Thanks guys for your comments so far, the Dr who is making the proposition is definitely one of the lower interventionist ones around these parts and he supports most of the local women who choose to have a homebirth. When I asked him how he thought it might work he didn't really seem to have much of an idea which leaves it pretty open to come up with our unique model. I will be pushing for visiting rights for independent midwives but am sure the insurance (lack there of) will be raised before too long. Lynne as you mention 'caseload' would be my preferred option but at the end of the day if this increases the choice for some women then it will be great because to be honest there is no choice at the moment here in the south west of WA. Unfortunately numbers will be an issue realistically we can probably only aim for around 100 births a year and that means staffing will be an issue because it will not be able to have staff on 24 hour basis. From my experience you need to be booking around 500 and have at least 350 births a year to justify a full complement of staff around 12-13 full time equivalents. Lynne with the private patients are they assigned a midwife and then does the women negotiate with that midwife to have antenatal care as well as their OB and would that woman try to be there for the birth or is dependent on what committment the midwife can make to the woman and in your clinics how do the women pay if they just see a midwife, does the hospital itself bill them and then they get the monies back off their health fund or does the OB have to be involved in the clinics.
Yours in midwifery Pete Malavisi -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
