Sydney’s Melissa Maimann is pioneering the way forward as one of Australia’s first eligible midwives under the maternity reforms.

A midwife for 10 years and in private practice for four years, Melissa believes she is the first in the country to negotiate a collaborative agreement with an obstetrician.

“I wanted to become an eligible midwife so that I could provide Medicare-funded care and to gain access in the future to hospital visiting rights,” she said.

Melissa’s Essential Birth Consulting practice provides Medicare-funded private midwifery care to women for births at home and hospital.

Under the reforms, her practice enables women to receive care from the one midwife for their entire pregnancy, birth and new parenting experience while also having the back-up security of obstetrician and immediate past president of the Australian Medical Association, Dr Andrew Pesce.

The first baby born under their joint care took place in March and they have women booked through until January.

Melissa said their collaborative agreement was based on a similar philosophical approach to maternity care and agreed practice guidelines that were safe, evidence-based and woman-centred.

“For the women, there is the reassurance of having private midwifery care with a known and trusted obstetrician available for labour and birth if needed; someone they have met and who knows their wishes for labour and birth care,” she said.

“I am able to work with an obstetrician who I know personally, who is very supportive, readily available at any time, with a shared philosophy and beliefs.

“This makes an enormous difference to women’s care and to safety as it removes all barriers to consultation and referral while promoting a professional relationship.”

Melissa said the maternity reforms were essential.

“Women have been very clear in the 2009 Maternity Services Review that they want choice, and the maternity reforms enable women, regardless of risk factors, to access insured and funded private midwifery and obstetric care.”

Figures from the Australian College of Midwives estimate only 40 midwives have become eligible to provide Medicare rebates to patients.

Melissa, who also provides consulting services to midwives entering private practice, said it was still early days for the maternity reforms.

And she said most midwives were employed at hospitals.

“The decision to move to private practice and pursue eligibility is a huge step, and as midwives are not taught business know-how in their midwifery degree, it is new information that midwives seek out when they enter private practice,” she said.

Melissa wants the issue with the current lack of visiting rights, which makes it impossible for midwives to admit their own clients under their name and to treat and discharge them, resolved.

“I think it’s very important that as midwives, we are able to work in all settings and as a private midwife, this will require visiting rights,” she said.