Background to the Graduate Diploma

The first course for training childbirth educators in Australia was set up in Sydney by Parents Centres Australia in 1977, using models from the UK (National Childbirth Trust) and the USA (International Childbirth Education Association) as a basis for developing an appropriate program. At that time, there were no defined standards for what educators should teach or what skills they should have to be competent and effective. Programs were designed according to their sponsors beliefs and philosophies regarding birth and parenting, with little input from the parents themselves into the process.

In 1987, the NSW Government established a Ministerial Taskforce on Obstetric Services*, to review maternity care and make appropriate recommendations for its development and improvement. This was the first such review held in Australia and paved the way for later reviews in other States. It also broke new ground by involving the community as well as stakeholders in the discussions and debate about the current and future directions of the services. Maternity care was divided into various sections and a working party for each was established that included representatives of the community as well as health care professionals and others directly involved in service provision. Public meetings were held across all regions of the State to take submissions and hear evidence.

One working party focussed on Parenthood Education. It was headed by Hilary Tupling, a clinical psychologist in private practice who had a special interest in this area. Associates in Childbirth Education, as an independent private consultancy, was not involved as a member of the working party, but other groups, such as the Childbirth Education Association and Parents Centres Australia (of which Andrea Robertson had been the President for 10 years until 1984) did have direct input. The terms of reference of this working party were wide and they investigated and reported on several issues, including the scope of prenatal education programs, who should lead parenthood education courses, their skills and training, the standards of practice that should apply to this field, the provision of programs for groups with special needs within the community, the resources that should be available, and the way these services should be structured.

The general consensus was that these services (amongst others) should be overseen by a new body that would co-ordinate and provide overall leadership. It was to be called the Institute of Maternal and Child Health and it was to have responsibility for the establishment and maintenance of standards and services across the State. In this area of prenatal education, it was envisaged that the Institute would coordinate an effective dialogue and collaboration between the various private and public agencies involved in providing services, consumers and other stakeholders; undertake research into maternal and child health issues and provide independent advice to the Minister for Health. This vision was never to be fulfilled.

The Parenthood Education working party produced many recommendations and guidelines. They identified the needs of special groups and described programs for their needs (pre-conception care, early pregnancy programs, postnatal groups, and ‘high risk’ groups such as aboriginal women, non-English speaking women, parents of the disabled etc). They set down aims and outcomes for these services and topics that were to be included in the classes.

They also described the basic skills that would be needed by the leaders of these programs: the ability to communicate, skills in leading groups and working with adult learners, a sound knowledge base and practical experience. An outline for their training was also described with the strong recommendation that an accreditation process be developed to ensure consistent and high quality leadership. It was envisaged that private, community based and public sector services would operate under the same umbrella, thus ensuring that parents would receive the same high calibre of education from whatever source they chose to access. On-going training of the educators was to be a priority and diversification of services into a wider spectrum of the community was to be encouraged.

The Final Report of the Ministerial Review was published in January 1989. Towards to end, ACE was invited to attend some of the meetings of the Parenthood Education working party. Contact was made with Hilary Tupling and when the working party was wound up, she was invited to work with ACE as a consultant. At the time, most of the recommendations made by her working party were already in place within the ACE childbirth education training courses and ACE was keen to ensure that these met both the spirit and intent of the Review’s recommendations. Hilary was ideally placed to assist in the further development of our courses and to undertake extended leadership training for our tutors and supervisors. The skills and competencies listed by the Ministerial Review for Childbirth Educators were adopted as the foundation for ACE training courses and every effort was made to meet the standards described as necessary for optimal prenatal education for parents.

In 1991, the Federal Government announced the establishment of a mechanism whereby it would enable private providers of educational programs to become registered and accredited as part of the National Training Reform Agenda. ACE decided to apply to have its training course accredited as Graduate Diploma. As part of the process, the standards of practice and skills and competencies of the graduates had to be defined so that appropriate learning outcomes for the Course could be identified. In formalising the standards that the Course already espoused, the Recommendations of the NSW Ministerial Review were used as the basis for the descriptors developed by ACE, as these were the only standards that had been described anywhere in Australia at that date.

Although VETAB (the administrative body set up to oversee the accreditation process for the Federal Government) does not require that all childbirth education training courses that it may accredit use the same standards of practice (and skills) as a basis for training programs, it seems logical that those accepted by a State Government as a basis for its services would be appropriate for all programs operating in that State. Until other States produce similar guidelines, ACE will continue to use the NSW Ministerial Review’s recommendations in this area as the basis for its work.

* Ministerial Taskforce on Obstetric Services, Final Report on Maternity Services in NSW, NSW Government, January, 1989.