Tomorrow’s history is being made today…
To meet the changing needs of our society and improve care for all Australian women, midwives across Australia are establishing new and innovative models of midwifery care, moving into private practice, lobbying for and establishing publicly funded homebirth programs, and researching to provide the evidence to support future maternity care practices. In the future we will look back on these programs, and the midwives involved, as playing an important role in our profession’s future history.
Here we present some highlights of innovative and pioneering practice in Australia today. We welcome any of our profiled groups to contact us to collaborate on how their program is described or depicted, and how to best tell their unique midwifery story.
We also welcome new stories. Are you involved in an innovative midwifery program? We’d love to feature it! Contact us here.
It is thanks to many pioneering midwives and women that most states in Australia have now established publicly funded homebirth programs. While these may differ from state to state, they have all added homebirth as choice to birthing women within the public hospital systems.
Read about the home birth program at Sydney’s Royal Hospital for Women (est. 2018) in this article by Olivia Willis Homebirth hospital program delivers babies safely and with less intervention, ABC News, Health & Wellbeing (16 November 2021), and their ‘birth announcement’ of their very first arrival here.
In Melbourne, Joan Kirner Women’s & Children’s Hospital offers the option for home birth as an extension of the Midwifery Group Practice Team.
The National Publicly-funded Homebirth Consortium is a network of the publicly-funded homebirth models of care in Australia.
The aims of the Consortium are to:
- Establish a network of the publicly-funded homebirth models of care in Australia
- Work collaboratively to support midwives and help sustain these models
- Act as a resource for managers, policy makers and researchers, as well as new models being developed around the country
The Molly Wardaguga Research Centre at Charles Darwin University
‘Birthing on Country’ programs are improving services for First Nations women in rural and remote regions of Australia. These models are pioneering cultural inclusion, partnership with Community, and birth as a social justice issue. Centre co-directors, Professor Sue Kildea and Professor Yvette Roe, are leaders in health services research in midwifery, culturally responsive models of care, and Indigenous health.
Birthing on Country has been described as an international movement with the overarching aim of returning birthing services to Indigenous communities and Indigenous control to enable a healthy start to life.
The Birthing on Country agenda relates to system-wide reform and is perceived as an important opportunity in ‘closing the gap’ between Indigenous and non-Indigenous health and quality of life outcomes.
Birthing on Country is a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies and their families, an appropriate transition to motherhood and parenting for women and an integrated, holistic and culturally appropriate model of care for all.
The Molly Wardaguga Research Centre was established in April 2019 and is dedicated to the late Molly Wardaguga, Burarra Elder, Aboriginal Midwife, Senior Aboriginal Health Worker and founding member of the Malabam Health Board in Maningrida, Arnhem Land.
Molly was an important contributor to the Australian discourse regarding the importance of Birthing on Country. Her work and mentoring in Aboriginal health and research; and maternal and infant health in particular, has galvanised many advocates to improve maternity services for Indigenous Australians.
Read Molly’s own birth stories and her midwifery journey on Trove (this page contains culturally sensitive material and is a women only page – no men please)
Midwifery Group Practices (MGP) consist of midwives who work together with a shared philosophy of physiological birth. MGPs usually consists of experienced, sometimes Medicare-eligible midwives who support the physiological processes and offer pregnancy, birth and post birth care. Often MGPs exist within public hospital maternity services. They may also offer: Calmbirth® courses; childbirth education; waterbirth; home birth; hospital birth support; lactation consultancy; shared care; allied health practitioners; and Medicare rebates for services.
You can explore some MGP here:
My Midwives (QLD & Vic)
The My Midwives website states:
“Founded in 2010, My Midwives is the first midwifery practice in Australia to admit women to hospital with Medicare rebates.”
Midwifery Group Practice, Women’s and Children’s Hospital, SA
Melbourne Midwifery Collective (Vic)
Sutherland Hospital, NSW
Around Australia, only 10% of women have access to a midwifery-led model of care due to many different barriers. Launching and sustaining a MGP requires an enormous commitment and passion for providing gold-standard maternity care to women. “When we launched the BHMGP in 2015, the Far West LHD undertook a complete overhaul of our maternity service,” said Chelsea Anderson, FWLHD Clinical Midwifery Consultant. “We are extremely proud to achieve this significant milestone and to provide all of the women in the Far West with access to their own midwife through the Broken Hill MGP.”
Alison Isaacs, Midwifery Unit Manager said local women using the service have consistently reported a very positive experience with the MGP. “They found that the most valuable aspect of the service was the close relationship they develop with their allocated midwife, which makes them feel comfortable discussing their concerns and asking questions”.
Broken Hill Midwifery Group Practice (MGP) Celebrate 5th Birthday, Far West Local Health District Media Release 01 July 2020
Waminda
South Coast Women’s Health and Welfare Aboriginal Corporation (Nowra, NSW)
Our vision is for Aboriginal women and (their) families to be leading and living self-determined futures.
A culturally safe and holistic service, providing women and their Aboriginal families an opportunity to belong and receive quality health and well-being support. Our key focus is to provide tailored strength based care.
Minga Gudjaga (Mother and Baby) is the child and maternal health program that offers community focused, holistic, continuity of midwifery care. We provide spiritual, cultural, emotional and physical support during pregnancy, labour, birth and up to five years of age.
Birthing on Country is about our women from community lead by our Elders and Aunties, to take back control for our Minga’s (mums) to birth healthy beautiful Gudjaga’s (babies) in a safe space that is centred around culture and then throughout the continuation of Minga’s and Gudjaga’s life cycle.
Alukura Women’s Health Service
Central Australian Aboriginal Congress (Alice Springs, NT)
Alukura Women’s Health Service is an Aboriginal women-only place caring for the health of our women and babies. The service is provided in a comfortable and culturally safe place for clients.
Our service provides a multi-disciplinary team approach to ensure Aboriginal Women and babies have access to best practice primary health care…
Australia’s eligible, privately practising midwives gained access the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Schedule (PBS) in 2010, providing Medicare-rebateable services to women and prescribing certain PBS-subsidised medicines, resulting in more affordable maternity care and choices for women.
The first Graduate Certificate in Midwifery course at Flinders University (SA) in 2014 had 160 applications, with 34 completing the course full time in one semester, and 79 more graduating after completing the course part-time.
Griffith University (NSW) offered a Screening, Diagnostics, Pharmacology and Prescribing for Midwives course in 2015, followed by University of Queensland, University of Canberra, and Edith Cowan University (WA).
Recent ‘Nursing and Midwifery Board of Australia Registrant data’ (September 2021) reported 760 midwives currently hold endorsement ‘or scheduled medicines for midwives.
Author of the initial Flinders and Griffith courses, Dr Kirsten Small, says
“…For midwives, they can actually now work to the full scope of their practice… It really respects them as a health care professional in their own right.”
Endorsed Midwife Hannah Dahlen says
“the move to midwifery prescribing is an opportunity for midwives to provide women with another service and reduce the fragmentation of care… Midwives are finally being recognised for the skills they have, and are now being given that recognition and respect.”
Read the interview with Dr Small here and an interview with endorsed Midwife Hannah Dahlen here.
Mackay Birth Centre was the first birth centre in Queensland in 1994, and in 2019 Birth Centre midwives Julie Pratt and Allison Davis became the first midwives to be able to prescribe medication at the Mackay Hospital and Health Service.
Small, K., Sidebotham, M., Fenwick, J., Gamble, J. (2016). Midwifery prescribing in Australia. Australian Prescriber 39, 215-218. doi 10.18773/austprescr.2016.070
In 2019, Dr Emily Slattery became the first woman in WA to give birth in a hospital under the care of her own midwife rather than an obstetrician, with endorsed private practice midwife Clare Davison.
“…A private practice midwife provides continuity of care, meaning the woman has the same midwife throughout their pregnancy, during the labour and birth and in the postnatal period up to six weeks.
An endorsed midwife can provide Medicare rebate services, including prescribing approved medications, ordering ultrasound scans and referring women to medical practitioners.
They can now also apply for hospital-admitting rights, which means they can admit the woman to hospital and take charge of the birth… Baby George was born at King Edward Memorial Hospital (KEMH), which is the first hospital in WA to allow independent midwives to admit their own clients…”
Nurses and midwives make up the largest sector in the health workforce, with around 450,000 registered practitioners. There are around 35,800 registered midwives in Australia today.
Find out more about regulation, registration, and workforce growth across Australia and in each individual State here Aust Govt Dept of Health & Aged Care
Women the Winners on Budget Night
Helen White, CEO Australian College of Midwives
The 2024 Federal Budget has been handed down by the Albanese Government and it contains some wonderful news for midwives which I wanted to outline for you. Many of the recommendations ACM has long been advocating for have been funded which is an incredible achievement. Importantly I acknowledge that this is a group effort; your voices along with other professional bodies and consumer advocacy groups have contributed greatly! Thank you!
The Albanese Government has:
- Funded the outstanding five recommendations for Medicare Benefits Scheme [MBS] items for Endorsed Midwives, from the 2020 MBS Taskforce, allowing women greater flexibility and access to best practice primary midwifery care. $56.5 million has been assigned to fund these items which include increasing the duration for initial antenatal appointment to 90 minutes, introducing a new item for antenatal attendance, and for complex antenatal care leading to hospital admission as well as a new 90 minute postnatal item which will allow women access to birth debriefing, mental health and domestic violence screening.
- Prioritised access to homebirth for women, which will cover 100% of claim costs for privately practising midwives providing low-risk homebirth and intrapartum care outside of the hospital further to legislation to come, planned to commence July 1 2025. This will end the longstanding professional indemnity insurance exemption with a permanent solution. Access to Birthing on Country [BoC] models of care for First Nations people is also significantly enhanced by this insurance solution, for midwives providing intrapartum care outside the hospital in BoC models.
- Allocated $5.2 million to training health professionals, including midwives, in the insertion, management and removal of long acting reversible contraceptives (LARC). This is clear recognition of midwives’ key role as primary sexual and reproductive health care providers and firmly places contraceptive care within a midwife’s scope of practice.
- Funded clinical placement payments for midwifery students from 1 July 2025.
More to come once we have reviewed the budget in detail. This budget is great news for midwifery and for women. Thank you to all for advocating for this funding over many years.