twrama 1990_final oc.. - AMA WA

EVENT
Obstetricians meet to discuss
midwife-led care
In late September, the Nedlands headquarters of the AMA
(WA) was the scene of one of the biggest collection of
obstetricians in recent memory. The meeting of GP and Specialist
Obstetricians – both AMA (WA) members and non-members –
was called by AMA (WA) President Dr Richard Choong in order
to formulate a view on issues around midwife-led care, specifically
the WA Health Department’s new Operational Directive to accept
transfers of failed homebirths from the Community Midwifery
Program.
The Commonwealth Government’s decision to vary the 2010
Determination on Collaborative Care was also discussed, along
with continuing issues related to home births. There was disquiet
about the moves by the State Government to change the current
system, with a number of participants indicating great concern
about replacing obstetricians, some with decades of experience,
with four-year-trained midwives.
“I was very excited to be able to hear the views about these
changes from so many obstetricians,” Dr Choong said.
“I will be able to use the views and the results of the meeting
in our future discussions and negotiations with state and federal
bureaucrats and politicians about maternity care policy,” he
added.
However, as one participant later said in a letter to Dr Choong:
“Chairing an obstetricians’ meeting has been likened to herding
cats.”
Dr Choong, along with AMA (WA) vice-president
Dr Michael Gannon, used the views collated from the meeting
with obstetricians in their most recent meeting with Health
Minister Kim Hames.
The AMA (WA) has been vociferous in its criticism of State
Government’s decision to alter collaborative care agreements
New members
The AMA (WA) welcomes the new members who joined
during October 2012
between medical
practitioners and
midwives. The
August edition of
Medicus carried a
feature story on this very subject
– with eligible midwife Pauline Costins arguing in
favour of the change.
“Eligible midwives need referral pathways to enable full
benefits of having a provider number to access Medicare for
antenatal and postnatal care,” Ms Costins said in the article.
“Please consider the benefits of working with an eligible
midwife who is referring women or engaging in a collaborative
agreement with them. There is much potential for women with
a continuity of midwifery model of care.
“This is about being a change agent. It is not about
homebirth. It is about offering women continuity of midwifery
care working in collaboration with doctors,” she concluded.
Dr Michael Gannon, who also heads the Department of
Obstetrics and Gynaecology at St John of God Hospital in
Subiaco, presented his views against the move.
“The dichotomy of high risk and low risk is a fallacy,”
Dr Gannon argued.
“Emergency situations requiring expertise commonly
develop without warning. Handing the care of healthy women
to midwives, away from GPs and obstetricians will not improve
outcomes or maternal satisfaction.
“It is time that we stopped measuring epidural rates and
caesarean section rates as indicators of failure. It is long overdue
that we took pride in the way we deliver maternity care in
Australia. We have much to be proud of.” ■
Jennifer Beale
Sangeeta Bhat
Amanda Boudville
Ngaire Caruso
Cuong Danh
Stephanie Flukes
Sara Foroughi
Fabrizio Goria
Wen Guha
Ayon Guha
Mohammed Hakeem
Rashida Hakeem
Maire Kelly
Timothy Koh
Darshan Kothari
Olivia Lee
Thomas Matthews
Daniel Mo
Deepti Prasad
Hari Ramakonar
Michelle Ross-King
Roy Soon
Matt Summerscales
Helen Thomas
48 MEDICUS October