Friday, March 24, 2017

Have your say! Consultation on the new Australian Maternity Services Framework


A pubic consultation is now open on the new Australian Maternity Services Framework. It's imperative that anyone with a stake in maternity; midwives, women, families, nurses, other words...everyone....has their say! 

The 2010-2015 Maternity Services Plan came to an end a while ago.  A lot of good ideas and actions were embedded in the Plan, such as a commitment to midwifery continuity of care and support of Birthing on Country. There have been some successes, but we still have an incredible amount of work to do to address such outcomes as caesarean section rate of over 30%; twice the mortality rate of indigenous babies compared to non-indigenous babies, and suicide is still a leading cause of maternal mortality.   

One of my concerns with this new document is that it is a "framework" and not a plan. This means that the government outlines a "vision" and "principles" but abdicates the responsibility for implementation and evaluation back to the states and territories. This will lead to further inconsistency and inequities around Australia, which increases risk to the maternity services.

I am pleased to see that cultural safety and woman-centred care are key principles, but continuity of midwifery care is not identified as an enabler despite very strong, high level evidence that it makes a considerable difference to clinical outcomes. There is a brief mention of continuity of midwifery care toward the end of the Framework, and no talk of 'birthing on country' at all, which is very disappointing. 

My overall impression is that the Framework is very focused on screening for and preventing medical complications, which is right and proper, but lacks a more holistic, community approach to improving care for women and their families. 

Have you reviewed the Framework? What do you think? What do you think the Framework does well, and what additions would you like to see?


Anonymous said...

I've commented on the consultation document. I felt it very much reflected the medical paradigm. Not surprising considering the involvement of medicine in writing them. Very interesting that 'midwives' were listed after obstetricians and nurses in much of the content, and 'continuity of care' mentioned rather than specifically 'midwifery-led continuity of care' (which the evidence supports). To be honest I am very disheartened with the way maternity care is heading in Australia. We are seeing this re-medicalisation playing out with local hospitals reinstating 'active management of labour' (2 hours VEs) and routine episiotomy. I'm waiting for the enemas and shaves to re-emerge.

Sarah Stewart said...

Thanks Midwife Thinking,you've reflected pretty much what I was thinking. I am putting together feedback on behalf of the ACM, so if you have any specific comments, I'd love to hear them: