Re: [ozmidwifery] test - delete from inbox
Hey Jennifairy I just got this mail Lisa - Original Message - From: [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 06, 2006 2:30 PM Subject: [ozmidwifery] test - delete from inbox Just testing, Ive sent 2 posts to the list today neither has appeared. So Im trying a post direct from my server to track down the *WTF?* moment Im having. jennifairy -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] C/S again
Low-risk cesareans carry increased neonatal mortality risk Source:Birth 2006; Not yet available online Examining infant and neonatal mortality among women with no indication of medical risks or complications who undergo a primary cesarean delivery. Low-risk mothers who opt for a cesarean face a higher risk of infant and neonatal mortality than those who deliver vaginally, researchers report. These findings should be of concern for clinicians and policy makers who are observing the rapid growth in the number of primary cesareans to mothers without a medical indication, said Marian McDorman, who led the study. The team, from the Centers for Disease Control and Prevention in Atlanta, Georgia, analyzed data on more than 5.7 million live births and 12,000 infant deaths over a 4-year period. The researchers focused on women with a singleton full-term gestation and no indicated medical risks or complications. They found that, overall, infants born to these low-risk women had a low incidence of neonatal death, at about one in 1000 live births. However, further analysis showed that those delivered by cesarean section had twice the risk of death as those delivered vaginally. This is worrying because the overall rate of cesarean delivery rose by 41 percent between 1996 and 2004 in the USA, while the incidence in women with no indication for cesarean almost doubled. Posted: 31 August 2006 Current Medicine Group 2006
Re: [ozmidwifery] Queries re PI insurance
Sue that is a very good point that I had not considered and would like an answer to. Did this come up in the discussion anyone who was there?Andrea QuanchiOn 06/09/2006, at 6:55 PM, Sue Cookson wrote: Firstly, there are BMid courses which allow students to attend with homebirth midwives - I'm in one and it's OK to do that. My insurance is covered by my uni. Secondly, I am concerned about a few aspects of this insurance deal - namely if I attend homebirths for women in categories where referral/transfer is recommended according to the ACMI National Midwifery Guidelines for Consultation and Referral - like VBACs, twins, postdates, breech etc- will the insurance company cover me for these births? Those who know Maggie's story - she was covered by PI insurance, but the insurance company found ways to withdraw from their obligations to her for various reasons. So I guess my question is about control of our practices. Will we have to notify the insurers of everyone we take on and their pregnancy histories etc for scrutinising, or will we only find these answers if and when problems arise? I'm happy to put my name down to look at these issues ... don't forget, we can only join up by choice... even as I say that, will it become 'illegal' to not join up if the majority do ... Food for thought, SueDear Lisa and All I agree Lisa we need to dispel fear around HB but to do that it needs to be accessible. Your experience of BMid students attending HB is a 1 off. I don’t believe any other BMid course enable students to work with IPM’s doing HB. They also have trouble finding continuity models (and yes WC in Adelaide is again different!). But what I want to respond to is the idea that insurance is just for midwives. What about women? I have had 6 children at home and I have NO FEAR!!! 2 with insurance and 4 without. I understand the legal issues and I TAKE RESPONSIBILITY and would be very unlikely to sue, but this is not the point. I do however believe that HB women must have the same rights as those accessing GP’s and Ob’s. Insurance is seen as a consumer safety mechanism just as it is seen as a professional protection for midwives. This policy to me is very worthwhile as it allows for coverage on a per birth basis. It will enable many more midwives wanting to ‘dip their toe in’ to private practice that chance. It has the capacity to transform maternity services. We can use the flexibility of this policy (and the business arrangements they offer) to recruit midwives who are currently reluctant to step outside of the system. Private midwifery could actually be a mainstream option with women choosing where they give birth. With PI ,midwives could be granted admitting rights and could therefore offer the marketplace a service in the home or hospital. I have spent 6.5 years advocating for women and midwives and 5 fighting for PI insurance. I can safely say that politically midwives will get nowhere without PI. With 200 midwives we can sell 1-2-1 midwifery further than HB (although HB is my passion!!). Yesterday Manchester Unity refused to pay for a homebirth (even though they offer midwifery rebates) citing a lack of PI as the reason. HBA are also reconsidering and MBF has ceased paying out for HB’s for the same reason. I have never had private health insurance and never will, but this is not about the few, again this is about reaching many more women. Private Health is well supported by the Fed Gov and it is a way to reach many more women. Fear can not be easily dispelled by something that is so poorly supported (ie by public or private funding). With an influx of private midwifery there is a much better chance that Medicare will flow on to midwives in their own right (rather than the current idea re Medicare item number 16400 that requires Drs overseeing midwives). Lisa you cannot liken the UK to here. Although I think team midwifery for homebirth is the pits, women in the UK have a legislative right to a public funded homebirth, even saying that in Australia would be considered reasonably outrageous. Unlike the UK, Independent midwifery is the only option for the vast majority of Aust women wanting a HB. Barb Vernon is one very busy person who is pushed and pulled in many directions but like us she is working hard to achieve this. She is recording every e-mail etc received in the hope we get to 200 soon. I hope you appreciate the benefits of this policy in both per birth coverage and business structure; and whilst I acknowledge some IPM’s with established practices may have preferred that this was not a requirement I hope that they too can think with a world view as we consumers are. In solidarity Justine Caines Homebirth Australia Maternity Coalition For the homebirth movement to move forward here we need to dispel the fear that women have surrounding birth, no amount of insurance can do that. I don't
[ozmidwifery] FW: Contracting Advantage - Melbourne meeting re PI
Title: FW: Contracting Advantage - Melbourne meeting re PI Dear All Here is a very comprehensive update re the Melb Contracting Advantage meeting from Robyn Thompson. I agree with what others have said re ACMI membership. If midwives are not members of the College then they choose to look after themselves re professional issues. The College is only funded by its members and I really dont think non members can expect a service from them. JC Hi All It seems we are moving closer to the long awaited moment for equal recognition of our most important profession in terms of Health Professionals Indemnity Insurance. Most of us said it was to good to be true and remained a little skeptical. We so much look forward to the terrible legislative restriction to private practice in the Northern Territory being lifted and equal opportunity for all midwives around the nation to practice their professional skills in any midwifery setting with the certainty of Insurance. Please forward this information wide and far to other colleagues and interested people. We had a very fruitful meeting with Anne OConnor from Contracting Advantage (CAdv) [EMAIL PROTECTED] yesterday 5th Sept hosted by Western Hospital, Sunshine Campus, Melbourne. Special thanks to Sue Davis and Patrice Hickey for the meeting venue and arrangements, thanks to Barb Vernon for her continuing efforts with Insurance Industry and thanks to Joy for the prompt synopsis. Anne is willing to travel to your state or territory if you feel you need to meet with her, or you can email or talk to her by mobile 0416 728 886. Anne opened the meeting explaining the role of CAdv the Agency between contractors/midwives and the Insurance Brokers, Jardine, Lloyd, Thomas Perth, Western Australia. . Anne first became involved with her endeavour to obtain insurance for Midwives when she was discussing the insurance dilemma over dinner and a red wine with a dear midwife friend from New South Wales. Anne took the story to her boss; the idea has developed progressively from there. Anne couldnt understand why the government hadnt tried to solve the issue for the midwifery; the only profession nationally unable to obtain fair and equitable access to Professional Indemnity Insurance. Anne showed her passion for the cause, she is a good business woman committed to having Professional Indemnity and Public Liability available for midwives in the near future. Thanks to background research and continuing discussions with Barb Vernon, Anne informed us the plan has already progressed to the point where IT systems are currently being installed to provide this new back-end service for contracted midwives. With great diplomacy Anne answered a bombardment of questions posed by a very interested group of midwives from hospital, private practice and some providing midwifery services in combined settings. Anne stayed overnight at my place and answered more questions (over dinner and red wine) put to her by my self-employed husband, a Plumber. CAdv have the necessary financial requirement that most small groups and contractors cannot raise; a Premium Pool of $250,000 - $400,000 secured by law for 15 years, they are in a financial position to buy the Insurance at wholesale price. Contracting Advantage offers two operating systems 1. The ODCO System Agency services to hospitals and other establishments with permanent employees 2. Independent System Agency services on a user pays basis for self employed contractors The ODCO Pty Ltd System is the original contracting system set up for self-employed contractors. The system has been tested in courts several times and has been legitimized after Unions questioned the legality of the Agency. The ODCO system continues providing services for contractors, is audited and complies with the legal requirement of appropriate Licencing Boards. An example of the ODCO System working for a Private Midwifery Practice: If the company Melbourne Midwifery wanted to permanently employ full-time or part-time midwives the ODCO system would require, a 10% Administration fee; 5% paid by Melbourne Midwifery and 5% by each employed midwife. This system can be offered with cost savings to hospitals, universities and other organisations employing full or part-time midwives. A midwife who has both private clients and is employed by a hospital system must be clear in declaring their client contractual arrangements from the outset. The Independent System a user pay system provides individual access for midwives to Professional Indemnity and Public Liability Insurance for any sphere of practice antenatal, labour and birth, postnatal, education (inside or outside hospital settings). The system is flexible it will meet the needs of midwives who have not yet set up a business and for those who have well established business facilities. Midwives pay a $500 per year up front fee for the Insurance Policy, there are no professional or other exclusions. The ACMI Codes and
[ozmidwifery] midwives birthing?
Hi, Does anyone know of any research that has been conducted on midwives birthing midwives? We've all caught our colleagues babies - but I'm trying to find some research for one of our students and I'm drawing a complete blank. Any ideas wise women?? Cheers, Sadie
Re: [ozmidwifery] FW: Contracting Advantage - Melbourne meeting re PI
Title: FW: Contracting Advantage - Melbourne meeting re PI Thanks Justine for forwarding the update. The college cannot look after their members re professional issues they have no lawyers or advisers. I don't think non members would expect a service from them. However in the case of insurance if they are only acting on behalf of their members I would assume you can only take out the insurance through the College. If this is the case with the college as the buffer the offer may be more attractive because they can negotiate to suit their members needs. If it is not the case then they are in fact acting on behalf of all midwives regardless to their membership status. I also take it that they need non members to sign up or they would already have over 200 people. Lisa - Original Message - From: Justine Caines To: OzMid List Sent: Wednesday, September 06, 2006 9:11 PM Subject: [ozmidwifery] FW: Contracting Advantage - Melbourne meeting re PI Dear AllHere is a very comprehensive update re the Melb Contracting Advantage meeting from Robyn Thompson.I agree with what others have said re ACMI membership. If midwives are not members of the College then they choose to look after themselves re professional issues. The College is only funded by its members and I really dont think non members can expect a service from them.JC
Re: [ozmidwifery] midwives birthing?
Hi Sadie Don't know of any research and we've all been aware of catching each other's babies in hospital for yonks as you say. I just want to say it is fairly common event in independent midwifery practice to be approached by midwives or midwifery students to provide pregnancy,birth and puerperal care at home. In fact one of my September clients is a midwife. She has just flown all the way home from o/s to have her first baby here in Sydney (the only 'choice' for o/s women in the country where her husband works is an obstetrician) She will be returning o/s about one month after the birth. There was some research done by Hilda Bastian when she was president of Homebirth Australia that produced a social profile of clients of independently practicing midwives. She used the results of this research very effectively to debate the home birth cause on a televised national debate (ABC Melbourne event) I think way back in the 1980s. When challenged by an obstetrician that the majority of home birth clients were 'alternative-type hippies' she was very quick to put him in his place by quoting the results of her national survey in fact the majority of home birth clients were HEALTH PROFESSIONALS. I still find that is the case with my practice today. For any budding PhD student it would be a great research topic to revive again you would need to find Hilda to get a copy of her paper ... I used to have it but now sure where it is buried in the piles of papers in my garage these days. The television debate would still be available from the ABC I would think. It would be worthwhile showing to students. While there is evidence that midwives eat their young and horizontal violence rules ... I believe there is also ample evidence in private practice that midwives midwife their own too. Does someone want to give it a go? Jan Jan Robinson Independent Midwife Practitioner National Coordinator Australian Society of Independent Midwives 8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350 e-mail address: [EMAIL PROTECTED]> website: www.midwiferyeducation.com.au On 6 Sep, 2006, at 22:04, Sadie wrote: Hi, Does anyone know of any research that has been conducted on midwives birthing midwives? We've all caught our colleagues babies - but I'm trying to find some research for one of our students and I'm drawing a complete blank. Any ideas wise women?? Cheers, Sadie
RE: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed
Title: Message Lisa, There is a word that describes those who are not members of an organisation/collective that declines to financially contribute to collective funds or provide input or energies yet expect to benefit or be rewarded bythe wins such as pay risesnegotiated by a collective group such as by a union. I will not say the word in such polite company but others will know a festering sore heals ever so slowly when constantly rubbed. I get rubbed by this all the time! However I would suggest Lisa you seriously consider why membership to your professional college would benefit you and especially to the woman you claim to 'care' for. We cannot take a Robinson Crusoe view and think midwives are on their own island when we have so many financial, political, professional, ethical and various codes of practice we are all expected to be accountable to. At the present time the College does not have the resources or funds to be able to provide legal or financial officers. They leave the industrial framework many midwives work in to the various unions in each state, howeverunfortunately named, the ANF. However some states with active midwives are working on the name change to be more inclusive of midwives. I can assure youthe ANF and Jill Iliffe are taking notice of midwives. Collectively we are strong and we can do anything in a way that respects all views. Can I urge you to get involved. Cheers Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lisa BarrettSent: Wednesday, 6 September 2006 12:36 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed Hang on personalising this debate is very important to me if I have to sign up. Maybe that's the problem not personal enough!! My SAIMA South Australian Independent Midwives Association. Should surely have received some information affiliated to the college or not. Having Insurance doesn't hinge on belonging to the College of Midwives. I was at the same day as Tania, Not a mention of any Insurance issues then. I don't think for one minute I have confusion. I want to feel to be important enough to be in the loop and wanted opinion from others around Australia of what they actually thought about this not just the party line. what I have to say is as important as everyone else just because I want to be cautious doesn't mean I should shut up surely. I know there are people working hard out there to benefit the midwifery community but please don't belittle my opinion or that of My SAIMA. Doesn't anyone else think that getting your woman to pay them and then they take what is required and give you the rest may be an issue. Can we all start charging 30dollars and will that cover our insurance tax, commission etc. What if they are not happy with something and won't pay up. They could start making policies and if we don't follow what they think is correct procedure they don't pay up. Has this been covered with the company? Thanks everyone Lisa - Original Message - From: B G To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 06, 2006 8:57 AM Subject: RE: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed Lisa, Personalising debate is not wholesome. Its like NIMBY debates! An email went out via ACM update that people can subscribe to about PI to express an interest to the CEO at that stage. This was then relayed onto ozmidwifery. I do not think it has progressed beyond an _expression_ of interest from midwives to the college. I rely on the elected members from my state branchof the College to act on everyones best interest. Some things especially business related do have some confidential discussions. One thing the College is particularly keen to do is to ensure safe practice and safe care hence progression of the Midwifery Practice Review nationally. Your SAIMA are they affiliated to the College or participate in the College activities because this is probably where your confusion is coming from hearing things as you said 3rd hand? The college update is very informative and keeps you in the loop. Barb
Re: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed
Title: Message Well Barb thanks for that. I can assure you that the women I "claim to care for" are very well looked after and I resent the inference made with that remark. I am in fact a member of my professional body the RCM and a member of the ANF and a member of the ARM(Association of Radical Midwives) I do not think or feel like I am an Island. I have been a midwife for 20 years and am well aware of my accountability. Respecting all views is surely that ALL views. All I am trying to get over is a full debate of what we are going to get with the insurance that is on offer. I not expect to benefit or be rewarded by any wins or pay rises negotiated on my behalf. I don't want an insurance offer put on the table on my behalf that I may not want but if agreed to I will be obliged to take or marginalise myself further. I'm sure that you can understand that. That's why a healthy discussion now is invaluable to us all. and mud slinging not productive. Lisa - Original Message - From: B G To: ozmidwifery@acegraphics.com.au Sent: Thursday, September 07, 2006 10:36 AM Subject: RE: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed Lisa, There is a word that describes those who are not members of an organisation/collective that declines to financially contribute to collective funds or provide input or energies yet expect to benefit or be rewarded bythe wins such as pay risesnegotiated by a collective group such as by a union. I will not say the word in such polite company but others will know a festering sore heals ever so slowly when constantly rubbed. I get rubbed by this all the time! However I would suggest Lisa you seriously consider why membership to your professional college would benefit you and especially to the woman you claim to 'care' for. We cannot take a Robinson Crusoe view and think midwives are on their own island when we have so many financial, political, professional, ethical and various codes of practice we are all expected to be accountable to. At the present time the College does not have the resources or funds to be able to provide legal or financial officers. They leave the industrial framework many midwives work in to the various unions in each state, howeverunfortunately named, the ANF. However some states with active midwives are working on the name change to be more inclusive of midwives. I can assure youthe ANF and Jill Iliffe are taking notice of midwives. Collectively we are strong and we can do anything in a way that respects all views. Can I urge you to get involved. Cheers Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lisa BarrettSent: Wednesday, 6 September 2006 12:36 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed Hang on personalising this debate is very important to me if I have to sign up. Maybe that's the problem not personal enough!! My SAIMA South Australian Independent Midwives Association. Should surely have received some information affiliated to the college or not. Having Insurance doesn't hinge on belonging to the College of Midwives. I was at the same day as Tania, Not a mention of any Insurance issues then. I don't think for one minute I have confusion. I want to feel to be important enough to be in the loop and wanted opinion from others around Australia of what they actually thought about this not just the party line. what I have to say is as important as everyone else just because I want to be cautious doesn't mean I should shut up surely. I know there are people working hard out there to benefit the midwifery community but please don't belittle my opinion or that of My SAIMA. Doesn't anyone else think that getting your woman to pay them and then they take what is required and give you the rest may be an issue. Can we all start charging 30dollars and will that cover our insurance tax, commission etc. What if they are not happy with something and won't pay up. They could start making policies and if we don't follow what they think is correct procedure they don't pay up. Has this been covered with the company? Thanks everyone Lisa - Original Message - From: B G To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 06, 2006 8:57 AM Subject: RE: [ozmidwifery] Fw: PI Insurance - urgent - more interested midwives needed Lisa, Personalising debate is not wholesome. Its like NIMBY debates! An email went out via ACM update that people can subscribe to about PI to express an interest to the
