The professional pathway, training and clinical experience of a Homebirth midwife in practicing in Sydney, Australia
In this Midwife At Your Door video interview, Danae explores the professional pathway, training and clinical experience required to become a privately practising Homebirth midwife in Australia. The midwives from The Nesting Hub share insights into their backgrounds, including university education, hospital training and the extensive experience required before moving into private midwifery practice.
Topics explored in this video
This interview explores the professional pathway, training and clinical experience required to become a privately practising homebirth midwife in Australia. The midwives from The Nesting Hub share insights into their backgrounds, including university education, hospital training and the extensive experience required before moving into private midwifery practice.
The discussion explains how midwives are regulated through the Nursing and Midwifery Board of Australia and the Australian Health Practitioner Regulation Agency, and outlines the additional requirements needed to practise independently, including endorsement as privately practising midwives, professional indemnity insurance and Medicare provider eligibility. The conversation also highlights the importance of continuity of care, where the same midwife supports families throughout pregnancy, labour, birth and the postpartum period.
Through this discussion, viewers gain a clearer understanding of the depth of training, clinical responsibility and professional accountability involved in the homebirth model of care. The interview helps dispel common misconceptions about homebirth by showing that it is supported by highly qualified healthcare professionals working within Australia’s regulated health system, combining clinical expertise with relationship-based care for families.
Video Transcript
You are seeing the Nesting Hub here today, but there are obviously lots of different private midwives working in different models of care.
But the one thing that is consistent across all of you is the experience, the training, the qualifications that you have before you even reach the point of becoming a private midwife.
So could you talk us through what that pathway looks like? How long does it take? What experience do you need? And what qualifications do you hold before you are able to support families in homebirth?
So in Australia the title of midwife is protected. You cannot call yourself a midwife unless you are registered with the Nursing and Midwifery Board of Australia.
That means we all complete a university degree in midwifery. Some midwives come through nursing first and then complete postgraduate midwifery training. Others complete a direct entry midwifery degree.
Once you graduate you must register with AHPRA, the Australian Health Practitioner Regulation Agency.
That registration means we meet strict professional standards and are accountable to national healthcare regulations.
But becoming a private practising midwife requires even more experience.
Before we can work independently in homebirth we must have substantial clinical experience in hospitals or other maternity settings.
We must demonstrate competence across pregnancy, labour, birth and newborn care.
We also complete additional professional development and meet endorsement requirements in order to practise privately.
Only once we meet those requirements can we apply for endorsement as privately practising midwives.
This endorsement allows us to hold Medicare provider numbers.
That means we can provide Medicare rebates for certain services, order pathology tests and ultrasound referrals, and prescribe a limited range of medications.
All of that happens within strict professional and regulatory frameworks.
So while people sometimes imagine homebirth as something informal or unregulated, the reality is that it is provided by highly trained and regulated healthcare professionals.
Private midwives carry significant responsibility.
We are responsible for clinical assessment, monitoring pregnancy and labour, recognising when something is outside normal, and coordinating care with hospitals when needed.
We maintain detailed documentation and follow professional standards just like any other healthcare provider.
Many people are surprised to learn that the pathway to becoming a privately practising midwife is long and rigorous.
But that training and experience is what allows families to receive safe, professional care within the homebirth model.
And that is really the heart of this model of care.
It combines clinical expertise with continuity of care and a deep relationship with the families we support.
So I would love to hear about your clinical backgrounds, why you’re such weapons. As the creator of Nesting Hub Gale, could you explain to us where your training comes from, how long you’ve been a midwife, and why you chose to move into home birth?
Yeah. Yeah. Well, I’m from Scotland. I was a trained midwife 15 minutes west of Edinburgh, as part of the NHS.
I am not a nurse. I don’t know if other people didn’t know that.
But I was in the second cohort through the direct entry program in midwifery in Scotland.
So in January 1995 I started.
I know here in Australia it started way later than that, but in the UK we were leaders in that regard.
So I didn’t do nursing first.
In January 1995 I started a three-year diploma.
Halfway through the diploma they introduced a degree program, so everybody after me became degree-qualified midwives.
I worked within the NHS system in Scotland for a number of years before coming to Australia.
When I came here I worked in hospital maternity care for many years, which gave me a lot of clinical experience across pregnancy, labour, birth and postnatal care.
Over time I became increasingly interested in continuity of care models and in supporting physiological birth.
That led me into homebirth midwifery.
The pathway to becoming a privately practising midwife in Australia is quite significant.
First you must complete your midwifery qualification and register with AHPRA.
Registration means you are accountable to the Nursing and Midwifery Board of Australia and must meet national professional standards.
After that you need extensive clinical experience.
Most midwives spend many years working in hospital maternity units before moving into private practice.
You must demonstrate competence across the whole scope of midwifery practice including antenatal care, labour and birth, newborn care and postnatal care.
To practise privately you must become endorsed as a privately practising midwife.
This requires additional requirements including professional indemnity insurance, continuing professional development and maintaining strict clinical documentation standards.
Once endorsed, midwives can obtain Medicare provider numbers.
This allows us to provide Medicare rebates for some services, request pathology tests, refer for ultrasounds and prescribe certain medications.
All of this happens within strict professional regulations.
So homebirth care is not unregulated or informal.
It is provided by highly trained, registered health professionals working within the Australian healthcare system.
We also maintain collaborative relationships with hospitals so that if a transfer of care is needed it can happen safely.
The important thing to understand is that homebirth midwives are experts in recognising normal physiological birth while also being very alert to when something moves outside normal.
If that happens, we escalate care and transfer appropriately.
Clinical judgment, experience and training are critical to this model.
Another important aspect of private midwifery care is continuity of care.
Women are supported by the same midwife or small midwifery team throughout pregnancy, birth and the postpartum period.
This allows strong relationships to develop.
Women feel comfortable asking questions and partners become familiar with the care team.
By the time labour begins, there is already trust established.
This relationship is a significant part of what makes the model work so well.
Women often feel safer and more confident because they know the person supporting them.
From a clinical perspective, that continuity also allows the midwife to understand the woman’s pregnancy journey very deeply.
We know her health history, her preferences and her family circumstances.
That knowledge supports safer and more personalised care.
Another part of private practice is being on call.
We are on call for our clients around the clock from around 37 weeks of pregnancy until the baby is born.
This means when labour begins the woman contacts her midwife directly.
We then attend the birth and remain with the family throughout labour and birth.
A second midwife is always present for the birth as well.
This ensures there are two qualified clinicians present for the safety of mother and baby.
After the baby is born, postnatal care continues at home.
Midwives visit regularly during the first days and weeks to monitor the baby’s growth, support feeding and ensure the mother’s recovery is progressing well.
Postnatal care can continue for up to six to eight weeks.
Many families say this extended care is one of the most valuable parts of the model.
Instead of leaving hospital after a short stay and navigating those early days alone, families receive continued professional support at home.
Another thing people often don’t realise is how much preparation goes into homebirth.
There is careful planning and risk assessment throughout pregnancy.
We ensure the pregnancy remains low risk and suitable for homebirth.
If risk factors develop, we discuss options and may recommend hospital care.
Safety is always the priority.
So while homebirth can appear very relaxed from the outside, behind the scenes there is a great deal of clinical knowledge, preparation and professional responsibility.
Private midwives carry significant responsibility for the wellbeing of both mother and baby.
We maintain detailed documentation, follow professional guidelines and remain accountable to national regulatory bodies.
The pathway to becoming a privately practising midwife is therefore long and demanding.
But it ensures that families receive safe, professional care within the homebirth model.
Ultimately the homebirth model of care combines clinical expertise with relationship-based care.
It allows families to experience pregnancy and birth with continuity, trust and personalised support.
And for many families that combination creates a deeply positive birth experience.
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