A group of Mid Mountains mothers is furious that a local doctor’s surgery is refusing to refer expectant mothers to midwifery services covered by Medicare.
Aimee Sing, a consumer advocate with Homebirth Access Sydney and part of the Blue Mountains homebirth community, claims Hazelbrook General Practice has been refusing to refer women to privately practising midwives (PPMs) for their Medicare rebatable antenatal and postnatal care for the past 15 months. At least 10 women have been affected.
Under Department of Health guidelines for privately practising midwives, a collaborative arrangement with a medical practitioner and a midwife requires a written referral.
“HGP has recently implemented a blanket policy which stipulates that GPs working within the practice are not allowed to provide referrals to women seeking the care of a PPM,” Dr Sing said.
“This blanket policy is not evidence-based, does not provide personalised care, is discriminatory against PPMs and is limiting women's pregnancy, birth and postnatal care options,” she said.
But the practice said there is some confusion over the referrals, leading to them being “targeted by a local home birth supporter” and “singled out for criticism by doula Aimee Sing”.
“This criticism seems to come from a misunderstanding of the legislation. The Medicare initiative requires home birth midwives to forge meaningful relationships with other local obstetric services," Dr Sarah Horniblow said in a statement to the Gazette.
"The intention is to make home birth safe and well supported for our mothers and babies. We absolutely support this initiative.”
And Dr Linda McQueen added “We're just not in a position to assist with those obstetric emergencies if things were to go wrong".
Dr Horniblow said they were not interested in providing “token referrals”. The practice is encouraging their “obstetric colleagues at referral hospitals to enter into dialogue with the home birth midwives and to support safe collaboration”.
But Dr Sing said there was no confusion. “The Department of Health note that eligible midwives can treat their own patients in collaboration with other maternity care providers including GPs, GP obstetricians and specialist obstetricians”.
“Since GP referrals to PPMs only cover antenatal and postnatal care, they do not require any action by the GP during the referred woman’s birth. Nowhere in any regulation, legislation or guideline does it state that the referring GP would be expected to attend a homebirth, or to provide obstetric or emergency care to a woman during her birth.”
Dr Sing said they had made multiple attempts to contact the practice manager – through a local midwife, consumer advocates, clients of the practice, and they had even sought help from Blue Mountains MP, Trish Doyle’s office.
The Gazette spoke to one mother who had two previous home births but was then refused a referral by the practice for a third. The mother said the clinic told her they were no longer able to give referrals “because our insurance doesn’t cover it”.
A spokeswoman from Ms Doyle’s office said they were just trying to open up dialogue between the mothers and the clinic, but had to date not been successful. “We have an interest in making sure women have access to choices, they said they were trying to get clarification from their insurers.”
