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 interventionABC 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 (women only page – no men)

Midwifery Group Practices (MGP) are self employed midwives who work together, and have a shared philosophy of keeping birth normal.

MGP usually consists of experienced, Medicare-eligible midwives who who support the physiological processes and offer pregnancy, birth and post birth care. They may also also offer: Calmbirth® courses; childbirth education; waterbirth; home birth; hospital birth support; lactation consultancy; shared care; allied health practitioners; and Medicare rebates for services.

Read about some MGP here:

My Midwives (QLD & Vic)

“My Midwives was founded in 2010 in Toowoomba Queensland and in 2011 became the first midwifery practice in Australia to be able to admit women to hospital with Medicare rebates.”

Broken Hill MGP 

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,

MAMA Midwives and Mothers Australia (Vic)

Melbourne Midwifery Collective (Vic)

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…

In 2019, Dr Emily Slattery 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…”

Read more here…

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).

The most 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

Dr Lucinda Coleman’s creative work Becoming takes the form of a contemporary dance film that responds to the experiences of registered nurses and midwives at Edith Cowan University.

You can read the story of making the artistic artefact here and watch the beautiful interpretation of our work below.