what have we done, and what's yet to be done?

With a 'for sale' sign in front of my home, and the last new baby in my homebirth caseload safely at her (equally new) mummy's breast, it's time for me to sort through folders and files in my office in preparation for a move.  Brochures, letters, and pictures from those busy days of maternity activism in the 1990s and early noughties have already surfaced, and triggered memories.


Today I would like to present snapshots of a few moments in the past 20+ years.  My story will link to the stories of others who saw the vision for maternity reform across this country.  Dear reader, if you are able, please continue with this vision.  There is as much need today as there was 20 years ago for maternity reform.

Working night shifts at the Women's, 1983

1983 - Snapshot #1

I am a mother with four children, aged 9, 8, 6, and 3.  My time is sucked up by the demands of the children for school, music lessons and practice, sport, Church, community groups, household chores, and the squeakiest wheel that grabbed my attention.  

I am working night shifts - permanent part time, two nights a week - at the Women's in Carlton.

In the mind-fog of tiredness I often spoke to colleagues of my dream that one day I would work with just a few mothers, and be the midwife through the birth and postnatal care at home.  I didn't know the phrase 'continuity of care' back then.  I felt as though I was having one night stands with women, and I wanted something better.

1993 - Snapshot #2

After 12 years of hospital night shifts I have resigned from the hospital, and (aged in my 40s) feel strong and ready for anything now that I am able to go to bed (almost) every night.  I have commenced private practice, joined Midwives in Private Practice (MiPP),  attended my first homebirth, subscribed to MIDIRS, read everything I could put my hands on by authors like Sheila Kitzinger, Michel Odent, certified as a lactation consultant, joined the Victorian branch executive of the College of Midwives, joined and chaired the Victorian Baby Friendly Hospital Initiative, and become a birth activist.

1993 - a midwife with her own private practice!

My children are growing up: the oldest at Uni and the youngest had started secondary school.  They don't need much from me these days.

Through MiPP I have met the women who had become active a few years earlier during the Victorian Birthing Services Review: Irene Shaw, Kerreen Reiger, Karen Lane, Rhea Dempsey, midwives Jenny Parratt, Annie Sprague, Robyn Thompson, Ali Page, Mary McKenzie McHarg, Chris Shanahan, Patrice Hickey, Clare Lane, and others.   I see a role for myself in the College of Midwives, and start writing responses to government reviews.

Victoria had the Midwives Regulations 1985, which said all sorts of things such as a midwife must have a doctor's permission to perform a vaginal examination (one might ask whose vagina?) and that a midwife must wear clean clothes of a washable material! The new Nurses Act came in in 1993, and we thought the Regulations would be set aside - even the lawyers at the time told us that they were unenforceable. But on the night before the new Act was voted on in the Vic parliament, the Health Minister Marie Teehan received a fax from RANZCOG (Vic) insisting that it was not safe for midwives to work without medical supervision. The solution was to retain the Regulations, which is what happened. All Regulations sunset after 10 years, so in 1996 we were released from them (only to be effectively re-regulated under medical supervision with the 2009 Report of the Maternity Services Review). 

In the early 1990s the Nurses Board of Victoria published a very nice Code of Practice for Midwives, based on the International Confederation of Midwives' Definition of the Midwife, which stated clearly that the wellbeing and safety of mother and child were central to all midwifery care, that the midwife was competent to provide midwifery services on her own authority, that midwifery was woman centred, that midwives collaborated with doctors when indicated ...  

Maternity Coalition and ACM ran the Midwifery Campaign, "To achieve for all women the right to choose a midwife as their primary caregiver during pregnancy and birth within the health system (public and private) whether in the community or hospital."

Our vision for maternity reform was inspired by stories from New Zealand: that midwives were able to be recognised as the primary maternity care giver (lead maternity carer or LMC); and that NZ midwives and doctors received equal pay from the public purse for equal work.  At the same time the news of Changing Childbirth reforms in the UK inspired us: that women wanted the 3C's: Continuity, Control, and Choice. 

At that time I dared to dream that Australian maternity care could also be reformed.

2003 - Snapshot #3

the journal of Maternity Coalition

'Push for better birth' 2003 - with the Melbourne skyline in the background.

I am confident in my professional identity as a midwife.  I love being with woman, and writing my stories, and have published The Midwife's Journal on my website.  I love being a leader in Maternity Coalition, and in the College of Midwives, and I have had a 3-year Ministerial appointment to the Nurses Board of Victoria, learning a great deal about statutory regulation and legislation.

In 2002 we published the National Maternity Action Plan in which we dared to dream

that Australian maternity care would recognise the midwife as “the most appropriate and cost effective type of health care provider to be assigned to the care of women in normal pregnancy and birth, including the risk assessment and the recognition of complications"(WHO 1996)

We continue working towards that goal.