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Section 51: Contract for Autonomy

Abstract:

The underlying belief structure of the women and midwives who fought for the midwifery profession over the last decade was that the midwives' ability to practise autonomously improved the experience and the birth outcomes for women and their babies. Midwifery's collective autonomy meant freedom from the authority of the medical profession concerning the provision of normal maternity care. It was considered essential that the women-intensive midwifery profession controlled midwifery in order for women to control childbirth. When the Nurses Act changed in 1990 practice autonomy also meant financial autonomy, as midwives gained entitlement to claim from the Maternity Benefit Schedule. This fee-for-service schedule was not popular within the Department of Health at the time as it was considered over utilised and abused by claimants. With the inclusion of midwives into its negotiation process, the Department of Health openly confided to the NZCOM that they hoped to restructure the whole method by which maternity services were paid.

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maternity services payment schedule, midwifery autonomy, Section 51