Since 2010, women and people giving birth have been able to access Medicare rebates for midwifery services, and some Medicare-funded pathology and radiology services provided by eligible midwives.
To be eligible to apply for a Medicare provider number, midwives must meet certain requirements as articulated by the Nursing and Midwifery Board of Australia (NMBA). Midwives who meet these requirements as approved by the NMBA are known as ‘endorsed midwives.’
Endorsed midwives are eligible to apply for a Medicare provider number and also authorised to prescribe within their scope of practice in accordance with the legislation and policy in their local jurisdiction. As a result, privately practising midwives (PPMs), Medicare eligibility and prescribing by midwives have been intrinsically linked. Many make the assumption that only midwives seeking to be a PPM need to consider becoming a midwife prescriber.
However, prescribing by midwives should not be confined to PPMs.
Providing holistic and personalised care underpins the midwifery philosophy of being with woman. Continuity of midwifery care and carer are considered valuable elements of a cohesive, quality maternity service.
When midwives prescribe, they are enabled to provide holistic and personalised care, continuity of care (CoC) and carer are enhanced and outcomes are optimised for women and people giving birth, babies and families.
When midwives prescribe, women and people giving birth gain timely access to medicines, treatments and preventative care, particularly important in regional, rural and remote areas. Fragmentation of care is reduced, CoC and carer are facilitated, and costs are reduced for individuals and the health system.
When midwives have the authority to prescribe in any context of practice – as a PPM or an employed endorsed midwife in a public health service or private health service entity, they can offer cost effective, timely comprehensive care, and the overall experience of care becomes less repetitious, consistent and coordinated for women and people giving birth.
It is essential the value of widespread midwife prescribing to the maternity care system is recognised and elevated.
The latest NMBA statistics demonstrate endorsed midwives make up 4.2% of midwives with general registration.1 Due to a lack of national consistency, leadership and local policy that promotes and authorises midwife prescribing, this component of care delivery is almost non-existent outside of the private sector.
There is also a professional barrier to normalising prescribing for all midwives. For many midwives, prescribing is just not on their radar. Pursuing further education in prescribing and diagnostics may seem superfluous to their context of practice.
However, midwifery prescribing is well established as a core component of midwifery practice in New Zealand, Canada and the United Kingdom. There is growing sentiment in Australia that prescribing and diagnostics are a foundational skill for all midwives and prescribing by midwives practising in any context will optimise outcomes for women and people giving birth.
United, Australian midwives can change this.
In 2024 bargaining, ANMF Vic Branch secured a 4% allowance for endorsed midwives utilising their endorsement in the public sector from 1 June 2025. This demonstrates the added value of prescribing by midwives to service delivery. Whilst many health services do not yet have the policies and procedures in place to enable endorsed midwives to prescribe, discussions are underway to change this.
West Australian midwives, Sonya Mahoney and Lauren Papalia, identified the underutilisation of prescribing by endorsed midwives in their health service and acted for change. Through advocacy and collaboration, barriers to midwifery prescribing were gradually addressed to enhance continuity of care for women and people giving birth within their health service, whilst enabling midwives to practice to their full scope. This grass roots approach demonstrated the power of midwives to make change to broader policy and the care women and people giving birth receive.
Nationally, through ANMF and other stakeholder advocacy, scholarships are available to support midwives to undertake the education required to apply for endorsement. For more information see health.gov.au/our-work/primary-care-nursing-and-midwifery-scholarship-program
Prescribing by midwives is about all women and people giving birth having access to seamless, timely services that meet their needs, and midwives practising to their full value in a challenged system. Start the conversation today in your workplace.
Reference
1 Nursing and Midwifery Board of Australia. 2024. Nurse and Midwife Registration Data Table September 2024. Accessed 10 February 2025 atahpra.gov. au/documents/ default.aspx?record=WD24%2 f34166&dbid=AP&chksum=mcROD5MET4V8ZTGkIb%2f9q Q%3d%3d&_gl=1*b4hgsc*_ga* MTgwNjIwNTQwNC4xNzM5 MTU1OTQw*_ga_F1G6LRCH ZB*MTczOTE1NTk0MC4xLjAu MTczOTE1NTk0MC4wLjAuMA
