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Absurd, childish and pathetic: the latest in maternity services reform

The 11 June issue of Australian Doctor carries a story (p5)  that is truely gob-smacking.

Apparently the NHMRC has been trying to organise a meeting between the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian College of Midwives to develop an agreement on referral guidelines, in relation to midwives being able to access the Medicare Benefits Schedule from November, provided they work “collaboratively” with doctors.

The RANZCOG has reportedly refused to attend the meeting because community representatives who support homebirths have been invited.

If you were ever in doubt about the need for reform of maternity services, then look no further.

If you were ever in doubt about why reform in this area is so excruciatingly difficult, then look no further.

And if you were ever in doubt that professional interests rule in the health sector, then look no further.

This really is pathetic. Absurd and childish are other adjectives that come to mind….

Comments 9

  1. SusieQ says:

    When will the Federal Govt pull the quacks into line and do something about this??

  2. Pete says:

    I think this clearly shows the ideological line that RANZCOG are taking in this whole debate. They are not interested in anything other than protecting their turf.

    This has always been about OB’s commercial interests, not the considering the wishes or values of pregnant women and their families.

    To the OB quacks: if you are genuine about your desire to “above all else do no harm” then you will attend these meetings and seek to enter into genuine systems of collaboration with ALL RELEVANT PRACTITIONERS AND STAKEHOLDERS!!!!

    The worst that will happen is that Australian women will get the best of all worlds!

  3. midwife says:

    How amazingly hippocritical is RANZCOG and the Obstetric profession! What exactly do they want? They want collaboration (one way only) and have “reportedly refused to attend the NH&MRC meeting because community representatives who support homebirths have been invited.” How daft can one profession be?
    The latest in non calloboration is the medical professions colluded unprofessional refusal to write prescriptions for women if they are planning homebirth. Requests for oxytocix drugs have been denied, apparently they don’t accept a letter from the midwife as referral and consultation. This drug is available for every other maternity professional in the case of post partum haemorrhage. Is this refusal discriminatory action? Bring on presribing rights and medicare rebate for midwife services and let them rot in their own pool of non collaboration. This is of course with the exception of the responsible medical practitioners who work sensibly with women and midwives.

  4. Croakey says:

    Justine Caines asked for this comment to be posted on her behalf: Alleluia! Thank goodness for Crikey/Croakey! I particularly loved this quote

    “Dr Rupert Sherwood, the college’s president-elect, said the choice of community representatives was biased “to the point of being ridiculous”, adding the Maternity Coalition were “not really friends of obstetricians”
    Oh spare me! Has anyone got the ticker to actually stand up and remind these people that women, like all health consumers have established rights to determine what does or does not happen to their body. As a signatory to the optional protocol of the Convention of the Elimination of Discrimination of all women (CEDAW) Australia has an obligation to uphold women’s reproductive rights.

    Guidelines may assist practitioners, but they can NEVER be a rulebook for women’s healthcare choices. Caselaw has established this and our Health Minister, Nicola Roxon understands this.

    To date informed consent in maternity care has largely been about getting a woman to agree to a particular course of action, often not even based on evidence but the custom and practice of the practitioner.

    Sadly the fundamental mistake Nicola Roxon made was persisting with the obstetrics/ midwifery turf war. She bleeted for it to be over without putting consumers in the centre of the reform. If we establish the clear rights of women and articulate them to both ’sides’ we lose much of the heat in the debate. It is very late in the reform process but never too late to affirm establish consumer health/women’s rights.

  5. Kate says:

    I suspect the midwives are likely the ones most at fault here. This is typical non compliant behaviour that is centuries old. The maternity reforms will only redirect taxpayers money from cash strapped obstetricians and GPs into the pockets of midwives. Women politicians are to be blamed for this. The same huge mistake happened across the Tasman ten years ago when the health minister legislated that midwives should be paid the same as doctors doing the same work. You can see where this has led. The rot has well and truly set in and as many as 80% of women in New Zealand book in with a midwife to look after them during their pregnancy. Can we begin to imagine how much over servicing would happen? And as for the rorts to the system – they are bound to be rife. If this nonsense continues doctors will have their work (and money) directed towards midwives who are continually putting doctors indemnity insurance at risk. Taxpayers have no idea how often doctors have to pick up the pieces and save the day when midwives order an induction at 37 weeks and the baby has to be rushed off to a neonatal unit because it cant breathe properly. And as for the resuscitations doctors are constantly called to perform for women whose midwives advised them to walk around in labour or sit in warm baths to help them relax instead of being given an epidural. But getting back to the issue here. It seems the biggest sticking point is getting doctors and midwives to sit at the same table to agree on guidelines for how to work together. The government calls it collaboration. But this is clearly a cover for getting something very sneaky through the back door. I know there are perfectly good rules written by doctors about how women should behave during childbirth. And I suspect that midwives are trying to subvert this process by suggesting they have a role in this sort of work. There are probably claims that women themselves be invited to the table to give an opinion on the sort of things they think are important for their care in pregnancy and birth. Australians will rue the day when women start making decisions about their maternity care (and doctors and midwives work together.)

  6. Croakey says:

    “Serin” asked that I post this comment on her behalf:

    Kate, I am loving the tongue in cheek nature of your post. However, it is true that midwives in the rush to be seen as equal, primary carers of professional standing, has enabled the government to run roughshod over women rights. Although I’m not really surprised I had hoped that they would stand up and say NO. Funny how RANZCOG had no hesitation in walking away from something they didn’t want to engage in.

    If Nicola Roxon understood that the electorate is more important than the corporate then none of this would have happened. Playing to the crowd that bayed for insurance and funding while being in the pocket of the medical establishment is to totally ignore the rights of women to chose their care provider and their venue of birth.
    Everyone in this process is out to promote their own self, may it be for money, control,ego or self importance. The women and their right to birth has faded into insignificance in the stampede

  7. bigboysgirl83 says:

    to kate, Have you given birth?, doctors can write all the rules they want when it comes to a woman’s behaviour during birth, it seems some what medieval, i myself have given birth naturally 7 times and never have I seen a OB/GYN throughout my deliveries, and the biggest waste of time for any mother at my hospital is “doctor’s clinic”, midwifes are the back bone for all delivering mother’s and the only time any of us see a OB/GYN is if something has gone seriously wrong, the one time i had a OB/GYN involved, both babies died and it was the midwifes picking up the pieces of his mess, to me it seem’s the midwifes attend to everything and the OB/GYN’s recieve all the credit, many women prefer natural labour to “epidural’s” and walking is for myself personally, excellent!. I do understand the nessecity for OB/GYN’s, especially for c-section’s, whether emergency or out of medical requirement, but midwifes are not given the due’s theyre owed, but this comes down to my hospital and the lack of OB/GYN’s vs the amount of midwifes, for any doctor or midwife in this field, the first place they should start is with the mothers and their choices, how they feel and what they deem is fit for themselves and their unborn children, but no one in this field ever listen’s to the mother and thats where both sides are going wrong., you statement is very onesided, leading me to think perhaps your a OB/GYN yourself?. The comments, well the whole statement is why OB/GYN’s and midwifes don’t and won’t collaborate.

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