Woman found not guilty of holding herself out as a midwife

26 Nov 2024

Gold Coast woman Andilla Parsons has been found not guilty of offences under the Health Practitioner Regulation National Law 2009 (National Law).

The Australian Health Practitioner Regulation Agency (Ahpra) had charged Ms Parsons with holding herself out as a midwife. Ms Parsons had previously been registered as a midwife but surrendered her registration on 4 January 2022.

In May 2023 Ahpra’s Criminal Offences Unit became aware of allegations that Ms Parsons may have continued to practise as a midwife offering home birth midwifery services through a new business after surrendering her registration and opened an investigation. An Ahpra inspector approached a person that was believed to be Ms Parsons via text message and during the course of the messages exchanged, the person indicated she could be a midwife for a home birth.

On 17 May 2024 Ahpra commenced a prosecution against Ms Parsons, charging her with one count of using, in advertising and social media, words or descriptions to indicate she was a midwife when she was not registered, and one count of holding herself out as a registered midwife to the Ahpra inspector in contravention of section 116 of the National Law.

On 25 November 2024, the woman pleaded not guilty in the Southport Magistrates Court. After extensive legal arguments, Ahpra offered no evidence in relation to the charge relating to advertising. At the conclusion of the hearing for the second charge of holding herself out as a midwife Magistrate Pamela Prowse decided that she could not be satisfied beyond reasonable doubt that Ms Parsons had been the person interacting with the inspector,and found her not guilty.

Despite the result in this particular matter, Ahpra will continue to actively pursue allegations of people holding themselves out as a midwife when they are not registered in light of the significant risk posed by such people.

Ahpra and the National Boards implement the National Registration and Accreditation Scheme (the Scheme) to protect the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered. One of the ways this is achieved is by each National Board requiring that registered health practitioners abide by high-quality, national standards, codes and guidelines.

When a person practises as a midwife without being registered, they are not regulated by the Board. This means that:

• There is no way of knowing if any unregistered person holds qualifications or training which would be necessary for their registration/endorsement as a midwife with the Board;
• Unregistered practitioners are not required to comply with the Board’s registration standards.¹ Registration standards define the requirements that applicants and registrants need to meet to be registered or have their registration renewed, which aim to ensure health practitioners are suitable to practise in a competent and ethical manner. Registered midwives are required to:
  
  • Undertake continuing professional development training each year;
  • Have sufficient practice experience to demonstrate their competence in the profession each year;
  • Advise the Board of certain types of pending criminal charges and convictions; and
  • Have competency in English to a certain standard.

Unregistered practitioners are not bound by professional standards which aim to protect the public, such as ethical codes, standards for practise and guidelines. Without the requirement to practise in line with these professional standards, any unregistered person may not be providing care to that standard and/or there may be limited regulatory consequences if something went wrong. The professional standards include:

• The Code of conduct for midwives,² which sets professional expectations for all midwives such as the expectation to provide safe, woman-centred and evidence-based practice for the health and wellbeing of women and, in partnership with the woman, promote shared decision-making, and the expectation to engage with women as individuals in a culturally safe and respectful way;
• The International Confederation of Midwives’ Code of ethics for midwives,³ adopted by the Board, which provides ethical mandates for all midwives, including the expectation to use support the right of women/families to participate actively in decisions about their care, and the expectation to use up-to-date, evidence-based professional knowledge to maintain competence in safe midwifery practices in all environments and cultures;
• The Midwife standards for practice,⁴ which provide a framework for midwifery practice, such as the expectation to promote health and wellbeing through evidence-based practice, to undertake comprehensive assessments and to develop a plan for midwifery practice;
• The Board’s guidelines such as the Safety and quality guidelines for privately practising midwives.⁵

This means that any unregistered person providing private midwifery services including homebirth services:

• May not be obtaining informed consent from the woman in their care to the requisite standard;
• May not have a documented process for identifying, assessing, treating, monitoring and evaluating clinical and environmental risks;
• May not have developed and completed critical risk management resources and risk assessments in accordance with the Australian College of Midwives’ National Midwifery Guidelines for Consultation and Referral;
• May not be skilled and current in obstetric emergency management, adult basic life support and neonatal resuscitation; and
• In the case of attending homebirths, they may not be skilled to a certain degree, and not have recently (within 2 years of each episode of care) completed education and/or training in obstetric emergency management, adult BLS and/or newborn resuscitation.

Unregistered practitioners cannot be subject to any ongoing monitoring by the Board and are not subject to the mandatory notification requirements of registered health practitioners.⁶

In addition to the above, by practising as a midwife without registration a person may be committing an offence under section 113 and/or section 116 of the National Law (in each state and territory of Australia) such as by using the title ‘midwife’, holding themselves out as being registered as a midwife, or claiming to be qualified to practise as a midwife.

Anyone who has information about any unregistered person claiming to be qualified to practise as a midwife is encouraged to contact Ahpra’s Criminal Offences Unit at criminal.offences@ahpra.gov.au.

Section 237 of the National Law applies to a person who, in good faith, gives information to Ahpra in the course of an investigation. It states that such a person is not liable, civilly (including for defamation), criminally or under an administrative process, for the giving of that information.

Anyone with concerns about whether an individual is registered can check the online Register of practitioners maintained by Ahpra or call 1300 419 495.

Contact us

• For media enquiries: (03) 8708 9200.
• Lodge an online enquiry form.
• Find out more about how to report an offence.

¹See the Registration Standards published on the Board’s website: https://www.nursingmidwiferyboard.gov.au/Registration-Standards

²See Code of conduct for midwives published on the Board’s website: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.

³See the International Code of Ethics for Midwives published on the International Confederation of Midwives’ website: https://internationalmidwives.org/resources/international-code-of-ethics-for-midwives/

⁴See Midwife standards for practice published on the Board’s website: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/midwife-standards-for-practice.

⁵See Safety and quality guidelines for privately practising midwives published on the Board’s website: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines/Safety-and-quality-guidelines-for-privately-practising-midwives

⁶This means there would be no mandatory requirement for:

• The unregistered person to make a notification about a registered health practitioner if the health practitioner were to practise while intoxicated, engage in sexual misconduct within the practice of their profession, or place the public a risk of substantial harm due to an impairment or by significantly departing from accepted professional standards; or
• Registered health practitioners to make a notification about the unregistered person, if they engaged in any of the behaviour described above.