Category Archives: News

Educating midwives of the future: Do professional standards reflect what students need?

In Australia, the standards for education programs leading to registration as a midwife are set by the Australian Nursing and Midwifery Accreditation Council (ANMAC). These are periodically updated to reflect the needs of the community for a flexible, responsive and sustainable midwifery workforce. Last updated in 2014, the Midwife Accreditation Standards are currently under review.

Education for prescribing practice

One of the significant changes under consideration relates to the inclusion of education on prescribing. At present midwives who intend to prescribe medications in their clinical practice must have a minimum of three years of post-registration experience and complete a postgraduate course in prescribing in order to be endorsed with AHPRA as a prescriber. In the new standard, ANMAC is considering shifting education for prescribing into the primary, pre-registration midwifery qualification. While further changes to legislation would be required to facilitate midwives commencing prescribing immediately on registration, the proposed change represents an important necessary first step. If introduced, this would mean that midwives would not need to return to university study at a later date to satisfy this part of the requirement for endorsement.

In other high-income countries such as New Zealand, prescribing education is successfully provided within the primary midwifery degree and immediately on registration midwives have the authority to prescribe medications. This avoids placing a number of significant barriers in the way of midwives being able to include prescribing in their scope of practice. It also provides the advantage that midwives new to prescribing are better supported in healthcare systems that recognise that them as new to practice. This is not the case for midwives new to prescribing in Australia who may be left to “sink or swim” in their prescribing practice with little support. The New Zealand example demonstrates that it is possible to include prescribing education within the primary degree without compromising the quality of midwifery education or undermining the safe care provided by midwives with this educational exposure.

Preparing midwives for a full scope of practice in midwifery continuity of care models

A team from the Trans-Tasman Midwifery Education Consortium recently conducted research which identified future priorities for midwifery education in both Australia and New Zealand (Sidebotham et al., 2020). Among the priorities considered essential for the preparation of the future midwifery workforce was the provision of clinical practice experience within a continuity of midwifery care model. Given clear evidence of the superiority of continuity of midwifery care models, it is imperative that midwifery education prepare students to experience, and develop confidence and competence in providing care in continuity models (Gamble, Sidebotham, Gilkison, Davis, & Sweet, 2020).

In 2010 ANMAC introduced a requirement requiring students to experience continuity of care for twenty women, and in 2014 reduced this to only ten. It is important that ANMAC standards continue to support and promote the expectation that students will develop competence in providing quality care in continuity models.
Also of note is the proposal to remove an existing ANMAC recommendation that all students be provided the opportunity to develop competence in essential, but less often used skills in midwifery practice such as vaginal breech birth, perineal infiltration, episiotomy and repair, through the use of simulation. In order for midwives to provide autonomous care with the scope for practice it is important that midwifery students are taught to assess the perineum following birth and develop skills to suture the perineum. This recommendation should therefore be retained.

How to contribute

Have your say about the future standards governing midwifery education in Australia by submitting a response to ANMAC. Information about the standards and how to submit your response can be found on their website .
Submissions for the current round of consultation close on 13 August, 2020.

References

Gamble, J., Sidebotham, M., Gilkison, A., Davis, D., & Sweet, L. (2020). Acknowledging the primacy of continuity of care experiences in midwifery education. Women & Birth, 33(2), 111-118. doi:10.1016/j.wombi.2019.09.002
Sidebotham, M., McKellar, L., Walters, C., Gilkison, A., Davis, D., & Gamble, J. (2020). Identifying the priorities for midwifery education across Australia and New Zealand: A Delphi study. Women & Birth, in press. doi:10.1016/j.wombi.2020.05.011

Praise for midwifery-led continuity of care

Midwife Dawn Reid with mother Samantha Love and her baby boy

Gatton mother of two, Samantha Love, gave birth to her second child using the continuity of care model and had one midwife from start to finish.

“I met my midwife at 12 weeks pregnant and had her on call 24/7 until six weeks following the birth of my son,” Mrs Love said.

“During this time, I was able to get to know my midwife and she got to know me – she spent time understanding my birth intentions, anxieties and beliefs.

“When it came to labour and birth, I felt so empowered and in control and knew that my midwife was there for me and looking out for my best interests.”

Director of Lockyer Valley Midwifery, Dawn Reid, was Samantha’s midwife and said women who have been through this service will swear by it.

“Women and families who have had their children through a midwifery-led continuity of care model can’t speak more highly of it,” Mrs Reid said.

“Continuity of midwifery care is not just about managing labour and pain during birth, it’s about holistic care, covering all aspects of pregnancy, birth, antenatal and postnatal whilst supporting the entire family and extended family to make the entire experience the most beautiful, empowering and memorable of your life.”

Mrs Reid has spent the last 7 years working in a continuity of care model prior to spending the last 30 years of her career in various other models of care.

“The benefits for women, babies and midwives is undeniable and cannot be overlooked,” she said of the continuity of care model.

“As a midwife, we go into this profession because we want to support women to be empowered and we can only do this when we have the opportunity to build a relationship with women and their families.

“Knowing the woman and the family you’re supporting is also critical to ensuring the health and wellbeing of the mother and their newborns.”

Maternity continuity of care model changing lives

Our workforce studies show working in continuity of care is better for midwives and women and helps retain this very important workforce. Our collaborator and Lead Author of the study Mary Sidebotham was interviewed for this Channel 7 News story that demonstrates the benefits of a Continuity of Maternity Care model for midwives and women.

Watch the full news story here.