This document discusses what it means to be a midwife from the perspective of Dr Belinda Maier, an adjunct associate professor. It explores various aspects of a midwife's role including why some choose the profession, career options, feminist perspectives, and ensuring women's dignity is respected during birth. It also examines risk discourse around birth and debates around different models of maternity care available to women in Australia. The document advocates for woman-centered care and greater choice, access and autonomy for women in their birthing experiences.

1. WWhhaatt iitt mmeeaannss ttoo bbee aa
mmiiddwwiiffee
DDrr BBeelliinnddaa MMaaiieerr
AAddjjuunncctt AAssssoocciiaattee PPrrooffeessssoorr GGrriiffffiitthh UUnniivveerrssiittyy
22001133
MMaaiieerr..BBeelliinnddaa@@yyaahhoooo..ccoomm..aauu

3. • Why midwifery?
• Cute babies?
• Cushy job?
• Career options?
• Climbing mountains?
• Feminism?
• Being political?

4. • 1989 my journey to midwifery started

5. • 1989: Lacey normal birth on birthing stool
• 1992: Macauley fast normal birth on
birthing stool
• 1997: Callum fast normal birth at home in
lounge
• 2000: Willow normal birth in water at home

6. • …a woman leaves her dignity at the
door…??????????
• That’s the space that makes me a
passionate midwife

7. • Dignity; is a term to signify that a being
has an innate right to be valued and
receive ethical treatment OR the quality or
state of being worthy, honored, or
esteemed

8. HHoollllyywwooooddiissaattiioonn ooff bbiirrtthh --
aarrgghhhhhh

20. SSoo wwhhaatt aattttrraaccttss yyoouu,, wwhhaatt
ssttiimmuullaatteess yyoouurr ppaassssiioonn ffoorr
bbeeiinngg aa mmiiddwwiiffee??

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KIGER, A. & CALDOW, J. 2007. Competencies and skills for remote and rural maternity care:
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23. Midwife
• A midwife is a person who, having been regularly admitted to a midwifery
educational programme, duly recognised in the country in which it is located,
has successfully completed the prescribed course of studies in midwifery
and has acquired the requisite qualifications to be registered and/or legally
licensed to practise midwifery.
• The midwife is recognised as a responsible and accountable professional
who works in partnership with women to give the necessary support, care
and advice during pregnancy, labour and the postpartum period, to conduct
births on the midwife’s own responsibility and to provide care for the
newborn and the infant. This care includes preventative measures, the
promotion of normal birth, the detection of complications in mother and
child, the accessing of medical care or other appropriate assistance and the
carrying out of emergency measures.
• The midwife has an important task in health counselling and education, not
only for the woman, but also within the family and the community. This work
should involve antenatal education and preparation for parenthood and may
extend to women’s health, sexual or reproductive health and child care.
• A midwife may practise in any setting including the home, community,
hospitals, clinics or health units.
• Adopted by the International Confederation of Midwives Council meeting,
19th July, 2005, Brisbane, Australia Supersedes the ICM “Definition of the
Midwife” 1972 and its amendments of 1990

24. EElliiggiibbllee MMiiddwwiiffee
• What is an ‘eligible’ midwife?
• An eligible midwife is a midwife who meets further professional criteria that enables them to work
in private practice and may obtain a provider number. By having a provider number their private
clients may access Medical Benefits Scheme and Pharmaceutical Benefits Scheme.
• This is legislated under section 38 (2) of the National Law.
• How do I gain registration as an ‘eligible’ midwife?
• The standards are documented on the Nursing & Midwifery Board of Australia website, available
at:
• www.nursingmidiwferyboard.gov.au.
• Summary of Requirements for Eligibility:
• A current general registration as a midwife in Australia with no restrictions on practice
• Midwifery experience that constitutes the equivalent of 3 years full time post initial registration as
a midwife
• Current competencies to provide pregnancy,labour, birth and post natal care to women and their
infants
• Successful completion of an approved professional practice review program for midwives working
across the continuum of midwifery care
• 20 additional hours per year of continuing professional development relating to the continuum of
midwifery care
• Formal undertaking to complete, within 18 months of recognition as an eligible midwife, or the
successful completion of recognised prescribing course.

25. • So is a midwife a midwife or is there better
midwives than others?
• If I work in homebirth today, shift work
model tomorrow, birth centre the next,
public model or private model; has my
midwife self been compromised? Am I of
differing values depending on where I
work and how does that fit with our
philosophy of midwifery – our woman
centeredness?

26. WWhhaatt aarree tthhee ooppttiioonnss aanndd wwhhaatt
sshhaappeess hhooww mmaatteerrnniittyy ccaarree iiss
pprroovviiddeedd ttoo wwoommeenn iinn AAuussttrraalliiaa??
Why do Australian women have different options to New
Zealand women or Dutch women or Italian women…?
•Political imperatives
•Patriarchal medical dominance
•History
•Culture
•Assumption of equity –
– Aboriginal and Torres Strait Islander women and babies
– Rural and remote women
•

27. EEmmppllooyymmeenntt aass aa mmiiddwwiiffee
• Public
• Private
• Self employed
• Hybrids of all of the above

28. NNaattiioonnaall aatttteennttiioonn ttoo wwhhaatt
wwoommeenn wwaanntt??
• National Maternity Services Review –
Commonwealth government repsonse

29. National MMaatteerrnniittyy SSeerrvviicceess PPllaann
•Five year vision
• Maternity care will be woman-centred, reflecting the needs of
each woman within a safe and sustainable quality system. All
Australian women will have access to high-quality, evidence-based,
culturally competent maternity care in a range of settings
close to where they live. Provision of such maternity care will
contribute to closing the gap between the health outcomes of
Aboriginal and Torres Strait Islander people and non-
Indigenous Australians. Appropriately trained and qualified
maternity health professionals will be available to provide
continuous maternity care to all women.

30. NNaattiioonnaall RReeffoorrmm
• Scope of practice
• Professional identify
• Private practice
• Access for your clients to have MBS/PBS
rebates
• Models of care – High risk, low risk, all risk
• Woman centered

32. ffuuttuurree
• Greater access to visiting rights, indemnity
insurance, credentialing…
• Negotiated contracts….
• More public models…
• More rural and remote models that utilise
midwives to full scope of practice….
• Rural/remote midwives with maternal child
health, sexual health and immunisation
qualifications….

33. "TThhee ppeerrssoonnaall iiss ppoolliittiiccaall"
• Are we living in an enlightened and equal
society?
• Risk has become the norm even normal is
only normal because there is as yet an
absence of risk!!!!!

34. RRiisskk
• Everything or nothing

35. • Why is it ok to assume medicine or
midwifery can determine what is good or
bad for women?
• When did it become ok to take women out
of their personal context and frame
everything for them in a medical context

36. RRiisskk iinn ccoonntteexxtt
• Amniocentesis versus VBAC
• Children drowning versus relocation for
birth

37. Fundamentally wwhhyy iiss iitt eevveenn ookk ffoorr
aannyyoonnee ttoo ddeecciiddee aannyytthhiinngg ffoorr
wwoommeenn??
• Water birth
• Pain relief
• Homebirth
• Cesarean section
• Sex???????

38. •• TThhee cchhaalllleennggee nnooww iiss ttoo pprraaccttiiccee
ppoolliittiiccss aass tthhee aarrtt ooff mmaakkiinngg wwhhaatt
aappppeeaarrss ttoo bbee iimmppoossssiibbllee,, ppoossssiibbllee..
HHiillaarryy RRooddhhaamm