Last remaining private midwife in Geraldton may have to stop practising due to legislative changes

Cath Tan is the last remaining privately practising homebirth midwife in Geraldton, which she fears could all be stripped away from her when legislative changes come into force at the start of next year.

Currently, private homebirth midwives have to resource a second medical professional for the birth of a child. This medical professional does not have to be a midwife, although they must have neonatal resuscitation and obstetric emergency training and experience.

Ms Tan would usually rely on another midwife; however, from next year, the secondary medical professional must be another midwife with an endorsement.

Ms Tan is already endorsed, and to become so a midwife must complete the Nursing and Midwifery Board of Australia (NMBA)-approved postgraduate program of study in prescribing and diagnostics.

Being the only privately practising homebirth midwife endorsed in Geraldton, brings with it great difficulty for Ms Tan.

“We rely on other health professionals to support us to be able to do this, so enforcing that there have to be two endorsed and insured midwives just is not feasible to have those people in regional areas.” Ms Tan said.

“The second midwife will have to carry her own insurance product. So, at the moment in Geraldton it will mean that the cost will have to be pushed on to families, which means it just won’t be affordable.

“I definitely will have to shut because I don’t have any second midwives who will be able to fulfil that criteria..”

The price of the insurance would be income dependent but the lowest tier is $2400.

This charge then transfers on to her clients and it makes safe homebirth practices inaccessible in Geraldton.

Ms Tan is the primary midwife for about 20 families a year, delivering safe access to homebirths.

There is a great demand for homebirths in Geraldton and she often has to turn down expecting mothers.

“Most of our clients book in with us as soon as they pee on that stick,” Ms Tan said.

“Without access to a midwife or to midwifery supportive home birth, I think more women will start free birthing, which isn’t always a safe option.”

Ms Tan said free birthing was “just higher risk”.

“You don’t have a qualified medical professional who can support anything that turns abnormal,” she said.

If any of her clients need to transfer to a hospital, either in pregnancy or in labour, or in the postpartum period, Ms Tan is still able to care for them there.

Ms Tan said the “people who are making laws don’t actually understand the issues”.

Australian College of Midwives chief midwife Kelley Lennon said: “The unintended consequence of this change we are already seeing is reduced options for women, as the costs of insurance for the second midwife, who may work primarily in the public system, is not financially viable.”

“ACM supports a more streamlined pathway for midwives to become endorsed and continues to work with the insurance provider and the Government regarding a viable insurance option for the second midwife.”

A spokesperson for the Federal Department of Health, Disability and Ageing said: “The Australian Government recognises that midwifery continuity of care is incredibly important and we will continue to work to make sure that it is accessible and supported.

“More midwives with an ‘endorsement for scheduled medicines’ are now able to access professional indemnity insurance for intrapartum care, including for births outside of hospital and Birthing on Country models of care — expanding access and choice for women.

“The requirement for two eligible midwives at out-of-hospital births strengthens safety for both mother and baby, while ensuring continuity of care, with a second midwife able to fulfil the primary role if required.”