July 25 2013 was an historic day for the Federation. That was the day our midwife members were officially recognised in our name: the Australian Nursing & Midwifery Federation (ANMF). The ANMF represents the largest number of registered midwives in the country, with over 19,000 members registered as midwives. This is more than half of all registered midwives in Australia, according to the total number of 35,577 shown in the June 2013 statistics from the Nursing and Midwifery Board of Australia (NMBA). Fitting, therefore, that our name signifies both the nursing and midwifery professions.
Given that this month’s Focus section in the ANMJ is on midwifery we thought it timely to outline some of the work undertaken on behalf of our midwife members. Midwives have been an integral part of the Federation since its inception in 1924. Professional and industrial gains have been fought for and achieved for our nurse and midwife members alike, over the intervening years. Of particular significance has been improvements to wages and conditions; implementation of career structures; introduction of workload management arrangements for safe care delivery; and university based education for registered nurses and registered midwives, across the country.
Prior to the introduction of the National Registration and Accreditation Scheme in 2010, our union took a leadership role with the Australian Peak Nursing and Midwifery Forum, in ensuring preservation of regulatory entitlements for nurses and midwives (protection of title and recognition as separate professions). The ANMF undertook extensive work during the establishment of the Nurse Practitioner (NP) role and more recently that of the Eligible Midwife (EM). This has included the development of related legislation and regulations, to allow access to prescribing, the ordering of diagnostic and referral by NPs and EMs. While the final outcome of this work was not all that we had desired, it gave us a basis from which to continue to advocate for the full rights of these experienced nurses and midwives who are the clinical practice leaders in our professions. The ANMF professional team represents and advocates for our midwife members in all written and personal representational work relating to professional matters. The policy issues we’ve contributed to over recent months on behalf of our midwife members include the following:
Review of midwifery accreditation standards
The Australian Nursing and Midwifery Accreditation Council (ANMAC) commenced the review of the Midwifery Accreditation Standards in February 2013. ANMF Federal Office has been represented on the Expert Advisory Group for this review by O’Bray Smith, a registered midwife member, from the NSW Nurses and Midwives Association Branch Council. Over the last 12 months the ANMF has provided a national response to two consultation papers; responded to, and circulated to members, two online surveys; attended and actively participated in three consultation forums, and four regional/rural/ remote focus groups. We have represented members’ views throughout ANMAC’s extensive consultation process. Our aim has been to ensure standards developed for accrediting midwifery programs in this country will be attainable for students in their preparatory content and produce registered midwives capable of delivering all aspects of maternity care. It is also our firm view that we need to prepare a workforce equipped and willing to work in regional, rural and remote parts of Australia, to protect the viability of already vulnerable and fast disappearing midwifery services in these areas. Throughout the ANMAC consultation process we have maintained that midwifery programs need to prepare safe and competent registered midwives through attainable requirements which reflect contemporary practice in the Australian context. We now await the result of the review following consideration by ANMAC Board, the NMBA, and finally, Health Ministers through the Standing Council on Health (SCoH), over the next few months.
Revision of the Safety and Quality Framework for midwives
The ANMF commended the NMBA for making the necessary changes to their document Safety and Quality Framework for Privately Practising Midwives attending homebirths, to extend applicability to all midwives. The midwife can best ensure safety and quality by focussing on the needs and safety of the woman and her infant(s), as well as their own professional obligations, when making decisions, recommendations and options for care.
Draft position statement on bed-sharing and co-sleeping
The information contained in the draft statement from the Australian College of Midwives covers several issues around mothers’ and caregivers’ rights in making informed choices about bed-sharing and co-sleeping. The ANMF expressed concern the draft statement did not wholly align with current expert, evidence-based guidelines (for example, those provided by SIDS and Kids, UNICEF UK, directives and guidelines from Australian health departments, and coronial recommendations).
The ANMAC is consulting on the Accreditation Standards required for Eligible Midwife Programs. This review will revise and update the Standards. The ANMF is responding as this column is being written.
For more information about the work of the ANMF federal professional team, including the submissions outlined above, go to the ‘Professional’ section at: www.anmf.org.au
Julianne Bryce and Elizabeth Foley
Federal Professional Officers