National Maternity Services Plan

Priority 4 — infrastructure

Information about the maternity services infrastructure.

Page last updated: 2011

Action 4.1 Ensure all maternity care is provided within a safety and quality system
Action 4.2 Ensure maternity service planning, design and implementation is woman-centred

Action 4.1 Ensure all maternity care is provided within a safety and quality system

(Aligned with Principles 2, 4, 5, 7, 8, 9)

A feature of this Plan is ensuring maternity services provide care within a sound safety and quality system, supported by a comprehensive evidence base to inform quality improvement. National quality and safety standards will help to maintain Australia’s outcomes for mothers and babies. Establishing and maintaining these standards is a priority as innovative and progressive models of maternity care are implemented around Australia.

Care along the maternity pathway is typically provided across a number of settings and by a number of different providers. Effective communication and coordination is essential to achieve continuity of care across service providers and settings. Ensuring maternity care is well integrated and coordinated also facilitates the appropriate care for women with complex needs.

Standards and programs to support accurate and efficient information transfers between maternity services across the public and private interface in primary, secondary and tertiary settings, including to rural and remote locations, are currently being developed as part of the National E-Health Transition Authority’s work program. The national implementation of woman handheld medical records supports women’s inclusion in their maternity care and facilitates sharing of information between maternity professionals.36

Strategies in this Plan address the linking of maternity services within a robust system of transfer and referral, including links within and from maternity services and specialist services (such as neonatal services) to other areas of the health system, such as preventative health, allied health, child and family health services. Specific action related to a safety and quality framework for the provision of private homebirth is at Action 1.2.3.

The National Registration and Accreditation Scheme (NRAS) for health professions commenced on 1 July 2010. The new system, developed with the agreement of the Council of Australian Governments, for the first time creates a single national registration and accreditation system for 10 health professions, including medical, and nursing and midwifery. National Boards for the professions are now operating with their full functions under the Health Practitioner Regulation National Law Act 2009, known as the National Law in participating jurisdictions. The National Boards, including the Nursing and Midwifery Board of Australia, have the over-arching aim of protecting the public.

Maternity care reforms are introducing new ways of working for eligible and privately practising midwives. Working under the new practice requirements of the Nursing and Midwifery Board of Australia requires a structure and process to monitor compliance with these practice requirements, and to provide support for eligible and privately practising midwives.
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Elements of the Plan described in this section also align with Action 2.1.
The initial yearThe middle yearsThe later yearsSigns of success
4.1.1 The Australian Government works with RANZCOG and ACM to inform the development of consultation and referral guidelines for maternity care.Australian governments work with RANZCOG and ACM to facilitate the use of consultation and referral guidelines into maternity care.Health professionals utilise the consultation and referral guidelines for maternity care.
4.1.2AHMAC maps current practices for the transfer of information and referral from maternity care to child and family health care, including general practice.AHMAC develops and endorses a nationally consistent approach to information transfer and referral from maternity care to child, and family health care, including general practice.
States and territories implement a nationally consistent approach to information transfer and referral from maternity care to child, and family health care, including general practice.
All women and babies are referred to child and family health care.
Standardised information is shared with child and family health care.
4.1.3 AHMAC develops a national woman-held pregnancy record.States and territories implement the national woman-held pregnancy record, complementing the PCEHR system.AHMAC evaluates the use of a national woman-held pregnancy record.Women have access to the national woman-held pregnancy record for the duration of their maternity care.
4.1.4 The Australian Government, in consultation with key stakeholders, commences planning for the introduction of a PCEHR.The Australian Government ensures that all Australians who choose to can register online for their PCEHR. Mothers and their newborn children will be a priority implementation group.The Australian Government further develops the PCEHR.Personally controlled electronic health records are available for women and babies.
4.1.5 The Australian Government funds the development of nationally consistent maternal and perinatal data collections.The Australian Government facilitates standardised nationally consistent maternal and perinatal data collections.
AHMAC agrees and begins facilitating the capture of standardised nationally consistent data items for the national data collections.
AHMAC facilitates the capture of nationally consistent data items for the national data collections.
The Australian Government publishes a report on maternal and perinatal outcomes.
Nationally consistent maternal and perinatal data are collected and reported.
4.1.6AHMAC explores options for using innovative technology solutions to provide specialist consultation and care to women in rural and remote locations.Australian governments facilitate the use of innovative technology solutions to provide specialist consultation and care to women in rural and remote locations.
Australian governments review the use of innovative technology solutions to provide specialist consultation and care to women in rural and remote locations.
Increased numbers of women in rural and remote locations receive appropriate specialist consultation and care through the use of innovative technologies in their maternity care.
AHMAC = Australian Health Ministers’ Advisory Council; ACM = Australian College of Midwives; PCEHR = personally controlled electronic health record system; RANZCOG = Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Action 4.2 Ensure maternity service planning, design and implementation is woman-centred

(Aligned with Principles 1, 2, 3, 4, 5, 7)

Top of pageThe planning, design and implementation of maternity services requires a woman-centred approach to meet the needs of women, and to provide equitable access to appropriate care that is clinically appropriate, culturally competent and provided within broader safety, quality and resource considerations. Women’s expectations for their maternity care must also be considered and inform strategic service planning initiatives.

Factors to be considered in service planning, design and implementation of maternity services include:
  • birth rates within communities
  • geographic factors, such as remoteness
  • socioeconomic factors including community levels of social disadvantage
  • links to medical specialists, allied health, child and family health, and other services
  • resourcing and service capability
A feature of the Plan is the development of a rigorous methodology to assist in woman-centred maternity service planning. This methodology, to be used in the context of broader resource considerations, would be expected to provide some guidance on the reasonable expectation of the local availability of maternity services for varying population centres, including consideration of:
  • access to a choice of birthing options
  • safety and quality requirements
  • numbers and qualifications of maternity care professionals
  • workforce/resource implications
  • sustainability of the services
The incorporation and adaptation of existing and in-development objective tools will contribute to that methodology. These tools may include:
  • a national service capability framework
  • Australian Bureau of Statistics birth rate data
  • the Rural Birthing Index developed in Canada
  • tools currently used by the jurisdictions to inform service planning Top of page
An audit of existing tools used to inform service planning, and the mapping of existing maternity services, Aboriginal and Torres Strait Islander services and other relevant services including allied health, will be followed by a gap analysis to identify existing areas of need.
The initial yearThe middle yearsThe later yearsSigns of success
4.2.1 AHMAC examines tools to assist in future planning for maternity care, including in rural and remote communities.AHMAC develops a rigorous methodology to assist in future planning for maternity care, including in rural and remote communities.Australian governments use the methodology to assist in maternity care planning.A rigorous methodology is used to assist maternity service planning.
4.2.2 AHMAC develops a National Maternity Services Capability Framework for the provision of maternity care.All jurisdictions implement a National Maternity Services Capability Framework.AHMAC reviews the National Maternity Services Capability Framework.A National Maternity Services Capability Framework is used by all jurisdictions.
4.2.3 Australian governments, through Closing the Gap initiatives, continue to provide supported accommodation and travel options for Aboriginal and Torres Strait Islander women and key family members who travel to access appropriate levels of maternity and neonatal care.
States and territories review existing accommodation and transport support mechanisms for women and key family members who travel to access appropriate levels of maternity and neonatal care.
As for year 1.
Australian governments explore options for increasing support for women and family members who travel to access appropriate levels of maternity and neonatal care.
Australian governments, through Closing the Gap initiatives, evaluate the provision of supported accommodation and travel options for Aboriginal and Torres Strait Islander women and family members who travel to access appropriate levels of maternity and neonatal care.
Australian governments implement strategies for increasing support for women and family members who travel to access appropriate levels of maternity and neonatal care.
Increased number of Aboriginal and Torres Strait Islander women and family members who travel to access appropriate levels of maternity and neonatal care have access to support for accommodation and transport.
Increased number of women and family members who travel to access appropriate levels of maternity and neonatal care have access to accommodation and transport support.
4.2.4AHMAC agrees to develop nationally consistent descriptors and definitions for the range of models of maternity care.
AHMAC develops agreed nationally consistent descriptors and definitions for the range of maternity care available.
There are agreed descriptors and definitions of the range of maternity care available.
4.2.5 The Australian Government introduces MBS and PBS subsidies for antenatal, intrapartum (excluding homebirth) and postnatal services provided by eligible midwives.
States and territories use best endeavours to amend the relevant drugs and poisons legislation to enable appropriate prescribing rights for midwives to facilitate access to PBS subsidies for women.
The Australian Government monitors the uptake of MBS and PBS subsidies by women.The Australian Government evaluates women’s access to MBS and PBS subsidies for services provided by eligible midwives.
The Australian Government reviews the health care settings under which MBS services for intrapartum care attracts a MBS and PBS subsidy.
There is an annual increase in the number of women accessing PBS and MBS subsidies for services provided by eligible midwives.
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