Midwifery Insurance Gap: Still No Solution for Past Due Date

A month after the Australian College of Midwives identified a gap in professional indemnity insurance for privately practising midwives, the loophole has still not been closed.

On Oct. 17, the college notified the federal health department that the only available insurance policy for endorsed midwives has an exclusion for intrapartum care (early labour) provided outside of a hospital.

Australian College of Midwives chief midwife Alison Weatherstone told AAP that, while they had been working closely with health department and government stakeholders, it was unacceptable that a solution had not yet been found.

“A month at the end of a woman’s pregnancy is a very long time, and to be impacted during that time is also unacceptable,” Ms. Weatherstone said.

The women who are most affected are those planning a hospital birth and using a private (or endorsed) midwife for antenatal and early labour care, including some Birthing on Country programs for Indigenous mums and babies.

“The gap in insurance means that they can’t receive their early labour care at home,” Ms. Weatherstone said.

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“And this is a crucial time for women to settle into labour and avoid the cascade of intervention that can happen if you present to hospital too early.”

Greens senator Larissa Waters, who raised the issue in a senate estimates hearing last month, called on the government to fix the problem as a matter of urgency.

“Midwives are essential to improving access to maternity and reproductive health care, particularly in regional and remote parts of the country,” Ms. Waters said.

“To learn suddenly that they are no longer covered to perform these services has direct implications on the livelihoods of midwives, and on the health outcomes of the people they are caring for during pregnancy and birth.”

Ms. Weatherstone said the gap was putting extra pressure on hospitals, midwives and pregnant women at a vulnerable and crucial time.

“Midwives work with women to provide woman-centred care that’s individualised,” she said.

“We are taking away choice from women by not enabling them to be in their home in the early stages of labour.

“The impact on one woman should be enough to launch the government into immediate action, and while we acknowledge that it takes time to change legislation and insurance, this amount of time is not acceptable for women and families in Australia.”

Planned home births are not affected.

Since no insurance product is available, the Council of Australian Governments (COAG) Health Council has issued an exemption that allows private midwives to attend births at home without intrapartum insurance, as long as they are covered by an appropriate level of indemnity insurance for their antenatal and postnatal care services.

Health Minister Mark Butler told AAP on Nov. 9 that they were “close to a solution”, but more than a week later there has been no change.