An Introduction to Midwifery Collaboration and Midwives with Medicare.
“The Australian College of Midwives National Midwifery Guidelines for Consultation and Referral” have been developed to assist midwives responsible for providing care to a woman to decide when it is appropriate to discuss care of that woman with a medical or midwifery colleague, or to refer a woman for further care/and or advice.
Midwives, as primary carers, need to make decisions when a woman in their care may need medical attention during pregnancy, labour, birth or the postnatal period. These Guidelines have been developed to provide midwives with support in doing this in consultation with the woman to whom the midwife is providing care. It is the intention that the Guidelines be used to facilitate consultation and integration of care between midwives and doctors, thereby giving confidence to providers, women and their families.
Basic Assumptions for Midwifery Care:
These Guidelines have been developed around the following set of core assumptions that are informed by international standards and best practice in maternity care.
- Pregnancy, birth and the postnatal period are normal physiological processes.
- Maternity care must be based on awareness of physical, emotional, social and cultural aspects of wellbeing for both the woman and her infant(s).
- *The achievement of collaboration and co-operation between professional groups involved in maternity care is of major importance for optimal care. This involves recognition of the particular expertise found within various groups of healthcare-providers. *
- The woman and the midwife work together during the whole maternity experience, building a relationship of trust with each other, sharing information and decision making and recognizing the active role that both play in the woman’s maternity care.
- Where a woman has selected a midwife for her care, the referral to secondary or tertiary level maternity care is carried out by the midwife (primary care giver), who is qualified for this task.
- Midwifery care may continue even when referral to care by a secondary or tertiary level health care provider is necessary i.e the midwife continues to provide midwifery care or support to the woman.
- In order to ensure that selection and referral takes place appropriately, the expertise of the secondary and/or tertiary level health care-providers must be accessible to the midwife by means of consultation and advice.
Agreement Requirements for Midwives practicing with Community Midwifery Services:
- All midwives practicing with Community Midwifery Services are contracted to follow these Guidelines for Consultation and Referral.
- *All midwives practicing with Community Midwifery Services understand the importance of collaboration and co-operation between professional groups and value this aspect of their care.
- All midwives practicing with Community Midwifery Services have been specially chosen by the team because of their experience as a team leader or previous Primary Health care role.
- All midwives practicing with Community Midwifery Services have to sign a “code of conduct” which indicates the importance of professional behavior at all times, whatever the setting, and in all their verbal or written communication with other members of the Primary Health, or Tertiary Health Care systems, including Allied Health organizations.
- Community Midwifery Services provides care which is evidence based, and we aim to work with the local or “host” hospital of the woman’s choice, to ensure the woman and her family has care which is culturally sensitive, and unique to that individual families needs.
Consultation with a medical or other health care provider:
- A consultation refers to the situation where a midwife recommends the woman consult a medical practitioner, or where the woman requests another opinion of a health care provider.
- It is the midwife’s responsibility to initiate a consultation and to clearly communicate to the health care provider that she is seeking a consultation.
- The consultation involves addressing the variance from “normal” e.g a “face to face” assessment, the prompt communication of the findings and the recommendations to the woman and the health care provider to whom the referral is made.
- Where a consultation occurs, the decision regarding ongoing clinical roles/responsibilities must involve a three-way discussion between the health care provider, the midwife and the woman concerned. This should include a discussion about any need for, and timing of, medical practitioner review.
- The midwife or health care provider will not automatically assume responsibility for ongoing care. This will depend on the clinical situation and the wishes and needs of the individual woman.
- After consultation with a medical practitioner, it should be clear whether primary care and responsibility: a) continues with the midwife or, b) is transferred to the medical practitioner.
- The midwife maintains overall responsibility for midwifery care within her scope of practice in collaboration with the medical practitioner and remains responsible for this discrete area of the woman’s care.
- Where urgency, distance, or adverse circumstances make a “face to face” consultation impossible between a woman and a health care provider the midwife should seek advice by phone. The midwife should document this request for advice in her records, and discuss with the woman the advice received.
- Areas of discussion and involvement must be agreed upon and clearly documented.
Referral Form for Collaboration with Community Midwifery Services.
Note to obstetricians and GP obstetricians: Louise Paterson –Clinical Midwifery Specialist, works alongside obstetricians and GP obstetricians to provide complementary midwifery care from pregnancy throughout the postnatal period. For clients to receive medicare rebates for my antenatal and postnatal care, please fill in the form below and email, post or send back to me with the client.
Please provide referral to Louise Paterson –Community Midwifery Services –
12 Dawson Court , Aspendale Gardens, Victoria 3195
Clinical Director – Louise Paterson (4445112Y)
Reason for referral:
Signature of Doctor:
Preferred contact details: