"Community Midwifery Services - Midland"

I recently birthed with the Community Midwifery Program (CMP) in Perth. My midwife was outstanding providing care throughout my pregnancy, birth and now postnatally. The CMP provides a crucial service to low-risk women wishing to birth at home or in a hospital and I believe operates a continuity of care model unlike any other in the public health service. It is exemplary and in my opinion needs to be protected, promoted and understood better at the higher ranks of the WA Health Service and by the public. 

As part of the model, anyone wishing to birth at home attends an appointment at their back-up hospital at 20 weeks and again at 41 weeks if necessary. Any issues during the pregnancy or labour and care is transferred to the backup hospital. This is well understood and all patients sign up to this agreement. 

However, as SJOG (St John of God) Midland was my back-up hospital - my midwife is no longer allowed to care for me if my care needed to be transferred. In fact, she is actively not allowed in the hospital at all. I believe this completely breaks the continuity of care model from the CMP, disempowers patients and leaves women feeling vulnerable and cast into a whole new model and set of rules at a time when comfort and support are absolutely necessary. It is frightening and I feel often results in needless interventions into midwifery care which CMP patients actively try and avoid by signing up to the CMP in the first place! 

I think it is also dangerous when care needs to be transferred during birth and the midwife who has been caring for the woman, knows her medical background and the reason for transfer - is left standing at the hospital door unable to transfer this knowledge and her support. 

If I lived in a different area and had a different back-up hospital none of this would be an issue as my midwife would still be allowed to attend to me in the hospital (e.g. Fiona Stanley, King Edward Memorial Hospital). So why am I penalised by my postcode? Why are women in the eastern region having their choice taken away from them because of the public-private model at SJOG and I believe their lack of support for the CMP model? They should lose funding if they are not going to support care in the way the other public hospitals do. 

In my view, either SJOG should not be a backup hospital for the CMP or it needs to follow the guidelines/care practices of the other public hospitals - otherwise I believe you are completely undermining the whole concept of continuity of care in community midwifery here in Perth.