Our Bodies, Our Babies: The
Forgotten Women's Movement

$5 MC member/unwaged
$10 others
Name _
Address ___


  

ABOUT
Our Bodies, Our Babies
The Forgotten Women's Movement
This is a wonderful book . . .  read it and consider what has been won, and 
how much more needs to be won, in the childbirth revolution!
Barbara Katz Rothman, City University of New York
Kerreen Reiger is absolutely right to see the childbirth movement as the 
forgotten women's movement, and the great pleasure of this book is to find 
in every chapter the right questions being asked.
Janet McCalman, University of Melbourne
For most of the twentieth century, childbirth and the care of mothers and 
babies in Western countries was controlled by doctors and a hospital system 
headed by men.
In Our Bodies, Our Babies, Kerreen Reiger traces the struggle of Australian 
women and others to change approaches to childbirth, to claim their right 
to choices in childbirth, and to educate themselves about birth and 
breastfeeding. She explores the movement which radically changed our 
maternity care practices, allowing fathers to participate in the birth of 
their children and babies to 'room-in' with their mothers.  This absorbing 
story draws on interviews with mothers, midwives and doctors, and on 
archival material from relevant women's organisations. It shows how the 
childbirth and breastfeeding movements are relevant to feminism and women's 
rights. Much has been achieved, but Reiger sees a need for still more 
political action.
Any woman who has given birth, and anyone who has cared for mothers and 
babies, will want to read this book.


Dr Kerreen Reiger
Director of Women's Studies
School of Social Sciences
La Trobe University 3086
Australia
ph: 61 3 9479 1040
fax: 61 3 9479 2705


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RE: centralised EFM.

[Johnston]

Good to hear from you Carol.
You're asking for efficacy of the monitor?  It just means there doesn't 
have to be a midwife in the room with the woman, doesn't it?
I saw the central monitor bank system in use in Michigan in about 95.  Went 
back to visit the hospital where 3 of mine had been born (and where the 
birth activist was born, I think).  The OB nurse told me that if a baby was 
about to be born, and the doctor was not present, no nurse would stay in 
the room with a woman - they couldn't take that sort of responsibility.  I 
feel great sadness at that thought.  We mustn't let that happen here.
Joy
-Original Message-
From:   Carol Thorogood [SMTP:[EMAIL PROTECTED]]
Sent:   Tuesday, August 07, 2001 9:45 PM
To: Ozmidwifery List
Subject:Re: centralised EFM.


Hi all
Yes I am still around, just ever so quiet!  Does anyone have any info or
know where I can get it or does anyone have experience with centralised EFM
in 'delivery' suites?  I need to know about the sorts of EFM where there is
a console in the office or somewhere to which all the fetal monitors are
linked up. Apparently the monitor 'reads' the EFM and the screen goes red 
if
the trace goes off. The mid students and I have done literature searches 
and
can't find anything about its efficacy. Help, please.

Carol

PS That's a loverly mat coalition website Joy.

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a lateral thought

[Johnston]

It has occurred to me:
Any midwife can attend a birth in any setting, on their own responsibility, 
and they don't have to tell anyone they are doing it.  It could be argued 
that unless a midwife has a condition on her/his registration that they 
cannot provide services out of hospital, they should be expected to be able 
provide a full range of out of hospital maternity services. (in the same 
way that midwives with B Mid who are not RNs are required to have a 
condition placed on their registration, that they are restricted to 
midwifery) They should be required to demonstrate competence in 
out-of-hospital birth, and to carry the same PI insurance that independent 
midwives carry.

If the profession and the consumers demanded a move like this, it would 
really throw the cat among the pigeons.
That's the way it looks from where I sit.  wadayathink?
Joy

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bestforwomen

[Johnston]

Dear list friends
This title begs the question, "Who decides what's best for women?"  Perhaps 
it will be answered at this conference:
You may be interested in the
combined RCOG/RANZCOG scientific meeting in Sydney next year. . 
 http://www.bestforwomen.conf.au/program.htm  the following is copied from 
the website:
  The Conference will be unique as the first joint scientific 
meeting of the Royal College of Obstetricians and Gynaecologists and the 
Royal Australian and New Zealand College of Obstetricians and 
Gynaecologists. The Conference will bring together internationally 
recognised experts in the provision of health care to women. With the 
combined resources of the two Royal Colleges an exciting and stimulating 
meeting is guaranteed.
  The program will address recent scientific advances which 
will affect the future practices of Obstetrics and Gynaecology.


  The Conference and Trade Exhibition will be held in the 
Sydney
  Convention and Exhibition Centre, which is adjacent to the 
heart of
  the city. The centre offers first class facilities to 
delegates,
  presenters and exhibitors alike and is the focal point of 
Darling
  Harbour, an imaginative urban redevelopment project which is 
alive
  with shops, restaurants and visitor attractions.


  The Organising Committee are dedicated to providing a total 
package of scientific merit
  and enjoyment in the unsurpassed facilities and environment 
of Sydney. In addition to
  this, delegates and their accompanying partners are 
encouraged to extend their stay
  and take advantage of the diverse range of pre and past 
conference tours available.

  A wide range of hotels and apartments have been booked to 
suit all needs and budgets
  and will be available to delegates through the Conference 
Secretariat. All
  accommodation is within close proximity of the Sydney 
Convention & Exhibition Centre.

  The registration procedure and call for abstracts will be 
available in October 2001. If
  you would like any information in the meantime please 
contact:

The Best for Women Conference Secretariat
   GPO Box 2609, Sydney NSW 2001 Australia
  Tel: +61 2 9241 1478Fax: +61 2 9251 3552
   E-mail: [EMAIL PROTECTED]


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Birth Matters Volune 5.3

[Johnston]

The next issue of Birth Matters, the journal of the Maternity Coalition, 
has gone to the printer, and I would like to encourage everyone to consider 
subscribing at this time when we all need, so much, to pull together.  The 
future of childbirth in Australia is at a critical point, and I believe we 
can work together strategically to bring in the needed changes.

This issue focuses on consumers, and the title on the front cover is:
"Closing the gap: on women's choice, control, continuity of carer and 
midwives' ability to practice"

It's a bumper issue. The articles include:
Consumer power, by Christine and Damien Toppi
Private Health Insurance Funds - Report by Emma Fleay
Consumer participation - who controls what you get? By Karen Lane
Trusting enough to be out of control, by Jenny Parratt
On being a mother - four accounts by women
Midwives and women: a with-woman relationship? By Fiona Brooks and Helen 
Lomax
The new midwife, by the B Mid student collective
Bachelor of Midwifery in Victoria, by Diane Cutts
My experience as a direct entry midwifery student, by Carole Bastian
A time of crisis - the gap is closing  - editorial
Press releases and reports on the PI crisis, by various organisations and 
individuals
ACT branch report
MIPP column
Letters, and lots more.

www.maternitycoalition.org.au
You may join/renew membership by sending your contact details with $30 to
The secretary, Maternity Coalition
PO Box 73
Brunswick South Vic 3055

Group subscription (4 copies of each issue to one address) $100
Bulk orders of 10 or more sent to one address may be ordered at cost price 
+ post.

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FW: Women's Health - For the Latest in OB/GYN, Women's Health, and Gender-based Research

[Johnston]

A few selected items fyi

-Original Message-
From:   Medscape's MedPulse [SMTP:[EMAIL PROTECTED]]
Sent:   Saturday, August 18, 2001 4:51 AM
Subject:Women's Health - For the Latest in OB/GYN, Women's Health, and 
 Gender-based Research

___
   >>>   MEDSCAPE's Women's Health MedPulse(r)   <<<
http://womenshealth.medscape.com
___

POLYUNSATURATED FATTY ACIDS IN MATERNAL DIET MAY RAISE ATOPY RISK
An excess of linoleic acid or a deficiency of linolenic acid in the
maternal diet may increase the risk of atopic disease in breast-feeding
infants, investigators in Finland report.
http://womenshealth.medscape.com/41619.rhtml?srcmp=wh-081701
http://womenshealth.medscape.com/41619.rhtml?srcmp=wh-081701";>
Read it Here

SMALL INCREASE IN ADVERSE BIRTH OUTCOMES LINKED TO LANDFILL SITES
Thousands of women who live near landfill sites in the UK could be at
increased risk of having an infant with a congenital anomaly, according
to a major study published in the British Medical Journal.
http://womenshealth.medscape.com/41790.rhtml?srcmp=wh-081701
http://womenshealth.medscape.com/41790.rhtml?srcmp=wh-081701";>
Read it Here

EVEN SMALL AMOUNTS OF ALCOHOL HARMFUL DURING PREGNANCY
Children whose mothers consumed even a small amount of alcohol during
pregnancy seem to be at increased risk of behavioral problems later in
life.
http://womenshealth.medscape.com/41564.rhtml?srcmp=wh-081701
http://womenshealth.medscape.com/41564.rhtml?srcmp=wh-081701";>
Read it Here

EPIDURAL DOES NOT RAISE C-SECTION RISK
Women who receive an epidural to reduce pain during childbirth do not
have an increased risk of Cesarean section, government researchers
report.
http://womenshealth.medscape.com/41590.rhtml?srcmp=wh-081701
http://womenshealth.medscape.com/41590.rhtml?srcmp=wh-081701";>
Read it Here

FORCEPS DELIVERY INCREASES FECAL INCONTINENCE RISK
Women who deliver infants with the help of forceps and those who develop
tears in the anal sphincter may be more likely to have difficulty
controlling bowel movements and gas in the 3 months after the birth, two
British studies report.
http://womenshealth.medscape.com/41768.rhtml?srcmp=wh-081701
http://womenshealth.medscape.com/41768.rhtml?srcmp=wh-081701";>
Read it Here

IMPROVED OUTCOMES FOR MOTHERS AND INFANTS WITH NURSE HOME VISITS
Prenatal care intervention in the home delivered by nurse specialists
with master's degrees can reduce infant mortality, improve maternal and
infant health, and lower healthcare costs.
http://womenshealth.medscape.com/41735.rhtml?srcmp=wh-081701
http://womenshealth.medscape.com/41735.rhtml?srcmp=wh-081701";>
Read it Here
MORE THAN 30 EDITIONS OF MEDPULSE NOW AVAILABLE Medscape offers 
MedPulse in more than 30 editions so you can stay up-to-date with the 
latest clinical information faster and easier.
Subscribe for free to as many editions as you like. There are very
specialized condition editions like Medscape's HIV/AIDS MedPulse and
broader topics like Women's Health MedPulse. To add or change your
subscription preferences, point your browser to the link below and edit
your profile.
http://www.medscape.com/Home/registration/profile/Profile.html

___
_ USER SUPPORT 
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Forgot your login info?:  http://www.medscape.com/password
(http://www.medscape.com/password";>Get Your Account Info) to 
retrieve your account information.
Need additional support?: http://www.medscape.com/help/tech (http://www.medscape.com/help/tech";>Technical Support)

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RE: Bipolar realities

[Johnston]

Dear Carolyn
There were a couple of reasons why I was not going to read your message. 
 It came as a text attachment, and I am very wary of attachments; and 
because you said it was long.  But because *you* wrote it I felt compelled 
to open and read.  I'm glad I did. Thankyou.

In my practice in the past week there has also been an event which has made 
me reflect seriously about streams of thinking.  I have been challenged by 
the boundaries of normalcy - particularly time.  The woman was planning 
homebirth; and experienced a slow and frustrating (first) labour that 
seemed to be going nowhere.  Having tried all the physical and mental 
empowerment strategies I know, I suggested to both mother and father that 
they close their eyes and rest a while, in preparation for transfer to 
hospital.  Stretched out in the bathtub, with soft winter light filtering 
through the closed louvres, with noone else around, and with me sitting on 
the floor with my back up against the bathroom wall, the woman's labour 
took on new energy and in a very short time the unmistakable sounds of 
pushing were heard.  This was about 2pm.
Four hours later, once again with infrequent and quite mild contractions, 
we agreed that hospital was the best place to be.  There was a wild storm 
outside.  I would have done anything to stay at home!  The woman was not 
distressed by labour - in fact she appeared tired but totally unstressed as 
we stood at the desk in the birth unit, and introduced ourselves.
In hospital, the doctor, a woman-friendly female GP with experience in 
homebirth, came into our partnership with new energy and confidence.  Her 
words "babies are meant to be pushed, not pulled", were beautiful.
It was about 10.30 pm, when the woman gave birth to a very healthy boy. 
 More than 8 hours after I suspected full dilatation!

Birth challenges us from many different perspectives.  I want to be able to 
be 'with woman' whether it's at home or hospital, whether I am taking a 
leading role, as the midwife responsible for the birth, or in a little team 
of strangers that have been allocated to work in that room.  In the 
situation I have described, I had become puzzled and concerned by the lack 
of activity.  Did I slow it all down even further by taking my client out 
through that storm?  Could I have confidently waited for a couple more 
hours? What then? ... (I have many unanswered questions.)

If anyone is interested in further reading on twin births, there is a 
wonderful account by Celia Adams and Tim Jacka - "Three births" in the 
Birth Story section of my website. www.aitex.com.au/joy.htm

Joy Johnston

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RE: Resolution for women's groups

[Johnston]

I support Andrea's call - which of course will only achieve anything if 
members of those organisations, once they have achieved agreement of the 
body on the matter, ensure that action is taken to follow through with 
lobbying and other political action.
Joy

Is there an ACMI member on the list who will be at the ACMI Annual Meeting 
in Brisbane next month?  We need a motion to be prepared, and sent on 
notice to ACMI in time to be included on the agenda, and the person moving 
the motion being able to speak to it. Also members to vote for it. (I can't 
be there, unfortunately)

Two suggested motions:
1. "I move that ACMI urges the Australian Federal government, and State and 
Territory governments, to recognise midwives as autonomous practitioners 
who work for the public good and as such should have access to the same 
medical rebates as medical providers of the same maternity service.
2. "I move that ACMI urges the Australian Federal government to ensure that 
midwives have access to reasonable and affordable professional indemnity 
schemes.


-Original Message-
From:   Andrea Robertson [SMTP:[EMAIL PROTECTED]]
Sent:   Sunday, August 19, 2001 11:37 AM
To: [EMAIL PROTECTED]
Subject:Resolution for women's groups

Hi Denise,

Here it is again:

This is the wording that is suggested by Karen Guilliland for a resolution
to propose at AGMs of any women's groups, as a way of gathering more
generalised support. It is similar to the resolution used with great effect 
in New Zealand:
--
that (the group) urges (government/state) to recognise midwives as
autonomous practitioners who work for the public good and as such should
have access to the same medical rebates and government/state funded
professional indemnity schemes as medical providers of the same maternity
service.
-

Andrea R

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RE: Bipolar realities

[Johnston]

I've just read Jan Robinson's twin story - WOW! Congratulations to all 
involved.
Jan Ireland, you have asked a lot of questions - I can't answer them all.
Throughout the pregnancy I try to stress to my clients that homebirth is 
not an end in itself. I liked the way Nicky Leap talked about her work in 
London, when the women were free to give birth at home or in hospital - it 
was no big deal.  That's what I would like to see here, but it becomes such 
a huge issue when a woman has to step out of the 'system', and be told by 
most people that she is mad, and pay a lot of money for an independent 
midwife!  I do my very best to facilitate homebirth, but once the 
recognised boundaries of wellness and time (from an exhaustion point of 
view) have been overstepped, I think a midwife needs to be very sure that 
it is the woman's wish to continue at home, and that the woman understands 
what's going on.  That's hard in labour, as it requires front brain 
thinking.

Many of the issues you raise would be good to deal with in a confidential 
Peer Review setting.  I would also like this for the birth I attended.  I 
hope MIPP will be able to establish a process for Peer Review, and do it in 
a way that is accountable and responsible.

I think in this case the reasons for transfer to hospital were a mix of the 
ones you mention, and a few more.  Once we were in hospital the woman 
rested and we waited for the doctor, who was delayed. As baby was a happy 
chappy, there was no need to stress about the lack of uterine action, or 
the slow progress.  It then became a collaborative decision with the doctor 
to NOT interfere.  Her words "babies are meant to be pushed, not pulled" 
were very reassuring.  An IV with only 5units of Syntocinon, and heaps of 
encouragement from the cheer squad, and we saw continued SLOW progress. 
 Baby was born by his mother.
Third Stage was also slow, and after about an hour, when manual removal 
under GA was mentioned, I advised active management - IV synt and 
controlled cord traction.  Placenta born beautifully, and minimal blood 
loss.

I must get into my car and visit them now.
Joy

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PI Insurance in Vic

[Johnston]

Dear ozmidpeople
PLEASE SUPPORT VICTORIAN INDEPENDENT MIDWIVES, AND WOMEN WHO HAVE BOOKED 
THEIR SERVICES.
Please write letters, requesting urgent action on behalf of women seeking 
maternity services, and midwives, to:

The Hon John Thwaites
Minister for Health
555 Collins Street
Melbourne Vic 3000

And to Dr Wooldridge

We have been given 4-days' notice that as of 1September, we will have no 
insurance cover.  Previously we had been told that insurance was being 
reviewed in September.  This is totally unreasonable.  The whole 
maternity/midwifery community should be outraged.  This applies to most 
midwives who attend women privately in Victoria.  Note that this has 
happened at the same time as ANF has accepted a midwife:woman ratio of less 
than 1to1 for women in labour in the State's hospitals.



Re: professional indemnity insurance for Victorian midwives

Midwives who have insurance through ANF will NOT be insured for independent 
practice from 1 Sept 2001.  Midwives employed in hospitals or health 
services will continue to receive PII cover.
This message has come from Lisa Fitzpatrick at the Vic ANF.  ANF will send 
a letter to members who have been identified as midwives in private 
practice, and inform them of this situation.

Midwives will individually decide whether or not they will continue 
practising without insurance.  It's not an easy decision.  If anyone wants 
to know, please ask the midwife concerned.
Maternity Coalition needs to send a delegation to John Thwaites, in an 
effort to protect the interests of women who engage a midwife for 
professional services, and in the interests of midwives whose livelihood is 
threatened.  [a request for such a meeting, seeking assurance that women 
who employ midwives will not be disadvantaged, has gone to the Minister]
Joy Johnston [EMAIL PROTECTED]


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RE: NVB, Independant Midwives and PII

[Johnston]

Dear Jen
I think you have taken it further than we really can be sure about in 
saying " we cannot be registered
without professional indemnity."
The new provision in the Act is "The Board may require the applicant 
[registered nurse] to provide evidence that the applicant is or will be 
covered by professional indemnity insurance that meets the minimum terms 
and conditions set out in guidelines of the Board."(Nurses Act 1993 No111, 
5(3)(d)).
It's a discretionary power, and I am asking the Board to ensure that it 
only demands what is reasonably accessible.  That's natural justice.  The 
CEO and Chairwoman of the Board have asked for a discussion document to be 
tabled at the next meeting, and that's what we have been working on.  So 
although it's possible that lack of PII could be considered to be 
unprofessional conduct, we need to proactively seek solutions rather than 
simply submit.

I don't know how to send (real) support and care via email, but here is a 
big warm hug from me to anyone who is hurting in this. We are midwives.  We 
are used to working with difficult situations as well as good ones.  Keep 
faith in the Truth that guides you.
Joy
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


-Original Message-
From:   Jenny Parratt [SMTP:[EMAIL PROTECTED]]
Sent:   Wednesday, September 05, 2001 7:21 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject:Re: NVB, Independant Midwives and PII

Yes you are right Tina. From sometime in November we cannot be registered
without professional indemnity. It calls into question the Vic Code of
Practice which requires PI - the VNC would have to recind it. We also would
not be able to be full members of ACMI as that requires us to be
register-able as midwives. We are being de-professionalised. The definition
of a midwife would have to be changed, in Vic at least as someone who could
only practice as an employee of a hospital.
We are very sad and confused and swing between hope and despair. I had my
first client today who I have had to discuss where she will go for her 
birth
as I and her second and backup midwives cannot be with her in a private
capacity (home or hosp). Jenny


Jenny Parratt
Independent Midwife Consultant
PO Mandurang Vic 3551 Australia
0409 393073
[EMAIL PROTECTED]
- Original Message -
From: <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Cc: <[EMAIL PROTECTED]>
Sent: Wednesday, September 05, 2001 6:07 PM
Subject: NVB, Independant Midwives and PII


> Hi all,
>
> can anyone confirm rumours that moves are afoot at the NBV to change
> legislation (Nurses Act 1993) to prevent independent midwives from
practicing
> without their insurance??
>
> Interested.
>
> Yours in birth,
> Tina Pettigrew
> Birthworks
> Independent CBE and aspiring B.Mid Midwife.
> Convenor, Aust B. Mid Student Collective.
>
> " As we trust the flowers to open to new life
>- So we can trust birth"
> Harriette Hartigan.
> ---
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action in Victoria

[Johnston]

FROM ANNIE SPRAGUE
Dear friends,

Regarding: No professional indemnity insurance for independent midwives

Today Joy and I were able to speak on the ABC 774.  The host of this 
program, John Faine has (I believe) considerable influence in getting to 
speak to politicians and forcing the newspapers to follow up on callers 
complaints.
My proposal is that if all of us are able to ring the station on 94141774 
each morning at 8.50am to speak on 'open line' for the next 3 weeks, we 
will be able to publicise the removal of choice for women & midwives.

The points to get across in a small 'bite' as I see it are:
to focus not on home birth but on choice of provider
all Independent midwives have lost indemnity insurance
minister for health should provide access for all women to choose 
continuity of care from a known midwife as their primary provider whether 
in hospital or in the community
there is already money in the system that women should be able to access
it is a women's right to choose a midwife as her primary caregiver - THE 
model that is strongly supported by research evidence; recommended by the 
World Health Organisation and continually supported and recommended by 
Government committees evaluating maternity health care provision both in 
Australia and internationally, is in effect being withdrawn.
why is midwifery practice being dictated to by insurance companies?
This action is causing great distress to women who have made plans to give 
birth in the care of a midwife


This is an issue that will affect all midwifery, not just home birth 
midwives. The impact of this crisis will be to disadvantage Victorian women 
and their families, as midwifery services will be withdrawn. Women's right 
to choose a midwife as her primary caregiver is being even further eroded.

This action removes the midwife's livelihood, and is not in the interests 
of the consumer
We believe that women have the right to choose where and how they have 
their babies. We understand that the midwife is the appropriate primary 
carer, and that midwives are entitled to practise midwifery (through 
protection of title and role of the midwife in the Victorian Nurses Act 
1993, and other similar Acts.).  We understand that any health care 
provider should be able to access, and should have indemnity insurance. The 
loss of cover to midwives is possibly only a first step in the loss of 
cover to any health care professional who works outside the hospital 
system, including nurse practitioners.  If midwives are practising within 
the law, which we believe is the case, it is totally discriminatory to have 
no access to hospital practising rights or affordable indemnity insurance 
cover.

Midwives who are unable to purchase reasonable PII are faced with a 
difficult decision, to either cease practising or to continue without PII. 
 Either option is unacceptable. Either option marginalises basic community 
midwifery, separating it further from mainstream health services.  We be  
lieve that in the interests of safety for the consumer, and under the 
provisions of the federal government's Competition Policy Agreement, the 
midwifery option must be protected.
"women have repeatedly stressed the importance of receiving care during 
pregnancy and childbirth from the same caregiver, or from a small group of 
caregivers with whom they can become familiar. Evidence from controlled 
trials shows that women who had continuity of caregivers were less likely 
to use pharmacological analgesia or anaesthesia during labor and birth, to 
have labour augmented with drugs, to have a labour length of more than 6 
hours or to have a baby with a 5 minute Apgar score below 8. They were also 
more likely to feel well prepared for labor, perceive the staff as caring, 
feel in control during labour and feel well prepared for child care".
The midwifery model of care which we are advocating is most likely to 
provide the true continuity of care for women that will result in these 
good outcomes.
In addition, our evidence supports the claim that such midwives act under 
the Code of Practice (NBV 1999) and are diligent in keeping their practice 
contemporary and their competencies up-to date. We know of no independently 
practising midwives in Victoria who have been sued.  A good record here 
highlights the low level of risk but it does not negate the importance of 
PII.  Under the Federal government's Competition Policy Agreement, 
restriction of 'trade' in health care can only be justified if there is a 
clear case that competition would be likely to harm the consumer.  For 
instance, the sale of antibiotics and the performing of surgery are 
restricted for good reason.  However there is no argument that the 
practising of midwifery is likely to harm the consumer.  The 
anti-competitive restrictions on consumer access to professional midwifery 
services should be removed, and appropriate measures to ensure that 
consumers have the choice of maternity care provider.

FW: from lina re: loss of PI insurance

[Johnston]

--
From:   "Lina Clerke" <[EMAIL PROTECTED]>
Date:   Thu, 06 Sep 2001 23:36:09
To: [EMAIL PROTECTED]
Subject:from lina re: loss of PI insurance

dear annie,
i am right behind you  - god bless your cotton socks. here is a note i 
posted onto the BMid group list in answer to one of their questions. can 
you forward it on to the ozmid list and anyone else?? this is how i am 
trying to do my bit. lots of love, lina you asked what can we do?
we need to let the powers that be know that there are ALOT ALOT ALOT of 
people out there who care about this issue and who want access to choice of 
carer and continuity of care.  this is a very real possible thing that 
everyone can do:
there is a petition on the maternitycoalition.org.au website. download it 
and each of us must fotocopy it 20 or 30 or 200 (i did that!) times and 
keep giving it /posting it to our friends, other mothers etc and have them 
in turn fotocopy and hand out to friends etc. like multilevel marketing. we 
need to generate THOUSANDS AND THOUSANDS of filled petitions!!it cannot 
simply come from tiny consumer groups and a small handfull of midwives. 
 there must be evidence that this is BIG and lots of people care. there 
is strength in numbers.
love, lina



>From:  Sprague




Get your FREE download of MSN Explorer at http://explorer.msn.com




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ACTU SURVEY/CHECKLIST OF WOMEN VOTERS

[Johnston]

This survey came to me via Women's Action Alliance.  It's an opportunity 
for women to have their say about important issues.
I have added a statement (in CAPS) to "any other issues".  Please send this 
off to the address below if you agree.
Joy Johnston

ACTU SURVEY/CHECKLIST OF WOMEN VOTERS


The ACTU would like to gather the opinions of as many women as possible - 
the greater the numbers, the stronger the message to the major political 
parties about the importance of women's issues and women's votes. The 
results will be launched by ACTU President Sharan Burrow
next month.

Please pass this email on to a friend or relative and ask them to nominate 
their three priorities from the list below:


. Family-friendly workplaces

. Job security

. More control over working hours

. Family leave and paid maternity leave

. Affordable and accessible child care

. Equal pay

. Fair workplace laws

. High quality health, housing, aged care and other community services

. Pay increases for low paid workers

. Equal access to quality, fully funded education and training 
opportunities

* Any other issues: 
...YES..  

MATERNITY FUNDING THAT ENABLES EVERY WOMAN TO CHOOSE WHO PROVIDES CARE 
(MIDWIFE OR DOCTOR) IN PREGNANCY AND BIRTH, AND WHERE THAT CARE IS PROVIDED 
(COMMUNITY OR HOSPITAL)









Please email those choices to: [EMAIL PROTECTED]

or post this to ACTU 393 Swanston Street, Melbourne  3000

More information is available on the ACTU website on: www.actu.asn.au



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RE: the red tent

[Johnston]

I haven't read the red tent yet, but hope to get it soon.
I would like to share a story that came to me from a young woman who had 
her last 2 babies at home (and I was there as midwife) in an 
outer-Melbourne suburb, and is now living, with husband and 5 children 
(youngest born Feb 2001) in a developing country, which due to the 
sensitivities of the situation, I will not name.  My friend (who has no 
formal midwifery education, though you will see that she has the skill of 
the midwife) tells about going to the menstrual and birthing house - a 
place where only women go. This is a small part of her story (Please do not 
reprint this in newsletters without permission):

"Upon entering the small room I found it packed with about fifteen women 
and a few babies who had come with their mothers.  There were two dim 
kerosene lanterns, and I could see U squatting on the floor with a couple 
of women, and other women sitting around the room on the edge of the 
two-deep beds looking at her.  There was a stove in the middle of the room, 
which was not lit as it was a hot night, and the floor was made of dirt. 
 There was a sort of funny smell, which was probably a mixture of old blood 
and excrement.

The women were pleased to see me, and said that I knew about these things 
and they didn't know.  I told them they did know.  I  squatted next to U 
and squeezed her hand.  She appeared very tired.  There was a piece of 
waterproof rubberised material on the dirt floor, upon which U was 
squatting, and there were a few small puddles of amniotic fluid.  Upon 
later examination by torchlight I found that this mat was very dirty.  I 
really wondered how I should deal with the situation, wanting to have 
cleanliness, but not wanting to barge in and tell them everything was 
wrong.

I was directed to sit on the edge of the bed, and someone pointed out with 
great amusement that a cat had come to have her kittens!  She was on one of 
the beds in the corner, wandering around every so often in search of 
something to eat.  "A cat" I thought, "how disgusting", but then I thought 
people probably have home births with inside cats, and besides there was so 
much other dirt around, what did a few cats matter?  I was given one of the 
kittens to hold, and wondered where I was going to wash my hands 
afterwards.  I never found the solution to that one.

I had arrived at about ten o'clock at night, and after a while most of the 
women had gone to sleep, two to a bed, and sometimes a baby as well.  There 
were a couple of women, one old and one younger, who seemed to be the main 
support people, plus me.  The younger woman did a lot of praying, holding 
her hands up near U.  I wonder what she said.  She kept telling U to say 
[""] but she was too busy concentrating on labour.  During the contractions 
U reached out to squeeze my hand tightly, and leaned against the younger 
woman whilst the older woman rubbed her back and legs.  At one stage U was 
fed some porridge looking stuff from someone's fingers.

U was worried that the labour was so slow, but I told her "in a little 
while your baby will be born" and prayed like mad I was telling the truth. 
 Sometime after midnight, I noticed the pain was becoming unbearable and 
thought second stage must be near.  I wished I knew how to ask "do you feel 
like pushing?"  She wanted to go to the toilet, and I thought this must be 
the urge to push coming on.  Upon her return I noticed her seeming to bear 
down a little during the contractions.

This stage seemed to go on forever, with long gaps between the 
contractions.  U alternated between lying on the bed, walking around 
slowly, and squatting on the mat on the floor.  She was obviously exhausted 
and would have liked to lie on the bed for longer, but the other women 
strongly encouraged her to squat.  I could never have squatted for that 
long but the K women are quite comfortable that way.  One of her legs was 
in a lot of pain so she kept stretching it out and we massaged it.  Around 
this time the support women brought some ghee and smeared it all over U's 
belly.

She was very concerned that the baby was not coming, and so they sent for 
the midwife to come from K.  I was a little concerned that she had become 
too tired to do strong enough pushes, since that's what happened to me when 
I was having Nathan.  Oh how I wished I had learned more relevant 
vocabulary, like "push hard!"  I began praying like mad.  I don't think 
I've ever prayed so continuously before.  She was pushing and nothing much 
appeared to be happening, other than a little fluid coming out each time. 
 The older lady was pinching her bottom together and pushing just above the 
anus, which I thought may be obstructing the baby so I took her hand away. 
 I hoped I had been right about the baby's position.  U was calling out now 
and moaning a lot, and crying.  I kept praying "Lord, let's see the head 
coming next contraction" but it didn't happen for a whil

farewells

[Johnston]

Dear friends
I have to go to Brisbane to be with my father who is dying.  I won't be 
online for a while, but will keep the ozmid open so that I can catch up 
later.

My dad is a man of great faith in the Father in Heaven, and is eager to 
hear the welcome "well done, good and faithful servant."
Joy

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RE: Homebirth stats

[Johnston]

Dear Jo
The group of independent midwives in Victoria who call ourselves MIPP 
(Midwives in Private Practice - a member group of the Maternity Coalition) 
have collected and collated homebirth data over the years.  The last 
triennial report is 1995-1998, reporting on 437 planned homebirths.  Jenny 
Parratt did the bulk of the work, with Annie Sprague helping and me in the 
background. (it's time for another report!)

22 women in the study had had at least one previous caesarean.  Eight had 
undergone caesar for the previous birth.  The report notes:
"Of the group who had a caesarean section in their most recent previous 
pregnancy, more than half had home births. There was one antenatal 
transfer, two labour transfers prior to delivery and one transfer for a 
retained placenta. One of the labours was greater than 24 hours long and 
two of the births were in water."

The numbers of VBAC planned homebirths are too small to draw conclusions 
from these figures.  We have simply reported on the numbers that we have. 
 Some women engage an independent midwife to go with them to hospital for a 
planned VBAC.  Those births are not included in the homebirth data.

As I said in my email earlier this month, the Vic government's statistics 
on births in 2000 have been published.  There is a report on this going 
into the next issue of Birth Matters. One of the clinical indicators is 
"Rate of vaginal delivery after primary caesarean section" which is 20.4%.

I hope you are able to collect lots of vbac information and make it all 
publically available.  People like you and Jackie Mawson and others who 
make it your business to find out these things have a potential for 
demanding change in a way that those of us on the job don't.
Joy Johnston
-Original Message-
From:   Dean & Jo Bainbridge [SMTP:[EMAIL PROTECTED]]
Sent:   Thursday, October 18, 2001 9:36 PM
To: [EMAIL PROTECTED]
Subject:Homebirth stats

 << File: ATT1.htm >> Is there any Australian homebirth stats avaliable 
from anywhere?  I would be especially interested in vbac related stats and 
the 'general type'.
cheers
Jo Bainbridge
founding member CARES SA
email: [EMAIL PROTECTED]
phone: 08 8365 7059
birth with trust, faith & love...

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RE: Admission CTG's

[Johnston]

This is a great reference.  Thanks for passing it on Bec.
Joy

-Original Message-
From:   Clinical Learning Coordinator [SMTP:[EMAIL PROTECTED]]
Sent:   Friday, October 19, 2001 10:39 AM
To: '[EMAIL PROTECTED]'
Subject:Admission CTG's

Dear List

There was a question posed a few weeks ago about routine admission CTG's and
their effects. I've been trying to dig up the article on this and now I have
it so I hope it is not too late for the midwife who was after the
information. It is:
Mires, G., Williams, F. & Howie, P. (2001), "Randomised controlled trial of
Cardiotocography versus Doppler auscultation of fetal heart at admission in
labour in low risk obstetric population", BMJ, 322: 1457-1462.
The conclusion states:
"There were no significant differences in the incidence of metabolic
acidosis or any other measure of neonatal outcome among women who remained
at low risk when they were admitted in labour. However, compared with women
who received doppler auscultation, women who had admission CTG were
significantly more likely to have continuous fetal heart rate monitoring in
labour, augmentation of labour, epidural analgesia, and operative delivery.
Compared with doppler auscultation of the fetal heart, admission CTG does
not benefit neonatal outcomes in low risk women. It's use results in
increased obstetric intervention, including operative delivery." (p1457)

Hope this is of some benefit.

Cheers
Bec


Clinical Learning Coordinators

Trevor Cresp  (pager 4287)
Rebecca Smith   (pager 4304)
Michelle Unetta  (pager 4428)
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MIDWIFERY & THE NURSE PRACTITIONER INFORMATION SESSION WED. 21 NOVEMBER 2001

[Johnston]

[Some readers may wonder what the words 'Nurse Practitioner' have to do 
with midwifery. Victoria has introduced new legislation which will be 
implemented in November, enabling a registered nurse (or a midwife - we are 
registered in Division 1 of the Nurses Register, whether we practice 
nursing or not) to be endorsed as 'Nurse Practitioner'.  This endorsement 
of the register will enable the person to have extended practices: ORDERING 
TESTS, PRESCRIBING, REFERRAL TO SPECIALISTS, ACCESS TO HOSPITALS.

These extensions to practice will be very attractive to midwives who 
currently practice with a degree of autonomy, such as in Birth Centres and 
caseload and team projects in hospitals, and in private practice.  Also 
midwives who are lactation consultants, and those who specialise in women's 
health.  I believe midwives should look seriously at this option for 
advancing our clinical practice.  This session will help get good 
discussion going.  Joy Johnston]


MIDWIFERY and the NURSE PRACTITIONER

A free information session to be held, hosted by ACMI Vic Branch and the 
Royal Women's Hospital

Wednesday 21 November 2001 (2 - 4pm)

Royal Women's Hospital
Yvonne Bowden Auditorium, 132 Grattan Street, Carlton

NO NEED TO REGISTER !   ~  ALL WELCOME !

Program includes:
The Victorian Nurse Practitioner Project ~ Overview
Claudia Trasancos
Senior Project Officer, Nurse Policy Branch, Department of Human Services

Community Midwife Nurse Practitioner Model
Helen Haines
Project Officer, Community Midwife Nurse Practitioner, Wangaratta District 
Base Hospital,

Woman Project
Alison Bean-Hodges
VNPP/WOMAN Project Manager, Royal Women's Hospital

Facilitated Discussion ~ Midwives and the Nurse Practitioner Role
Joy Johnston
Midwife in Private Practice

Inquiries: ACMI Vic 03 9349 1110, or Lynne Kubis 
[[EMAIL PROTECTED]]

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RE: Rescue Remedy

[Johnston]

It's a fantastic name, isn't it.  That must have value, even if the stuff 
in it doesn't work.  I often find those who want to use it are doing 
remedies at the very time that their bodies are getting on with the job 
anyhow.

Joy j



-Original Message-
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Tuesday, October 23, 2001 9:30 PM
To: [EMAIL PROTECTED]
Subject:Re: Rescue Remedy



The only reference on our midwifery database which specifically mentions 
"rescue
remedy" is:

 van der Mey C. Bach flower essences: part 2. Birthplace, no 64, Spring
1998, pp 22-23

Kathy Levine
Information Officer
MIDIRS (Midwives Information and Resource Service)
9 Elmdale Road
Bristol BS8 1SL
England

Tel: 0117 925 1791
Fax: 0117 925 1792
Websire: www.midirs.org
E-mail: [EMAIL PROTECTED]


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RE: Rescue Remedy

[Johnston]

Dear Jenny, you replied off the list, but I think it's a valid comment for 
discussion. (see below)

I didn't say there was no value in the rescue remedy.  I really like the 
name of it!  If someone said to me when I was feeling crook, "here have 
some of this - it occasionally helps", I wouldn't feel very confident.  But 
if someone says with great confidence "this *remedy* will *rescue* you", 
and I believed them, then it probably would work unless I was in major 
strife.  The mind is a very powerful part of our bodies.
[I find the use of the word 'remedy' leaves me with big unanswered 
questions.  I would be wary about claiming anything is a 'remedy'.  It's 
not that long since snake oil was all the go.]

I understand that there is not strong evidence to support many of the 
popular treatments that people use, including medical ones. That doesn't 
necessarily mean we shouldn't use them.  I don't have good evidence that 
sitting on exercise balls in late pregnancy helps women with birthing, but 
I recommend them and offer an opinion about them if anyone asks.

So, in this matter I hope you find evidence that satisfies you.
Joy Johnston
-Original Message-
From:   pjwant [SMTP:[EMAIL PROTECTED]]
Sent:   Wednesday, October 24, 2001 1:51 PM
To: [EMAIL PROTECTED]
Subject:Re: Rescue Remedy

Sorry Joy that you find no value in bach flower remidies but there are
birthing women who do myself included.
What I am after is evidence to back a practice that I value.
Jenny
- Original Message -
From: Johnston <[EMAIL PROTECTED]>
To: ozmidwifery list (E-mail) <[EMAIL PROTECTED]>
Sent: Wednesday, October 24, 2001 8:40 AM
Subject: RE: Rescue Remedy


> It's a fantastic name, isn't it.  That must have value, even if the stuff
> in it doesn't work.  I often find those who want to use it are doing
> remedies at the very time that their bodies are getting on with the job
> anyhow.
>
> Joy j
>
>
>
> -Original Message-
> From: [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
> Sent: Tuesday, October 23, 2001 9:30 PM
> To: [EMAIL PROTECTED]
> Subject: Re: Rescue Remedy
>
>
>
> The only reference on our midwifery database which specifically mentions
> "rescue
> remedy" is:
>
>  van der Mey C. Bach flower essences: part 2. Birthplace, no 64,
Spring
> 1998, pp 22-23
>
> Kathy Levine
> Information Officer
> MIDIRS (Midwives Information and Resource Service)
> 9 Elmdale Road
> Bristol BS8 1SL
> England
>
> Tel: 0117 925 1791
> Fax: 0117 925 1792
> Websire: www.midirs.org
> E-mail: [EMAIL PROTECTED]
>
>
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> This mailing list is sponsored by ACE Graphics.
> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>
> --
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> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>
>



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RE: Rescue Remedy

[Johnston]

Dear Lieve
Your messages to this list are always good.  And your kind words about 
Australian midwives are appreciated.  I think Belgian midwives are pretty 
special people too.
I want to thank all who have shared their knowledge and beliefs about the 
flower 'remedies'.  There are many things about which my knowledge is 
limited, and I see many midwives claiming knowledge in the fields of 
alternative therapies and other modes of healing.

I constantly struggle with our society's *need* to have treatments and 
therapies - and hence my sceptical response.  I know this human body is 
imperfect, and can be very easily put into a cycle of illness and 
destruction.  I think we feel compelled to interfere if we believe that by 
not interfering the outcome is likely to be bad, and that we can make it 
better.  That's what a rescue is all about.
In learning to be a midwife I have been learning about a woman's 
empowerment from within. By this I mean that I (the midwife) don't usually 
do the 'empowering' (or healing or treating or therapies).  My presence 
should enable the woman's own inner knowledge to become freed up, and 
healing comes with that empowerment.  I am constantly amazed and in awe 
when I see that this has happened.  Sometimes the woman uses medicines of 
one sort or the other in her process of healing, but in the end there's a 
sense of (to quote Tao Te Ching): "the mother will rightly say, 'we did it 
ourselves'."

Joy


-Original Message-
From:   Lieve Huybrechts [SMTP:[EMAIL PROTECTED]]
Sent:   Saturday, October 27, 2001 5:47 PM
To: [EMAIL PROTECTED]
Subject:RE: Rescue Remedy

Hello Jenny,

I work for a few years with the Bach Flower Remedys, for myself and my
clients. They helped me a lot in the growing we all have to do and let me
understand why we meet challenges.
In childbirth I use them , but not standard at every pregnancy or birth,
only when something unexpected happens, extreme fear with the mother,to 
heal
a bad experience in previous birth, or to help a baby after a difficult
birth.
I had once a nice story. A single mother had a very difficult delivery in
the hospital.  The birth ended horribly with a difficult ventousse, that 
got
of the head for three times. The baby's head was in asyncletisme and the 
gyn
didn't allow it to turn. The baby needed oxygen after birth, the skin of 
the
head was damaged and she had a large hematoom. We succeded to get the baby
with us for a couple off minutes without anyone else. She was still so
shocked she didn't try to drink at the breast. I gave her some rescue and
also did some drops on the head (I hoped they wouldn't smell the cognac 
that
is in) and massaged it softly into the damaged skin. Then the baby was 
taken
away to the neonatal ward. Next morning the pediatrician (who also attended
the birth ) came in with the baby and sayd: "I have never seen a baby
recover so quickly after such an horrible birth." We could go home the same
day.

Dear Joy, I also read your comment and I agree  what we say can have great
power. But the flower remedys do work, the proof is easely given when you
use it on young children, people that have Alzheimer and animals, often 
with
great results.

I attended the Paris conference off Midwifery Today. I met  midwifes from
over the world, also your collegues of Australia. I loved to be with them,
to share storys, to learn from experiences. It was warm and beautifull to
see that worldwide midwifes are standing up and struggle for their
profession. We still have a long way to go and Belgium is just at the start
of growth.

Warm greetings
Lieve

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RE: Midwives Support Picnic & Rally - Geelong

[Johnston]

It was a great picnic, with big banners and tents and tables and lots of 
people.
Wonderfully organised Sally Anne, Sally, and everyone else. The singers and 
speakers were very good, and the way the PA system was placed on the band 
stand, overlooking the park, added to the impact. It was good to meet some 
of the 'names' on this list, who I hadn't previously met.  Well done.
Our towns and cities have lovely parks and gardens, and we ought to be out 
there, getting the message out about birth reform. I only wish I could have 
been at the Newcastle one too! When/where is the next public gathering?
Joy Johnston

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RE: Radio National Today

[Johnston]

Well done Justine!
I can't believe that people would approve of this inequitable baby bonus 
scheme that the Libs have put up!  Are they trying to buy off the young 
couples/families' votes?  When will the message be got across that it 
should be the consumer, not the provider of the service, that decides what 
they want (and that's straight from Trades Practices Act/ Competition 
Policy stuff)???
Also all the policies directing funds to private hospitals (read big 
business) and running down the public hospitals.  Where will it all end?

I am worried.
Joy Johnston

-Original Message-
From:   Justine Caines [SMTP:[EMAIL PROTECTED]]
Sent:   Monday, October 29, 2001 9:57 PM
To: OzMid List
Subject:Radio National Today

Hi All

It seems I was lucky enough to get on "Australia Talks Back" this afternoon
and got half a question to Wooldridge and Macklin.  I mentioned that I was 
a
member of Maternity Coalition and that we had met with both their offices
and that neither of them had taken our issues seriously.  I also got it 
that
childbirth is the most important reason for hospitalisation in the country
and that very little has come from all the inquiries!  I was then cut off
and I was sorry I didn't get to mention COST!!

Anyway.  For those who didn't hear it Wooldrige gave that crap line about
psysiotherapists and chiropractors and that he wasn't prepared to fund
midwives.  Macklin gave the mirror answer, looking into it!

I am posting this because (if that pathetic gov is returned and as they are
campaigning on the backs of dead people they proabably will) they need to 
be
taken to task on this utter garbage.  We are talking LIKE services and the
pregnancy and birth of a baby no matter what!! Even so Wooldrige went on to
say with other callers that Medicare was too Doctor focussed and he was 
glad
to offer services to Psychologists for non-drug related therapy etc and 
that
a model of wellness and preventative care were important to the Gov!!  Yeah
but let's not take a cent from the Obstetricians.

Angry and Praying for a Labor Gov with some Greens and or Democrats to keep
the Bastards honest!!

Justine Caines
Maternity Coalition - ACT Branch
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RE: Newborn footprints

[Johnston]

My first 3 babies were footprinted at birth (ie before I was able to hold 
them!) as part of identification.  They were born in Lansing, Michigan, in 
1973, 75, and 77.  I was given birth certificates with the footprints - and 
presumably could use these as proof if there was any question of 
baby-swapping.
Joy J

-Original Message-
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Tuesday, October 30, 2001 8:05 PM
To: [EMAIL PROTECTED]
Subject:Re: Newborn footprints



I haven't been able to find much published on the subject of newborn
foorprinting for security purposes on our midwifery database. Apart from a
couple of anecdotal items from the mid 90s, the only article evaluating its 
use
is:

Butz AM, Oski FA, Repke J et al. Newborn identification: compliance with 
AAP
guidelines for perinatal care. Clinical Pediatrics, vol 32, no 2, Feb 1993, 
pp
111-113.

Kathy Levine
Infornation Officer
MIDIRS
9 Elmdale Road
Bristol BS8 1SL
England

Tel: 0117 925 1791
Fax: 0117 925 1792
Website: www.midirs.org
E-mail: [EMAIL PROTECTED]


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birth stories

[Johnston]

I have recently uploaded a couple of new birth stories to my website. 
 These are wonderfully poignant accounts written by the mothers of babies 
Kobi (born at home) and Lois (born in hospital).

Joy
www.aitex.com.au/joy.htm

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RE: Nurses Board of Vic

[Johnston]

Dear Bronni
It's great to hear of your meeting in Healesville.
I'll have a go at answering your questions.  Although I am a member of the 
Board (I think I'm the only one on this list), I am also finding the whole 
PI insurance issue very difficult.
The Victorian Nurses Act 1993 has recently been amended, and the amendments 
have come into effect 1 Nov.
The new section 5 (3) (d) states:
[The Board] "may require the applicant [for registration] to provide 
evidence that the applicant is or will be covered by professional indemnity 
insurance that meets the minimum terms and conditions set out in guidelines 
of the Board."

Does this mean the Board can deregister someone (ie an independent midwife) 
who is not insured?  It probably does.  I have been assured that it's a 
DISCRETIONARY power - but even that doesn't make me feel very comfortable. 
 It will probably begin to take effect as people apply for endorsement as 
Nurse Practitioners, if they want to work outside the hospital system.
(for those in other places, the NP endorsement will enable a person to have 
extended practices  - prescribe, order tests, refer to specialists.)

I believe we need to get insurance.  ACMI members would have received a 
discussion paper and ballot to return, so that we can choose option 1 or 
option 2.  I and other independent midwives look forward to resolution of 
that issue, as it's the only insurance on offer at the moment.  I hope 
AHMAC (health ministers advisory c'tee) under whatever new government gets 
up on Saturday will set up a system of no-fault insurance similar to what's 
done in NZ.  I see no future with spiralling costs for insurance.

Doctors who belong to the Medical Defence Association of Victoria (an 
insurer) have already been told:
"Warning to members in obstetric shared care.
Members should be aware of the recent decision of Guild Insurance to 
withdraw the provision of indemnity to midwives.  This may spell the end to 
midwife-supervised home deliveries as a choice for the community."
The statement goes on to warn members against working with uninsured 
midwives! (Medical Defence Update newsletter, Winter 2001)

Consumers and midwives need to consider what this means, and keep on 
working together to resolve the PI crisis.
Joy Johnston
-Original Message-
From:   Steve & Bronni McGrath [SMTP:[EMAIL PROTECTED]]
Sent:   Thursday, November 08, 2001 2:03 PM
To: list
Subject:Nurses Board of Vic

 << File: ATT6.htm >> i spoke recently at a community forum in 
Healesviile where local hopefuls for the up coming election had been 
invited to hear what we really think about some gritty issues ( minus the 
Liberal candidate who was unable to attend or send someone in her place ). 
 As a result Jim Romagnesi ( Greens ) forwarded me their recent press 
release on backing for midwives which included this paragraph:

> The Greens Victoria have thrown their weight behind the states midwives
> following the ongoing crisis with professional indemnity insurance and 
the
> recent announcement from the Nurses Board of Victoria that they will have
> discretionary legislative powers from November to deregister any nurse or
> midwife who practices without adequate professional indemnity insurance.

could some kind person please inform me as to what this actually means and 
is this just recent and how come as a registered nurse i have not been 
informed by the NBV?  i'm feeling a little scared but i sense that this may 
be sensationalism of legal wording ( i hope)

thanks to you all
Bronni McGrath
Mum, Midwife and Supporter

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RE: Social Justice - Women and Birthing First! Vote 1 Democrats

[Johnston]

Not sure what the appropriate greeting is here, but my best wishes to you 
Carolyn in the election (I don't think it's luck).  Also to other 
candidates who will support total reform of the maternity system in this 
country, and enable women to choose what they think is best for them.
Joy Johnston
-Original Message-
From:   Heartlogic Consultancy [SMTP:[EMAIL PROTECTED]]
Sent:   Thursday, November 08, 2001 1:58 PM
To: Ozmidwifery
Subject:Social Justice - Women and Birthing First!  Vote 1 Democrats

 << File: ATT5.txt; charset = Windows-1252 >>
Dear all,

Have been busy of late, so haven't been able to contribute to the list 
-apologies for that.

I'm writing on the eve of our Federal Election to ask you to vote 1 (in 
both the lower and upper houses)  for the Democrats this election.

This election is vital - consider what kind of Australia you want.

Do you want the manipulation of prejudice, lack of cultural sensitivity and 
policies that give a fair go to the elite and discriminate against the 
poor, the vulnerable and the weak?

(Not me!!!)

Do you want an Australia that is able to  pride it self on its compassion, 
it's sound and just social policies, it's effective and intelligently 
funded public utilities and its strong, vibrant, creative, inclusive 
leadership?

(I certainly do!)

The Democrats have midwifery (and nursing) as a key issue in its health 
policy.  The Democrats recognise the importance of midwifery care for women 
and babies health status (so much so that I decided to become a member and 
a candidate for my local area).

The Democrats call for a change in politics -  about finding positive 
solutions and achieving them working together as a nation, community by 
community - creating the Australia we want over the next 30 years - not 
just the next three years.

The Democrats are well known for our traditional role in the Senate - 
providing a check on executive power and encouraging transparency  and 
accountability in Government dealings.   The Democrats have always been
years ahead in regards to protection of the environment, respect for human 
rights, social justice issues; reconciliation and a sustainable economy.
The Democrats are committed to top quality public eduction and primary 
health care.

Please take time to have a look at the Democrat policies and issue sheets.
Go to www.democrats.org.au and look up the campaigns  - check the health
policies, you will be delighted with what you find there.

Towards a brilliant, hope filled future for women, men and children across
Australia!

Carolyn Hastie (Democrat candidate for Dobell)

 "No pessimist ever discovered the secrets of the stars, or sailed to an
uncharted land, or opened a new heaven to the human spirit"
 Helen Keller
Coast Homebirth
Midwives in Private Practice

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Our Business is Progressive Personal Development.
Our Strength is our people.
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RE: from the greens website

[Johnston]

This press release is past history now.  Let's work on towards ".. 
supporting
and strengthening the family unit, by providing fully funded community
midwifery models of care such as those in WA, SA and the ACT. Our
governments should provide no-fault PI insurance for all midwives, as is
done in New Zealand".

BUT
I want to make it clear here that the legislation requiring midwives and 
registered nurses to have PI insurance was in the pipeline for years, and 
is consistent with model legislation for all health professions.  It's 
supposed to protect the public!  The Nurses Board has had a part in this, 
as has many other organisations and individuals.  So please understand that 
it's not the Nurses Board that took the 'radical step'.  Noone thought it 
was radical, and we all had insurance, so we all agreed it was a good ideal 
 The Nurses Board is only the messenger - the means by which the wishes of 
the community (via our government) are carried out.


The Geelong picnic was a wonderful, colourful, happy gathering.  The 
speakers and singers were great.  I have a bunch of photos to remind me. 
 But so far we haven't made any changes that I can see. Let's not give up, 
but realise that we are working against entrenched community attitudes that 
have been shaped over generations.
Joy Johnston

-Original Message-
From:   Sally Westbury [SMTP:[EMAIL PROTECTED]]
Sent:   Monday, November 12, 2001 7:41 PM
To: Sally-Anne Brown
Cc: [EMAIL PROTECTED]
Subject:from the greens website

 << File: spacer_green.gif >>
Greens back State Midwives



27 October 2001

The Greens Victoria have thrown their weight behind the states midwives
following the ongoing crisis with professional indemnity insurance and the
recent announcement from the Nurses Board of Victoria that they will have
discretionary legislative powers from November to deregister any nurse or
midwife who practices without adequate professional indemnity insurance.


The Greens Otways Branch Convenor Sally-Anne Brown, together with Sally
Westbury (Independent Midwife, Geelong) have co-ordinated a picnic and
support rally for the state's midwives this Sunday at Johnstones Park
Geelong 11am -3pm, to protest against the lack of state and federally 
funded
insurance coverage for Victoria's midwives and the radical step that the
Nurses Board of Victoria will introduce next month.

"It is completely unacceptable that at a time when there is so much
uncertainty in the world, that families are now being further compromised 
by
being told that their midwives may not be able to attend as their primary
caregiver due to lack of insurance. It is also unreasonable that the Nurses
Board of Victoria are now jumping on the bandwagon, threatening to
deregister midwives, further inflaming a situation that they could have
actively defused, by supporting their midwives as well as the families they
care for", Ms Brown said.

"It is this top down effect, that the bureacrats effectively impose on
childbearing women that has gone too far. The focus should be on supporting
and strengthening the family unit, by providing fully funded community
midwifery models of care such as those in WA, SA and the ACT. Our
governments should provide no-fault PI insurance for all midwives, as is
done in New Zealand". Ms Brown said.

The rally will attract up to 300 midwives and families from all around
Victoria. There is free childrens entertainment, live bands, featuring a
special appearance from the "Stiff Gins" and guest speakers include Vanessa
Owen (ACMI, president), Dr Peter Lucas (Wattle Park House), Scott Kinnear,
(Vic Greens Lead Senate candidate) and Gavin O'Connor MP, Corio.

"This rally is a symbolic and strong gathering for the families of the
future and the midwives who have cared for them. It is a first for 
Victorian
midwives and I anticipate it will be the spark that will light a candle for
ongoing support for our midwives for a long time to come. We don't need the
'out of control fires of the NBV and Insurance companies'. It is a time for
calm, clarity and adequate funding to strengthen
midwifery care for all families."


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RE: Update of Australian Midwifery Campaign Brochure

[Johnston]

Dear Denise
I hope you don't want me to answer your string of questions one by one.
Yes, the boundaries of the campaign are as wide as we ourselves make them. 
Anyone who belongs to a play group, a farmers union, a church ladies guild, 
ABA or whatever can approach that group with a simple request that the goal 
of the midwifery campaign be endorsed, and that this be minuted.  If the 
news finds its way back to me, I will gladly put it on the brochure.
As far as WHO, ILF, and NHMRC are concerned - AS IF!  What about AMA, 
RANZCOG, and all the rest? Please prove me wrong!
Joy

-Original Message-
From:   Denise Hynd [SMTP:[EMAIL PROTECTED]]
Sent:   Monday, November 12, 2001 10:59 PM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject:Re: Update of Australian Midwifery Campaign Brochure

Dear Joy
Will ACMI put a brochure and article in their news to every member asking
them to collect signatures and seek the support of other groups to which
they belong such as Playgoups, other female unions


What about ABA could they be persuaded to be supportive put a brochure &
article  in their newsletter - there is a precedent, I remember they had a
postcard to send to Carmen Lawrence when she was Mins of Health seeking
midwifery options!!

Also  ACMI could get the support of the all the other "nursing" groups eg
ANF, CNA, and other female unions and the support of the TLC?? ?

As WHO recognises midwives as the appropriate carers for healthy women the
endorsement of WHO, ILO, Unicef etc could be a goal & something to go to 
the
governmemnts with??
And whilst we are there NHMRC and every other group who has had review into
Australian maternity services could also endorse the campaign??!!

Now there some supporters to put on the brochure which would have to be a
booklet??

Denise
Also
- Original Message -
From: "Johnston" <[EMAIL PROTECTED]>
To: "ozmidwifery list (E-mail)" <[EMAIL PROTECTED]>
Cc: "ACMI (E-mail)" <[EMAIL PROTECTED]>
Sent: Monday, November 12, 2001 7:43 AM
Subject: Update of Australian Midwifery Campaign Brochure


> Dear listfriends
> The Brochure of the Midwifery Campaign is due for updating, and my 
current
> plan is to make one brochure that can be used across Australia (rather
than
> keeping the State brochures), with space for local contact details to be
> added by a stamp or sticky label (or hand written).  It is hoped that
these
> brochures will then be copied by the 100s, and put out for people to take
> wherever people gather.
> The new brochure will list groups that have stated their support.  If you
> know a group or organisation that is not listed below, and you would like
> to have it listed, please forward this message on to the leader(s), and
> request their response. All we ask is that the group agrees with the goal
> of the Australian Midwifery Campaign, and makes an effort to support the
> movement:
> "TO ACHIEVE FOR ALL WOMEN THE RIGHT TO CHOOSE A MIDWIFE AS THEIR PRIMARY
> CAREGIVER DURING PREGNANCY AND BIRTH WITHIN THE HEALTH SYSTEM (PUBLIC AND
> PRIVATE) WHETHER IN THE COMMUNITY OR HOSPITAL"
> Please take up the challenge to follow up on this if you can.  Every 
group
> that has a commitment to women and families is welcome to add their
support
> to this campaign.  We need indigenous women's groups, breastfeeding
groups,
> country groups, education groups ... (the font will get smaller as we add
> more to the list!)
> (for further detail check out www.maternitycoalition.org.au )
>
> This is the list as it stands.  (If any group is named, and wants to be
> removed (?) please let me know)
> The Maternity Coalition and the Australian College of Midwives (ACMI),
> representing national consumer and professional bodies committed to
> improving maternity services in Australia, jointly host the Australian
> Midwifery Campaign.  The following organisations and groups (in alpha
> order) have stated that they support the Campaign:
> ACE Graphics
> ACMI Branches
> ASIM (Aust Society of Independent Midwives)
> AIMS Australia (Assoc for Improvements in the Maternity Services)
> AMALG Australian Midwives Act Lobby Group
> Birthing Options Geelong
> Birthrites: Healing after Caesarean Inc
> Birth Matters SA
> CARES SA (Caesarean Awareness Recovery Education and Support)
> Childbirth Information Service (NBAI Tas)
> Choices for Childbirth (Vic)
> Colac Otway FAB (Families and Babies) (Vic)
> Community Midwifery Program WA
> Homebirth Access Sydney
> Homebirth Australia
> Homebirth Network of SA
> Maternity Coalition ACT Branch
> Mercy Birth Centre Family (Vic)
> Midwives in Private Practice (Vic)
>
>
> I appreciate your help with this update.  The Midwifery Campaign has no
> office or workers - it's up to you and

RE: Third stage

[Johnston]

A story from me:
I don't want to minimise the importance of what you and others have been 
saying Jan, and I agree that sharing our stories does make us feel 
vulnerable at times.
I found that sometimes I worry about these things unnecessarily.
The woman had given birth at home to her 7th beautiful healthy baby.  This 
was her first planned homebirth.  Two hours after the birth she was sitting 
in a lounge chair, just soaking up the delight of the moment.  Placenta was 
still in, and cord not cut.  There had been no bleeding.  I had spoken a 
few times about getting the placenta out, but evidently my words had gone 
over her.  I cleared my throat and gently informed her that I really needed 
to recommend a dose of syntocinon and controlled cord pressure (I believe 
that it would be dangerous to pull in a grand multi without synt), and if 
it wouldn't come we would have to bundle up and transfer to hospital 
blahblah.
Karen seemed to come out of her trance, looked straight at me and said, a  
 little puzzled, and said "If I stand up it will come".  And it did.
Silly me.
That was some time ago, and many of you wise women out there probably know 
how to work with the woman better than I did then.  I was worrying 
needlessly.  Learning to deal with third stage, and not be afraid, has been 
one of the most significant learning experiences for me in becoming an 
independent midwife.
Joy Johnston
-Original Message-
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Tuesday, November 13, 2001 5:32 AM
To: [EMAIL PROTECTED]
Subject:Re: Third stage

 << File: ATT5.htm >> To really share is difficult at times but the 
same fear emerges for me re transfer age I think 1 hr is normal I think at 
2 hrs if third stage del soon great but if I wait any longer the facility I 
transfer to will be punitive to my client. So off I go. I have trans fered 
once at 1.5 hrs and negotiated for spinal for manual , not happy jan and 
the placenta was picked out bit bt bit I truly believe it would not have 
come and I'm glad I didn't wait longer.
A collegue braver than I waited 7 hrs and it still didn't happen of to hosp 
were they were not sweetness and light neither werethe parents  once they 
teamed up with the doctors and heard about the danger they had been 
submitted to.

In a nutshell if the woman is well NO TIME LIMIT BUT YOU HAVE TO FACE 
GREATER HOSTILITY THE LONGER YOU DELAY TRANSFER SORRY TO SAY.
I GUESS IT'S GOOD TO ADMIT THAT MIDWIVES ALSO HAVE THEIR OWN NEEDSjan
  - Original Message -
  From: Sally Westbury
  To: ozmidwifery
  Sent: Monday, November 12, 2001 7:42 PM
  Subject: Third stage


  How long is the longest people have waited patiently for a placenta to 
arrive when there was no bleeding??

  Sally Westbury

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RE: Update of Australian Midwifery Campaign Brochure

[Johnston]

Denise I totally support these goals.  Are you going to take these on as 
your project?  I am happy to support you, share any information, review 
drafts of letters &c for you or anyone else who is prepared to direct their 
efforts towards the achievement of the goal of the midwifery campaign.
You think pigs might fly?  I remember also the saying of throwing pearls 
before swine, and try to direct my pearls strategically.
Joy


-Original Message-
From:   Denise Hynd [SMTP:[EMAIL PROTECTED]]
Sent:   Wednesday, November 14, 2001 5:46 PM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject:Re: Update of Australian Midwifery Campaign Brochure

Dear Joy
All right let us at least start with 2 which are possibly acheivable now 
and
maybe one day we may be in the realms of flying pigs or at least where our
kiwi sistera ar?

1) Get ACMI to put a new brochure and article in their news to every member
asking them to collect signatures and seek the support of other groups to
which  they belong such as Playgoups, other female unions!

2) Work on persuading ABA to be supportive (understand they have their AGM
coming up soon in Melbourne - get ABA to put a brochure &
> article  in their newsletter - there is a precedent, I remember they had 
a
> postcard to send to Carmen Lawrence when she was Mins of Health seeking
> midwifery options!!

a lover of flying procine
Denise

- Original Message -
From: "Johnston" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, November 13, 2001 12:16 PM
Subject: RE: Update of Australian Midwifery Campaign Brochure


> Dear Denise
> I hope you don't want me to answer your string of questions one by one.
> Yes, the boundaries of the campaign are as wide as we ourselves make 
them.
> Anyone who belongs to a play group, a farmers union, a church ladies
guild,
> ABA or whatever can approach that group with a simple request that the
goal
> of the midwifery campaign be endorsed, and that this be minuted.  If the
> news finds its way back to me, I will gladly put it on the brochure.
> As far as WHO, ILF, and NHMRC are concerned - AS IF!  What about AMA,
> RANZCOG, and all the rest? Please prove me wrong!
> Joy
>
> -Original Message-
> From: Denise Hynd [SMTP:[EMAIL PROTECTED]]
> Sent: Monday, November 12, 2001 10:59 PM
> To: [EMAIL PROTECTED]
> Cc: [EMAIL PROTECTED]
> Subject: Re: Update of Australian Midwifery Campaign Brochure
>
> Dear Joy
> Will ACMI put a brochure and article in their news to every member asking
> them to collect signatures and seek the support of other groups to which
> they belong such as Playgoups, other female unions
>
>
> What about ABA could they be persuaded to be supportive put a brochure &
> article  in their newsletter - there is a precedent, I remember they had 
a
> postcard to send to Carmen Lawrence when she was Mins of Health seeking
> midwifery options!!
>
> Also  ACMI could get the support of the all the other "nursing" groups eg
> ANF, CNA, and other female unions and the support of the TLC?? ?
>
> As WHO recognises midwives as the appropriate carers for healthy women 
the
> endorsement of WHO, ILO, Unicef etc could be a goal & something to go to
> the
> governmemnts with??
> And whilst we are there NHMRC and every other group who has had review
into
> Australian maternity services could also endorse the campaign??!!
>
> Now there some supporters to put on the brochure which would have to be a
> booklet??
>
> Denise
> Also
> - Original Message -
> From: "Johnston" <[EMAIL PROTECTED]>
> To: "ozmidwifery list (E-mail)" <[EMAIL PROTECTED]>
> Cc: "ACMI (E-mail)" <[EMAIL PROTECTED]>
> Sent: Monday, November 12, 2001 7:43 AM
> Subject: Update of Australian Midwifery Campaign Brochure
>
>
> > Dear listfriends
> > The Brochure of the Midwifery Campaign is due for updating, and my
> current
> > plan is to make one brochure that can be used across Australia (rather
> than
> > keeping the State brochures), with space for local contact details to 
be
> > added by a stamp or sticky label (or hand written).  It is hoped that
> these
> > brochures will then be copied by the 100s, and put out for people to
take
> > wherever people gather.
> > The new brochure will list groups that have stated their support.  If
you
> > know a group or organisation that is not listed below, and you would
like
> > to have it listed, please forward this message on to the leader(s), and
> > request their response. All we ask is that the group agrees with the
goal
> > of the Australian Midwifery Campaign, and makes an effort to support 
the
> > movement:
> > "TO ACHIEVE FOR ALL WO

maternity coalition annual dinner 24 Nov

[Johnston]

PLEASE RESPOND IMMEDIATELY (email reply is OK - post will take too long)
If you are planning to come to the dinner
At Box Hill Community Arts Centre
24 Nov, from 6.15 pm
(details have been posted previously, but can be sent again if you request)
Great food, good company, entertainment, and a special visit from Barb 
Vernon  and Justine Caines who will represent the ACT branch of Maternity 
Coalition.

ALSO
AGM at 5.30 pm.
The Maternity Coalition is an incorporated group, and a registered charity. 
 The AGM is held in accordance with the law, and includes reports and 
election of the officers for the coming year.  In this the year of the 
volunteer, MC is an example of volunteer commitment to a very important 
cause.
If you are a member and can't attend the meeting, please reply with your 
apology.  Otherwise, it appears that you don't care.  (attendance at the 
AGM without staying for the dinner is OK, but of course we would prefer to 
have you stay on!)

Please reply by email or phone or fax:
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448



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FW: WOMEN'S HEALTH MAC consultations

[Johnston]

Victorian women please note:

-Original Message-
From:   Absolute [SMTP:[EMAIL PROTECTED]]
Sent:   Friday, November 16, 2001 2:23 PM
To: (Recipient list suppressed)
Subject:WOMEN'S HEALTH MAC consultations

PLEASE CONTACT EMMA GLOUFTIS ph (03) 9616 8047 FOR MORE DETAILS
The Ministerial Advisory Committee on Women's Health & Wellbeing want women 
to participate the the development of the Victorian Women's Health & 
Wellbeing Strategy.  A discussion paper has been developed for input. (the 
paper can be accessed at www.women.vic.gov.au)  Also if you book into a 
consultation Emma will send you a copy.
Attached are the details of statewide consultions & times.

1 November 2001

Dear Women and Service Providers,

On behalf of the Ministerial Advisory Committee on Women's Health and 
Wellbeing (MACWHW) and the Department of Human Services, we are writing to 
invite you to participate in the development of the Victorian Women's 
Health and Wellbeing Strategy (WHWS).

The WHWS is a commitment by this Government to develop a policy and 
strategy that aims to:
* Improve the health and wellbeing of Victorian women, particularly those 
most at risk; and
* Provide a policy framework for planning, funding and delivery of services 
to women in relation to their health and wellbeing

Over the past months the MACWHW has been consulting with 5 population 
groups of women who previously have not been consulted fully or whose needs 
have been under researched.  These are Koori women, women with 
disabilities, working women (paid and unpaid), women in and post release 
from prison and lesbians.

We have now analysed that information, added to it the material gathered 
from previously held consultations and areas of research, to develop a 
Discussion Paper.  The paper outlines key action areas, principles and 
possible directions and strategies for feedback.  These directions and 
strategies aim to target those population groups and issues which most s  
ignificantly affect the health and wellbeing status of women.

We would like to hear your thoughts on the paper in general, and answers to 
the questions that will be explored in the forthcoming workshops.

To this end, we are holding 14 consultations across Victoria in November 
and December.  A schedule of those consultations is attached to this 
invitation and we would welcome your involvement.  Childcare, transport, 
interpreters and catering will be provided with adequate notice.

Please respond to Emma Glouftis on (03) 96168047 before 4pm by the required 
RSVP date listed on the schedule to confirm your attendance and your 
requirements for the day.  You will be sent a copy of the Discussion Paper, 
which you can also access on www.women.vic.gov.au

We look forward to meeting with you and working with you to further improve 
the health and wellbeing of Victorian women.

Yours sincerely,

The Hon Caroline Hogg MP
Chair
Ministerial Advisory Committee on Women's Health and Wellbeing



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group midwifery care/discussion

[Johnston]

NEXT GROUP GATHERING

WED 5 DECEMBER, 1pm - 3pm
FIRST Wednesday OF EACH MONTH, 1pm to 3pm, at my house, 25 Eley Rd 
Blackburn South
You may need to park your car on a side street nearby.
[Except January, when I plan to have the group Wed 9 Jan]

Women who are pregnant, or have recently had a baby, are welcome to come to 
this monthly group gathering.  Also women who are interested in becoming 
midwives, or extending their midwifery skills to independent practice.

A nominal charge of $10 is made for the session.



Please pass this message on to anyone who might want to know about it.

Sincerely
Joy
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


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RE: ACMI provides midwives with legal benefits and insurance options

[Johnston]

Vanessa
Please progress negotiations to a point where there is a firm offer of PII 
for all members.

The interests of all members need to be taken into account.  Each of the 
options discussed seems to have some merit, and the people who have taken 
the responsibility of acting on behalf of the college will eventually have 
to make up their minds as to the better option - unless a decision is made 
to put the issue to a postal vote of all members.   I will not be able to 
say if I think the offer is good until I have seen it in print and can have 
it checked by an independent and suitably qualified person.

Joy Johnston

-Original Message-
From:   austmid [SMTP:[EMAIL PROTECTED]]
Sent:   Friday, September 28, 2001 11:32 AM
To: ozmidwifery
Subject:ACMI provides midwives with legal benefits and insurance options
Importance: High

 << File: ATT4.htm >>
 
  
 Information re

 Legal Benefits & Indemnity Insurance for Midwives

   from the

   Australian College of Midwives Incorporated.




The Australian College of Midwives Incorporated (The College), has 
negotiated two options of indemnity insurance and legal benefits for its 
members, and the wider midwifery community, to consider.


The withdrawal of indemnity insurance from midwives has threatened the very 
essence and autonomy of the midwifery profession and choice for women 
across Australia. Women are now facing increasing lack of choice regarding 
options for maternity care including choice of practitioner, choice of 
place of birth, and the ability to make informed decisions about their 
pregnancy and childbirth care.

The College is keen to consult with as many midwives as possible about 
these options before making a decision. This consultation process was 
commenced at the recent ACMI National Biennial Conference in Brisbane, 
September, 19 - 21, 2001.


At this meeting it was agreed that this issue affects all midwives, 
regardless of place of practice or employment, as it strikes at the very 
heart of the autonomy of midwives practice and the issue of choice for 
women.

The option favored at the Biennial Conference was where all midwives, 
regardless of place of practice pay a nominal amount for the benefits of 
legal benefits and indemnity insurance.


The legal benefits would include access to legal advice and representation 
at any inquiry into the professional ability of a midwife to practice, such 
as nurses boards, coronial inquiries etc. Other legal benefits are also 
being negotiated for members, such as free advice on a variety of personal 
issues as members require.


The issue of indemnity would enable midwives to work either within an 
employment model, such as in a hospital, or privately, such as a midwife in 
private practice. Those who work in a combination of the systems would also 
be covered. Indemnity would range from $2,000,000 up to $10,000,000 
depending on the model of practice. Indemnity would be provided for 
midwives who also work as Registered Nurses within their work setting.

The other option discussed at the Conference was where midwives who are 
privately employed pay extra to the midwives who are employed in a hospital 
setting. The legal benefits cover would be the same. While this option was 
considered, it was not regarded by the members present as the most 
beneficial to the profession of midwifery.

The College does not have these options finalized as yet. The consultation 
process with the members and the wider midwifery community will continue to 
ensure that the option decided on will best represent the views of midwives 
throughout Australia.

The College will also progress the work of negotiating with federal and 
state governments to provide subsides for midwives in relation to indemnity 
insurance.

Further information will be available on the acmi website ( 
www.acmi.org.au) next week and in the next edition of the Australian 
Midwifery News.

If you require further information please contact the National Office of 
the Australian College of Midwives Incorporated on 03 9804 5071, 1300 360 
480 or [EMAIL PROTECTED] I can be contacted on 0417 544 824 or 
[EMAIL PROTECTED]


Yours in midwifery

Vanessa Owen

National President

ACMI


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WABA GLOBAL FORUM 2002

[Johnston]

Preliminary Announcement - Save the Dates!

Nurturing The Future:
Challenges to Breastfeeding in the 21st Century

WABA GLOBAL FORUM 2
23-27 September 2002, Arusha, Tanzania

The Key Facts

The World Alliance for Breastfeeding Action (WABA) announces plans to hold 
their Second Global Forum entitled Nurturing the Future: Challenges to 
Breastfeeding in the 21st Century. The Forum will bring together a diverse 
group of individuals and organisations and provide a unique opportunity  to 
discuss, review and formulate strategies to improve infant and young child 
health, nutrition and care through the protection, support and promotion of 
breastfeeding, with the focus on the community.

Forum 2 will focus on:
* Research which provides the evidence base for appropriate actions
* Capacity building to enable groups to implement more effective actions
* Popular mobilisation to ensure that actions are community and 
people-centered

With its African venue, Forum 2 will focus on lessons the rest of the world 
can learn from this unique and age-old breastfeeding culture and ways of 
protecting it from today's threats, varying from the baby food industry and 
its exploitation of the HIV/AIDS issue to globalisation and free 
marketeer's efforts to destroy the Code. The Forum has been planned with 
assistance, funding, and enthusiastic support of a host of groups involved 
in the breastfeeding and allied movements, including women, environment, 
consumer, human rights and food security groups.

. . . What?
The two main goals of the Second WABA Global Forum are:

* To provide an opportunity for rallying worldwide participation in the 
movement to protect, support and promote breastfeeding and childcare;
* To spread awareness on the rights of children and women to adequate food, 
health and care especially in developing countries.

. . . Where?
Forum 2 will be held in the city of Arusha in northern Tanzania. With a 
temperate climate and its location close to Mount Kilimanjaro, the city 
offers excellent conference and hotel facilities and is close to 
world-famous attractions such as Serengetti National Park and the Ngorogoro 
Crater.

. . . Who?
WABA invites participation from individuals and groups interested in the 
topics of Forum 2, ranging from women, children, environmental and consumer 
groups, to individuals such as health workers and young people. There will 
be a strong training and capacity building focus. The presence of many 
experts in the fields of health and nutrition, child care and community 
participatory action will make it possible to share skills and knowledge 
about advances along a wide front.


Key Issues

The thrust of the Forum programme is on the primary goal of the Innocenti 
Declaration: all women should be enabled to practise exclusive 
breastfeeding for six months and to continue to breastfeed while providing 
appopriate complementary foods, for up to two years of age or beyond. WABA 
aims to do this through strengthening the four Innocenti targets and 
addressing key issues:

* HIV/AIDS
A strategy to strengthen the protection, promotion and support of 
breastfeeding in the face of HIV/AIDS.

* Maternity Protection
Inspiring the development of regional and national strategies for 
implementing the new ILO Convention 183 on Maternity Protection by 
promoting its ratification. Also strengthen maternity protection among 
women working in the informal sector.

* The Code
Continue to strengthen the promotion of the International Code of 
Marketing of Breastmilk Substitutes in the face of the baby food industry's 
recent marketing initiatives (such as new ways of marketing via the 
Internet, and promotion during emergencies). Adopting the Code is part of 
governments' obligation when they implement the Convention on the Rights of 
the Child (CRC).

* Mother Support
Recognise and strengthen mother support groups and other community based 
support systems.  WABA is developing a Global Initiative on Mother Support 
(GIMS) as a means to build support from the grassroots as well as from 
international organisations to foster global initiative to support women 
throughout their reproductive cycle and in particular before, during and 
after birth. GIMS aims to link with the UNICEF CARE Initiative and other 
relevant international programmes and initiatives.

* BFHI & Birthing Practices
Extend the Baby-Friendly Hospital Initiative (BFHI) to include good 
birthing practices in order to transform the BFHI into a Mother-Baby 
Friendly Initiative. Work with UN agencies and others to develop new 
guidelines for maternity care and a joint declaration for maternity.  BFHI 
practitioners have noted that poor birthing practices lead to poor 
breastfeeding initiation.


What's New

* This Forum will expand the horizons for the breastfeeding movement, 
moving us into unchartered territory and linking us with new partners.

* Our African venue will lend an African perspect

RE: independent midwives

[Johnston]

Yes, there are quite a few groups of independent midwives around the 
country.
I will forward this request to the midwifery chat line and am sure you will 
get some responses.  The group in Victoria, which I am personally involved 
with, is Midwives in Private Practice, which is a member group of the 
Maternity Coalition Inc.
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


-Original Message-
From:   Connolly, Belinda [SMTP:[EMAIL PROTECTED]]
Sent:   Wednesday, November 28, 2001 12:07 PM
To: '[EMAIL PROTECTED]'
Subject:independent midwives

Hi,
I'm a journalist for Practical Parenting magazine and I'm trying to find an
independent midwives association. Are you aware of such group? I'd really
appreciate if you could provide me with a contact number, or website
address.

Cheers,
Belinda

Belinda Connolly
Writer / Sub-editor Practical Parenting
Level 2
Stockland House
181 Castlereagh St
Sydney 1028
02 9288 9608



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maternal deaths report

[Johnston]

Dear ozmidders
I have read this report and found it quite stimulating.  It took a good day to get 
through.  I would encourage others to do likewise. 
Here's the NHMRC site address for those who want it.

http://www.nhmrc.gov.au/publications/pdf/wh32.pdf 

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RE: farewells

[Johnston]

Sincere thanks to all who sent messages of love and support.
I was able to say goodbye and be with my father in his dying (age 90). 
 This was a precious time - another basic life event.

The baby I was waiting for was born at home, as I was travelling up the 
Newell Highway.  My colleagues Michelle Carrucan and Annie Sprague and Sue 
Budge stood in for me and gave me peace about leaving. My very special 
thanks to you.

We had planned a family reunion this past weekend at Mount Tamborine, for 
my 5 sisters and my brother and me, our partners and all our 23 children 
(and their grandpa).  The reunion went ahead, though not as we had planned. 
 The young ones particularly have come away knowing and loving each other 
in a very special way, from this shared experience.

Now I'm back home and 'at work'.  If anyone has been trying to contact me, 
please have another go.

I am looking forward to seeing those who are able to be with me for the 
Midwifery Discussion Group advertised in Birth Matters
this Friday 12 Oct (7pm for a 7.30 start)
at my place 25 Eley Rd  Blackburn South Vic  Tel:03 9808 9614, M: 04111 
90448
Topic: Accountability and Peer Review
ALL welcome.

Joy Johnston

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national homebirth awareness week 25-31 October

[Johnston]

G'day
Several people have asked me if the midwifery campaign has posters that 
express the goal of a known midwife and choice of place of birth.

We don't, but that shouldn't stop anyone from making up their own.

My suggestion is that anyone who has the computer capacity and know-how (or 
children/friends/partner) should make up posters (A4 pages can be 
enlarged).  The posters should have a simple message such as a quote from a 
woman as to why she chose to plan homebirth.
"I chose homebirth because ..."
Here are a couple of examples:

"I chose homebirth because I want safety for myself and my baby."
"I chose homebirth because giving birth is one of the most intimate and 
important acts I will ever engage in."
national homebirth awareness week
25-31 October
[insert your local homebirth/maternity group's contact number]

If you like this idea, and are able to make up some posters, please 
consider sharing your ideas via this list.  Some people who can't do it for 
themselves may want to have copies made and posted to them, so you would 
need to set a fee to cover your costs.  Also some might be prepared to 
share photos.  Some of the photos on my website would be suitable, and the 
women would agree - I'll have to go through them.

Not much time to get this organised, but it is do-able.
Happy poster-making
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


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perinatal data

[Johnston]

The Victorian Perinatal Data Collection Unit has published statistics for 
births in the year 2000.  I plan to prepare a commentary on this document 
for the next issue of Birth Matters (Maternity Coalition)

The letter accompanying 'HOMEBIRTHS 2000' invites those who receive the 
information to "make copies and distribute it widely" (in bold type)

If anyone in other States has access to similar documents, please fax or 
mail relevant pages to me, with details of the publication for reference 
purposes, and I will be happy to publish it.  We need to get serious about 
the appropriateness/safety of the homebirth option, before it is forced out 
of existence.  This is information that discerning members of the public 
will value.  At present it's a well kept secret.

Thanks
Joy Johnston
25 Eley Rd  Blackburn South Vic  3130
Tel:03 9808 9614
Fax:03 9808 3611
M:  04111 90448
www.aitex.com.au/joy.htm


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community midwives in tassie

[Johnston]

Is there a midwife on this list who works in/around Hobart?
If so, please contact Alison Walker [SMTP:[EMAIL PROTECTED]] who 
wrote:


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RE: Breastfeeding during severe pih.

[Johnston]

Stephanie
The practice of isolating a mother from her baby has been pretty standard 
in my (limited) experience when high dependency midwifery care is required 
by a mother whose life is threatened.  I commend you for protecting the 
bond between the mother and baby; and protecting breastfeeding, in this 
case as you have described it.  There are many accepted practices that are 
not based on the available evidence, and this is probably one.

I know of no scientific justification behind the fear that breastfeeding 
would overstimulate the mother.  If the baby is suckling, the mother's 
oxytocin release should be calming to them both.  The best reference I know 
on oxytocin this is the Pederson et al (editors) 'Oxytocin in Maternal, 
sexual, and social behaviours', published in 1992 by the New York Academy 
of Sciences (Vol 652)  There are some drugs that are given to hypertensive 
mothers that may be of concern in breastfeeding, but MgSO4 is considered 
safe for the breastfeeding infant (Lawrence)  See the chapter by Ruth 
Lawrence on medical complications of the mother in 'Breastfeeding: A guide 
for the medical profession.'

Joy Johnston
-Original Message-
From:   stephanie bethel [SMTP:[EMAIL PROTECTED]]
Sent:   Sunday, October 14, 2001 3:31 PM
To: [EMAIL PROTECTED]
Subject:Breastfeeding during severe pih.

Recently we had a lady that required a magnesium suphate infusion post 
birth
for svere PIH. While her BP stabilised, her reflexes were quite brisk but
her observations stable. She was admitted to our high dependency unit under 
the care of a midwife. Fornutely we were able to have the father and baby
close by,and breastfeeding was established early, infact the baby was fully 
breast fed from birth and escaped any complimentary feeds. We were
berated(by nursing admin.) for having the baby with the mother during this
time, stating that this will overstimulate the mother worsening her
condition.We put forward our point of view that it would have been more
stressful for the mother to have seperated her from her baby. I would be
interested in what your veiws are in this situation.
'Steph' <[EMAIL PROTECTED]>

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