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Position Statement on
Planned Home Births with a
Midwife
Adopted by APMA: 29 October 2009
Introduction
Australian Private Midwives Association (APMA) represents the majority of privately practisingmidwives in Australia, who are also the responsible professional attendants at the majority ofhomebirths in this country. APMA aims, through representing private midwives at nationalprofessional discussions, to support women through promoting and protecting continuity ofmidwifery primary care. APMA is a key stakeholder in any professional discussion abouthomebirth.
Many APMA members are active professionally in the Australian College of Midwives (ACM),as well as in groups that establish partnership between midwives and consumers, such asAustralian Society of Independent Midwives, Midwives in Private Practice, Maternity Coalition,Homebirth Australia, Home Midwifery Association (Qld), Homebirth Access Sydney (NSW),Birth Matters (SA), and Birthing and Babies Support (BaBS).
The following statement represents the view of APMA on planned home births with a midwife.APMA reserves the right to revise and update this Position Statement as time passes. APMAencourages ACM and other stakeholder organisations to endorse this statement and adopt itwithout change as their Position Statement on Home Births with a Midwife.Statement
1. We support home birth with a midwife in attendance for women who haveuncomplicated labours.
1.
Midwives practising in any setting are responsible and accountable for theirdecision making about their own scope of practice and referral and transfer ofcare.
2.
We support the use of the National Midwifery Guidelines for Consultation andReferral (ACM 2008) as a guide in midwifery referral decisions.
2. We support and adopt the International Confederation of Midwives’ (ICM) Definitionof the Midwife (2005) (attached below), which is foundational to all midwifery practice,including homebirth. The ICM Definition of the Midwife establishes the followingprinciples which apply in this statement:
1.
The principle of ‘partnership’: “The midwife … works in partnership withwomen …”
2.
The principle of professional responsibility: “The midwife is recognised as aresponsible and accountable professional …”
3.
The principle of continuity of carer (‘caseload’) – primary care: “The midwife… works … to give the necessary support, care and advice duringpregnancy, labour and the postpartum period, …”
4.
The principle of primary care – on the midwife’s own responsibility: “… toconduct births on the midwife’s own responsibility and to provide care for thenewborn and the infant.”
5.
The principle of health promotion: “This care includes preventative measures,the promotion of normal birth,…”
6.
The principle of detection of complications, consultation, referral, and carryingout emergency measures: “This care includes … the detection ofcomplications in mother and child, the accessing of medical care or otherappropriate assistance and the carrying out of emergency measures.”
7.
The principle that midwifery care has broad community health implications:“The midwife has an important task in health counselling and education, notonly for the woman, but also within the family and the community. This workshould involve antenatal education and preparation for parenthood and mayextend to women’s health, sexual or reproductive health and child care.”
8.
The principle of ‘any setting’: “A midwife may practise in any setting includingthe home, community, hospitals, clinics or health units.”
3. We support the right of every woman to access a midwife as the primary maternitycaregiver who works in partnership with the woman throughout the episode of care,who is able to be the responsible professional in attendance at the birth either athome or hospital, and who is able to make appropriate referral and transfer of carewhen required.
1.
We support a woman’s right to self-determination and control over her bodyand her pregnancy, including the right to give birth in the place of her choice.
2.
We support and value the woman’s ability to make informed decisions aboutplace of birth, and other choices as her pregnancy and labour progress, inpartnership with a known and trusted midwife of her choice.
4. We support the right of a midwife to practise privately
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in a fee-for-service orfunded relationship with the client, or to take up employment.5. We support only those regulatory restrictions that are able to pass the ‘publicinterest’ test: “How does this promote health and wellbeing in the mother and baby?”
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6. We support an expectation of equity, including equal pay for equal work throughouta midwife’s scope of practice. Midwives who provide primary maternity care areentitled to the same public funding, the same opportunity to charge a fee-for-service,the same access to hospital referral, and publicly supported indemnity insurance, asmedical practitioners providing the same maternity services.
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7. We support processes by which midwives are able to gain experience andmentoring in order to commence and demonstrate continuing competence inhomebirth practice.
8. We support seamless and reliable processes by which midwives are able to makehospital bookings for women planning homebirth, and arrange transfer to the hospitalin a timely way when needed.
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