Relevant clause in Section 88 - DA27
A general practitioner or midwife must provide the following services as required to women during labour and birth:
(a) urgent care and treatment to support a LMC in a rural or remote rural domicile (as defined in Schedule 2) if the services of an obstetricianor paediatrician are needed but are not available and the LMC requires assistance from another practitioner who has additional maternity skills:
(b) accompany the woman in an air/road ambulance from a rural or remote rural domicile area
This module is designed to support a midwife’s costs/expenses of returning home and/or accommodation after a transfer was initiated from a rural or remote location (this includes the woman’s usual place of residence or from a primary care hospital) to secondary/tertiary care.
It can be claimed at any time during a woman’s pregnancy (antenatal, labour and birth, and postnatal). However, this module can be claimed once per day, per woman, per LMC. Finally, the fee can only be claimed if the LMC escorted the woman or baby via ambulance or air transport.
This module is not designed to compensate a back-up midwife for his/her presence at a home birth. It is customary practice for a back-up midwife to be present at a planned home birth. The Ministry of Health has implemented a home birth supplies fee to cover the costs of replenishing a home birth kit and/or to reimburse the back-up midwife’s time and assistance at a home birth.
This module cannot be claimed if the transfer occurred from a semi-rural location (woman’s home or primary care unit) or if an ambulance transfer occurred from a city hospital to another city hospital.
Example for when this fee is applicable:
- A woman had a planned home birth in a remote rural location and is not coping with the pain and wishes to have an epidural. The midwife arranges for an ambulance transfer and rides with her woman in the back of the ambulance until it reaches the secondary care hospital for pain relief intervention.
Examples when this fee is not applicable:
- A woman had a planned home birth and back up midwife was present the entire time assisting the LMC.
A woman is in established labour in a primary care hospital but develops pyrexia and needs immediate intervention in a tertiary care facility. The ambulance is full leaving no room for the LMC, so he/she follows the ambulance using his/her own vehicle.