MIDWIVES would be able to provide taxpayer-subsidised drugs and care under recommendations made to the Federal Government by its chief nurse.

But Commonwealth funding for home births has been rejected.

A review of maternity services, headed by chief nurse Rosemary Bryant, recommends changes to Commonwealth funding arrangements to support a greater role for midwives.

It recommends expanding Medicare and the Pharmaceutical Benefits Scheme access to appropriately-qualified midwives.

It also suggests the government provide professional indemnity insurance support to midwives, but rejects Commonwealth funding for home births.

Ms Bryant said the review found there was a case to expand the range of models for maternity care, giving women greater choice.

“There is a lack of unanimity within and between some groups of the medical and midwifery professions on the issue of how to deal with risk and consumer preferences,” she said.

“While it is acknowledged that safety and quality of care is an overarching goal, it would be remiss to always use it as an excuse not to change practice.”

There were differing views on to what extent taxpayers should fund extra services to meet the preferences of individuals, Ms Bryant said.

Birth outcomes for indigenous Australians was a pressing national issue, with the review recommending an expansion of maternity services programs. Aboriginal and Torres Strait Islander women are almost three times more likely, than non-indigenous women, to die while pregnant, during labour or up to six weeks after giving birth.

The high rate of maternal mortality among indigenous woman has not abated since first measured in the early 1990s.

Homebirth Australia said in its submission there had been a rise in the number of women giving birth at home without medical assistance due to the current lack of funding and professional indemnity insurance for midwives.

Health Minister Nicola Roxon said she was determined Australia’s children get the best start in life.  “That means giving women the choices they need, wherever they live, and whatever the challenges confronting them,” he said.

The review will help the development of a national maternity services plan.