As part of the Rudd Government’s healthcare reform package, changes to the registration and accreditation system for Australian midwives, along with enhancements to the Medicare rebates regime for midwifery, promise a new era of increased choice for healthcare consumers. Significantly, the changes also promise to improve uptake of the midwifery profession, as well as enhancing career prospects for those entering it.

For Fiona Bogossian, Acting Head of the University of Queensland’s School of Nursing and Midwifery Associate Professor, “the long awaited introduction of a single national registration and accreditation system for Australian midwives” under the new National Registration and Accreditation Scheme due to commence on 1 July, is a boon for the midwifery profession. She believes the move will improve consistency of regulation, codes of practice, responses to practice complaints and standards of education and practice across the midwifery profession.

“Standard recognition of registration in all States and Territories will increase the flexibility for midwives to access employment opportunities, and respond to areas of critical midwifery shortage or the needs of specific groups of marginalised women across the country,” she adds.

Meanwhile enhanced access to Medicare for eligible midwives, which will enable women seeking midwifery care to claim for services from Medicare, will in turn help to raise the standing of the profession. Once new Medical Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) arrangements are introduced from 1 November 2010, mothers-to-be and new mothers will be able to access midwife maternity services subsidised by the Government through both the MBS and PBS. The move will provide new means by which maternity and midwifery services are delivered, with women given the choice of receiving Medicare rebate able care from a midwife or group of midwives working in collaboration with doctors, or choosing to have their care shared between a doctor and a midwife.

This continuity of care will enable the woman and her family to develop a relationship with the same carer or team of carers throughout the pregnancy, birth and postnatal period. Medicare rebate able postnatal care by a midwife will also assist women in obtaining early parenting guidance.

While women will clearly benefit from greater choice about the types of maternity care they receive, the remit of eligible midwives will also expand, with practitioners enabled to provide Medicare rebate able maternity services, as well as being newly empowered to prescribe selected PBS medicines.

With national cross-professional guidance set to support collaborative care arrangements between maternity related health care professionals, the reforms also promise to alleviate workforce pressure, particularly in rural areas. Bogossian believes current proposed reforms to maternity care such as reopening rural services and increasing access to birth centres under the developing National Maternity Services Plan, “further reflect the roles and responsibilities of midwives in Australian society and the ability of this profession to practice across varied care settings.” These settings exist across public and private health care, maternity and neonatal care, rural and remote health and aid organisations as well as in academic, research and teaching positions.

For University of Queensland midwifery students, the new legislation will offer graduates future career opportunities to practice “to the full scope of their capabilities”, Bogossian says. “UQ midwifery graduates are well-equipped for beginning practice across a variety of settings and the quality of their undergraduate education provides a firm foundation for advanced practice development.”

Indeed, if University of Queensland’s figures are any indication, demand for midwifery education is on the rise, having increased in 2010 as a choice by about 17% from 2009, while demand for dual degrees encompassing midwifery and nursing increased by 10% in the same period. Demand also exceeds supply of places; for the Bachelor of Midwifery 73 candidates chose the program as their first preference and 255 chose it as one of their six preferences. UQ accepted 31 people into the program.

Bogossian attributes heightened demand to the enhanced standing of the profession, which in turn promises that high standards of education will continue to attract top calibre candidates to midwifery.

By Belinda Smart

Copyright NCAH