The Australian College of Midwives has warned there are limited insurance offerings for members in private practice.

For employed midwives, mandatory professional indemnity cover is provided by their employers.

But for those working in private practice, for any portion of their work, Medical Insurance Group Australia is the only major insurer available, the college says in a submission to a federal parliamentary inquiry into small business cover.

The MIGA product is underwritten by the Australian government and was recently expanded to include insurance for intrapartum care outside of a hospital.

However, the product is available only to “endorsed” midwives, who make up less than 5% of the profession. Midwives are endorsed if they meet Nursing and Midwifery Board of Australia requirements to qualify to prescribe scheduled medicines and order diagnostic tests.

“This creates a regulatory paradox,” the college’s inquiry submission says. “Midwives must hold insurance to practice but cannot access an insurance product to work in private practice ... without an additional qualification.

“This is a systemic failure that impacts on midwifery workforce and maternity care options for women.”

Endorsed midwives operate in public and private health services, in group practices, in general practice clinics and in private practice.

“There are low but increasing numbers of endorsed midwives in Australia,” the submission says.

Women cared for by private practice midwives report the most positive birth experiences and the lowest rates of birth trauma and obstetric violence, according to the submission.

“Both women and midwives are calling for increased private practising midwives. However, lack of insurance options [is] a significant barrier to expansion of private practising midwives.

“Availability of one single insurance option which is restricted to endorsed midwives means there is no market competition and that insurance is inaccessible to the majority of midwives in Australia.

“This limits the ability of midwives to run small businesses and restricts services for women and families.”