Fact sheet: Safety and quality guidelines for privately practising midwives

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The Nursing and Midwifery Board of Australia (NMBA) carries out functions as set by the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law). The NMBA regulates the practice of nursing and midwifery in Australia, and one of its key roles is to protect the public. The NMBA does this by developing registration standards, professional codes, guidelines and standards for practice which together establish the requirements for the professional and safe practice of nurses and midwives in Australia.

The Safety and quality guidelines for privately practising midwives (the guidelines) are intended to protect the public through a robust regulatory framework for privately practising midwives (PPMs). The guidelines provide PPMs with clarity and support to practise their role with safety and quality, while facilitating workforce flexibility and access to services.

Background

Privately practising midwives (PPMs) practise in a range of settings that can include providing midwifery services in the woman’s home. This practice is outside the routine clinical governance arrangements of a health service provider.  

Section 284 of the National Law gives privately practising midwives (PPMs) providing homebirth services an exemption from the NMBA’s professional indemnity insurance (PII) requirement set by section 129 of the National Law. The exemption has been extended on two occasions and is currently in place until 31 December 2021.

Section 284(c)(ii) states:

  1. the midwife complies with any requirements set out in a code or guideline approved by the National Board under section 39 about the practise of private midwifery, including –
    1. any requirement in a code or guideline relating to the safety and quality of the practise of private midwifery.

These guidelines replace the Safety and quality framework for privately practising midwives attending homebirths and describe the regulatory requirements with which a PPM is expected to comply in order to be eligible for an exemption from requiring professional indemnity insurance (PII) for providing intrapartum care for homebirths (under section 284 of the National Law), and the requirements for PPMs who provide care in discrete areas such as postnatal care, antenatal care and/or specialist lactation services.

These guidelines have been developed after undertaking an extensive consultation of the previous Safety and quality framework for privately practising midwives attending homebirths.

The following questions answer common queries that you may have about the Safety and quality guidelines for privately practising midwives.

This fact sheet applies to privately practising midwives including those with an endorsement for scheduled medicines.

The guidelines replace the existing framework and set out:

  • the requirements set by the NMBA relating to the safety and quality of private practice midwifery, in the provision of home birth services for PPMs to be exempt from the professional indemnity insurance (PII) requirements set by the National Law1, and
  • the legislative and regulatory requirements of applicable registration standards, professional codes and guidelines.

1Sections 129 and 284 of the Health Practitioner Regulation National Law as in force in each state and territory

The key features to the guidelines are:

  • the requirement for a risk assessment based on the Australian College of Midwives (ACM) National midwifery guidelines for consultation and referral
  • the presence at a homebirth of two registered health professionals, educated to provide maternal and new born care and skilled and current in maternity emergency management and maternal/neonatal resuscitation, one of whom is a midwife
  • completion of a professional practice review program (PPRP), and
  • demonstration of annual competencies in adult basic life support, neonatal resuscitation and training.

You may need to update or change your practice to demonstrate that you have met the requirements of the guidelines. The NMBA will develop additional guidance and will work with the profession to provide clarity on how you can meet these requirements.

The requirement for a second registered health practitioner at a homebirth provides support for the midwife to manage the homebirth and any emergency situations that may arise.

Based on the feedback received during the consultation on the guidelines it was considered that the PPRP was best placed in the guidelines.

The NMBA has the discretion to select a random number of midwives to be audited at any time. You will need to provide evidence that you have met the requirements of the Safety and quality guidelines for privately practising midwives. The guidelines section ‘Audit of practice’ details the evidence needed to meet the requirements of the guidelines. The guidelines set these out clearly in table format according to the registration status and context of practice for the PPM. For further information, please see the ‘Table of evidentiary requirements for PPMs’ provided in the guidelines.

 
 
 
Page reviewed 7/05/2019