Friday, October 10, 2014

Should Midwifery have its own National Board?

A massive change in the way health professions, including midwifery, are regulated

Four years ago Australia underwent a huge change in the regulatory system that oversees health professions. A National Registration and Accreditation Scheme (NRAS) was created.  This change saw the consolidation of 75 Acts of Parliament and 97 separate health profession boards across eight States and Territories into a single National Scheme. The National Scheme sets a minimum standard for safe practice by health professionals. This minimum standard can be and is, augmented by states, professions and institutions. 

The National Scheme is overseen by the Australian Health Practitioner Regulation Agency (AHPRA); each profession regulated by the National Scheme has its own board apart from nursing and midwifery who have the one board. The Nursing and Midwifery Board is responsible for the regulation of midwives which involves setting midwifery policy, standards and guidelines; managing midwifery registration; dealing with complaints against midwives; and assessing overseas midwives.



Midwifery coming of age as a profession


Whilst for many decades midwifery was seen as a nursing speciality, there has been an increasing recognition of the differences between nursing and midwifery. Australian maternity services and the way midwives are being educated have been changing dramatically in the past two decades in response to consumer demand and an increasing body of national and international evidence on the importance of midwifery models of care in meeting women's needs and resulting in cost effective, best outcomes for childbearing women and their infants (Barclay et al. 2003; McLachlan et al. 2012; Renfrew et al. 2014; Sandall et al. 2013; Tracy et al. 2013). There has also been increasing recognition of the necessity for midwifery to be developed as a separate profession. 



The National Registration and Accreditation Scheme (NRAS) is under review


The review is being led by Mr Kim Snowball, and the public consultation closes today, on the 10th October 2014.  Our Australian College of Midwives has submitted a proposal for a separate Midwives Board to the review: 



Why we need a Midwifery Board!

The ACM has provided a list of concerns about the current combination of both nursing and midwifery professions under the current board in their document above.  They also identify that midwifery must be regulated by midwives in the form of a Midwifery Board, in order to ensure that:
  • Midwifery practice issues are assessed and regulated by a full Board who are both credible and cognisant of the issues in the provision of contemporary, safe maternity care
  • Issues associated with privately practising midwives and eligible midwives would receive attention from individuals who are appropriately qualified and experienced
  • Complaints are managed in an appropriate and timely manner which includes the application of the principle of natural justice i.e. to be judged by peers who are competent to make a judgement
  • Protection of the public is increased through the nimbleness of a midwifery focussed Board thus improving responsiveness to emerging issues associated with rapid escalation
  • There is an increased understanding of the regulatory context for midwives in private practice providing a fee-for-service model
  • Community representatives who are aware of the relevant issues for childbearing women and families are recruited to the Board thereby ensuring accurate assessment of practice-related issues for midwives
  • Cost effectiveness is achieved by appropriate regulation and protection of the public
  • Data collection about practising midwives is improved, which will improve workforce planning
  • The issue of midwifery invisibility in the legislation, and its consequences, would cease 
  • The Nursing Board would be free of the time consuming complexities of midwifery issues and able to concentrate fully on the important issues for nursing.

Do you support an Australian Midwifery Board? 


If you do agree that midwives should be regulated by midwives, please make your voice  heard by writing to Mr Snowball by close of business today, the 10th October and attach the ACM submission:


or write a letter outlining why you think midwives should have our own Board and email to: nras.review@health.vic.gov.au

Share the ACM submission with colleagues, even if they are not ACM members, and encourage them to make their own submission.


Any questions about the NRAS Review or the ACM submission, please contact Sarah Stewart, ACM Professional Officer: sarah.stewart@midwives.org.au or phone (02) 6230 7333.