Where we stand at the minute.
Jan. 30th, 2009 06:30 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
squeefulfishI should be heading out the door to college now, but I can afford to be a few minutes late. This is pretty much for my own amusement and rantage, you've been warned.
Until April or so 2008, independent midwives in Ireland were insured by the Irish Nurses Organisation. Now, I quite like the INO as a union despite having some issues with it not keeping up and not mentioning midwifery in its title. The midwives who did the pilot programme of what I'm doing are not nurses, and there are still a few working who qualified before the 1957 change to midwifery training where it was decreed that you needed to be a nurse before you could be a midwife. That's leaving aside the non-Irish-trained midwives working in the country who are not nurses and there are many of them.
For reasons uncertain, the INO decided to discontinue insurance coverage of IMWs. Then changed their mind again and brought it up to September last year when someone pointed out that the insurance is only about a grand a year. That's less than some people's car insurance. Yes, insurance companies realise that's how low risk home birth is for the majority of those who choose it. Compare that to medical insurance where in the 90's most maternity hospitals were paying 20% of their annual budget in medical insurance. There are a whole host of reasons, not least those related to the carer-woman relationship, for that.
So last year, the INO finally went "no no no no no la la la la la can't heeeeear youuuuu!" and the IMWs entered talks with the HSE to get insured under the same scheme as GPs are insured under. Again, nice n low risky stuff. And after a while a document emerged. The Memorandum of Understanding. So IMWs can now be insured by the HSE (and paid by the HSE to care for women under the Maternity and Infant Care Act as they bloody well should have been before but weren't which meant that only those who could afford it could engage an IMW - more rantage about power of medics) Cark and Kerry women could get an IMW through the HSE before that, which was nice but not so helpful if you live elsewhere. Yay insurance! Yay being paid! Yay women not having to pay! (I'm including private health insurance as women paying cos that ain't free.)
Only thing is, the HSE noticed that there are about 100 midwives about to finish their training in September 2010. Oh noes! Untested in the field because they get at most a month of community midwifery training in that 4 years! But until now, coming straight out of training and going independent wasn't an issue. Not many did it, we've 15 IMWs in the entire country (nice clustering around Cark/Kerry) but there was no reason why they couldn't. But now, a midwife needs three years post-registration midwifery experience before they can get insured and paid by the HSE. But! There is no mention of if that's full-time experience, or where that experience had to be gained. Brilliant. So someone like myself, contemplating further education after graduation/registration with An Bord Altranais and working occasionally as an agency midwife to keep food on the table while studying is deemed to have the same post-reg experience as someone who goes straight into a hospital to work full-time? Yes! Brilliant.
While I love that I'm living in a country that listens to the WHO and FIGO about how bloody brilliant midwifery is and doesn't make my profession illegal or alegal, it does rather annoy that there's not enough trust being put in the education system to get me out as a safe midwife and that for many the only way to get the three year's post-reg experience will be in a hospital. Three years is more than enough time to get ground down and lose faith in midwifery and women's ability to birth.
And now I'm going to be late for my bus. Oopsie.
Until April or so 2008, independent midwives in Ireland were insured by the Irish Nurses Organisation. Now, I quite like the INO as a union despite having some issues with it not keeping up and not mentioning midwifery in its title. The midwives who did the pilot programme of what I'm doing are not nurses, and there are still a few working who qualified before the 1957 change to midwifery training where it was decreed that you needed to be a nurse before you could be a midwife. That's leaving aside the non-Irish-trained midwives working in the country who are not nurses and there are many of them.
For reasons uncertain, the INO decided to discontinue insurance coverage of IMWs. Then changed their mind again and brought it up to September last year when someone pointed out that the insurance is only about a grand a year. That's less than some people's car insurance. Yes, insurance companies realise that's how low risk home birth is for the majority of those who choose it. Compare that to medical insurance where in the 90's most maternity hospitals were paying 20% of their annual budget in medical insurance. There are a whole host of reasons, not least those related to the carer-woman relationship, for that.
So last year, the INO finally went "no no no no no la la la la la can't heeeeear youuuuu!" and the IMWs entered talks with the HSE to get insured under the same scheme as GPs are insured under. Again, nice n low risky stuff. And after a while a document emerged. The Memorandum of Understanding. So IMWs can now be insured by the HSE (and paid by the HSE to care for women under the Maternity and Infant Care Act as they bloody well should have been before but weren't which meant that only those who could afford it could engage an IMW - more rantage about power of medics) Cark and Kerry women could get an IMW through the HSE before that, which was nice but not so helpful if you live elsewhere. Yay insurance! Yay being paid! Yay women not having to pay! (I'm including private health insurance as women paying cos that ain't free.)
Only thing is, the HSE noticed that there are about 100 midwives about to finish their training in September 2010. Oh noes! Untested in the field because they get at most a month of community midwifery training in that 4 years! But until now, coming straight out of training and going independent wasn't an issue. Not many did it, we've 15 IMWs in the entire country (nice clustering around Cark/Kerry) but there was no reason why they couldn't. But now, a midwife needs three years post-registration midwifery experience before they can get insured and paid by the HSE. But! There is no mention of if that's full-time experience, or where that experience had to be gained. Brilliant. So someone like myself, contemplating further education after graduation/registration with An Bord Altranais and working occasionally as an agency midwife to keep food on the table while studying is deemed to have the same post-reg experience as someone who goes straight into a hospital to work full-time? Yes! Brilliant.
While I love that I'm living in a country that listens to the WHO and FIGO about how bloody brilliant midwifery is and doesn't make my profession illegal or alegal, it does rather annoy that there's not enough trust being put in the education system to get me out as a safe midwife and that for many the only way to get the three year's post-reg experience will be in a hospital. Three years is more than enough time to get ground down and lose faith in midwifery and women's ability to birth.
And now I'm going to be late for my bus. Oopsie.
