A self employed midwife, together with her back-up colleague, provides continuity of care to women and their families 24/7. Before setting up in community based practice consider:

• Who will be your back-up to ensure you have sufficient support and time off
• How you will reciprocate for this back-up and how will your clients meet your back-up
• The impact of an on-call lifestyle so you can provide continuity of care to women and whether this suits you and your family
• The size of caseload sustainable for you and your area. The College recommends 40 to 50 women per year as a sustainable full-time caseload with adequate leave.

• The College provides the Midwifery First Year of Practice Programme which is compulsory for newly registered midwives and provides structured mentoring and education hours.
• The Rural Midwifery Recruitment and Retention Service (RMRRS) can advise on Lead Maternity Carer (LMC) vacancies in rural localities, provide locum and mentoring support and practice establishment assistance for midwives new to rural practice.
• The Midwifery and Maternity Provider Organisation (MMPO) can provide information on birth volumes in different areas and link you with local LMC midwives to investigate potential partnerships.
• Consider having a midwife mentor, particularly while you establish your practice. The College can provide information for you to connect with a mentor.
• The College midwifery advisors can provide you with advice and link you into your regional College network if you are new to an area.

The MMPO was established by the College to provide LMC midwives with a supportive practice management and quality practice system.
As a provider organisation, the MMPO is focused on providing services that support you and streamline the practice management of your caseload including:

• Section 88 Primary Services Notice (Section 88) claiming via the Ministry of Health (Ministry), including claiming in relation to complex/exceptional pregnancies
• 8 business day turnaround for payments
• support and facilitation in resolving and resubmitting claims rejected by the Ministry
• whether you claim electronically or manually by using the MMPO Maternity ‘Pink’ books, all necessary information for clinical care and health payment claiming is captured. Full or partial maternity claims are generated automatically from the information you enter
• disbursements to your back-up midwife
• reports for Midwifery Standards Review
• An IT Help Desk with on-line training sessions and technical support of the electronic system available weekdays from 7am to 7pm
• access to language line – FREE Interpreters for members
• statistics, voluntary bonding and other practice reports
• Start-up loans for members of MMPO
• Clinical data supplied to MMPO is aggregated and anonymised to provide annual reports which describe midwifery practice and support maternity service development.

You will need to consider:

• Indemnity insurance – provided by the College for members. Your College membership category will need to be self employed
• Maintaining Midwifery Council recertification requirements: visit www.midwiferycouncil.health.nz
• Section 88 – Understanding obligations of the service specifications of this contract

The College has regional meetings every month which can offer valuable support.

Introduce yourself as an LMC Midwife to:

• Other midwives – LMC and core/obstetricians/paediatricians/anaesthetists
• GPs and Well Child/Tamariki Ora services
• Pharmacies
• Local social and support agencies, Women’s Refuge, Oranga Tamariki services, Family Start, social workers
• Other health professionals/emergency service contacts
• Local facilities that you will require an access agreement for
• College Resolutions Committee regional contacts

The College recommends using the MMPO maternity notes/systems. These provide a framework for quality documentation and provides a copy for women.

Health records need to be kept for ten years after care is completed. Consider where to securely store records to maintain client privacy.

Individual MSR outcome data reports can be obtained if you use the MMPO system. Contact msradmin@nzcom.org.nz or telephone the College for any Midwifery Standards Review enquiries.

• Pinards and/or sonicaid, sphygomomanometer, stethoscope, thermometer, phlebotomy equipment, electronic adult and baby scales, opthalmascope, fundal height tape measure, urine testing kit, uninary cathetor, neonatal heel lancets, IV fluids, angiocatheters and giving sets, gloves, sharps disposers, cord clamps/ties
• Equipment for births at home (regardless of whether planning to offer home birth)
• Suturing equipment
• Uterotonics (and a way to keep them cool), vitamin K, other emergency equipment (oxygen cylinder, regulator, ambubag – adult and neonate, suction)

• Annual Practising Certificate and recertification costs
• College membership (includes professional indemnity insurance)
• MMPO maternity notes and Electronic Midwifery PMS
• Equipment (see above)
• Travel – car expenses
• Telephone/paging system/answerphone
• Ongoing education
• Accountancy fees
• Office/rooms/clinic/stationery
• Advertising, (the College’s Find Your Midwife website is free to members)
• Income tax and GST
• ACC levies
• Insurance premiums