When Olivia Tierney did a stint with a maternity service as a first-year nursing student, she knew midwifery was where she wanted to be. Now she is shaping maternity care policy.
Olivia Tierney is the inaugural Commonwealth chief midwife at the Department of Health, Disability and Ageing, a role announced just last month which will bring a voice to midwifery policy at the national level.
Dr Tierney was most recently the midwifery advisor in the previous Chief Nursing and Midwifery Officer division before commencing her new job.
Dr Tierney’s career includes almost 30 years as a midwife, with experience working in clinical, education, and management positions – as well as completing a PhD while working full-time.
Coming from a small NSW mid-north coastal town – and still based in a rural area – Dr Tierney has extensive experience in the complex challenges facing maternity care in rural and remote communities.
Ms Tierney tells Health Services Daily that she is enormously proud of her work establishing midwifery-led continuity of care models in that region and in bringing a Bachelor of Midwifery program to a rural area.
Could you tell us about your career background?
I went into nursing not really knowing if it was absolutely what I wanted to do, but I knew I wanted to work in health. At that time, there was no other pathway into midwifery – you did need to be a nurse first.
I worked as a nurse for a year, and during that time, I was really fortunate to spend some time in a maternity service, which was unusual for a first-year nurse. That was where I really knew that midwifery was going to be my area of interest, my passion throughout my career.
I was really lucky to get into a midwifery program. They were quite competitive at the time. They still are today.
I had a fantastic introduction to midwifery in the Gosford and Wyong area. I come from a rural area. I live and work from Port Macquarie and have spent most of my life in rural New South Wales. Going to Gosford to do my midwifery was the first time I lived in a bigger town or a city.
Once I became a midwife, I knew that’s where I would stay, and I have spent most of my career, over 20 years, on the mid-north coast of New South Wales.
I had various roles in midwifery. I’ve been very fortunate to have the opportunity to work in clinical midwifery and midwifery group practice, in continuity of care models.
I’ve worked as an educator. I’ve worked in the academic sector. I then worked in the management of maternity services, first the Port Macquarie maternity unit, and then moved into a broader district-wide midwifery leadership position.
Then I was able to work for NSW Health at the Ministry of Health and the Chief Nursing and Midwifery Office, which was such a wonderful opportunity.
When I came across into the Commonwealth, I’ve most recently worked as the midwifery advisor to the Chief Nurse and Midwifery Officer, and then as an election commitment in 2025 the government looked to implementing the Commonwealth Chief Midwife role.
Nursing and midwifery are really strong allies, and nursing and midwifery have a lot in common, but midwifery does have its distinct needs. It can be quite complex.
Having midwifery leadership at a Commonwealth level recognises the profession as a standalone profession from nursing and brings that allyship to a Commonwealth level.
What have been your career highlights?
A number of years ago I moved into the tertiary sector and worked for the University of Newcastle. The highlight for me in that role was leading the commencement of the Bachelor of Midwifery program in Port Macquarie.
Previous to that, there was no university campus anywhere in our region that offered the Bachelor of Midwifery program. I was part of bringing the midwifery program to the region, and it was really successful.
It was a career highlight for me to be part of that commencement of midwifery in our area. We did that to address our own midwifery workforce shortages, to be able to grow our own in our local area and support people regionally and rurally to be able to become midwives without having to leave home, and that was a really successful program.
Another career highlight would be working as a midwifery manager for the Mid-North Coast Local Health District. We have over eight hospitals and a number of community services in that geographical footprint.
When I started that role, there was no midwifery-led continuity of care model within the district, and I worked in that role to implement midwifery continuity of care models as an option for women in our community.
The thing I’m most proud about is that we went from having the only district in New South Wales with no continuity of care model, and now all those maternity services in that district offer an option of midwifery continuity of care for women in the community.
That was absolutely a highlight for me to be part of that work and to lead that work.
I’ve also completed my PhD, and it is such a personal achievement that I am so proud of.
I took the long road to PhD. I worked full-time the entire time and was very part-time in my PhD and stopped and started three times. It took eight years, but I got there.
I like to tell that story to share with others that it’s absolutely possible. And if you love your research and the work that you’re doing, and you’re doing it for the right reasons, you can get there, even if it’s a very long journey. It takes a lot of perseverance.
It’s not easy, especially when you’re working in the health sector and not in the tertiary sector.
Working in health research, you’re not always in a position where research is part of your responsibilities. In fact, they’re quite few and far between.
To be able to not only manage your time but also be in a position where you can be supported to continue your research and your study is a rarity in the health service.
I’m very fortunate for the leaders I had who supported me to do that.
And my next career highlight will be commencing in the Commonwealth Chief Midwife role.
What motivated you to go for that role?
It is such an honour and such a privilege to be in a position like that. I wanted to be part of making an impact, and if I could be in that role to do that, then I wanted to give myself that opportunity.
All the decisions I’ve made throughout my career have been about how I can have the broadest impact or influence in the work that I do that makes a difference for women who access midwifery care. How could you not try and do that from a Commonwealth perspective?
So, I absolutely needed to see whether I could take the opportunity that was in front of me and be able to do that.
In practice, what are some of the things you’ll be working on?
It’s only been a few weeks, so at this point the focus is around ensuring a midwifery perspective and advice continues, and being able to provide expert advice to government around midwifery and maternity services and women’s health, across the workforce, models of care and broader health system reform.
Moving into the Chief Midwife role, initially my immediate priorities are around establishing the role.
It is the first time the position’s been in place, and so it’s really important to have that clear understanding around how the role can be best positioned within the department and within the government.
Priorities in the initial phases are around not only understanding that but engaging with stakeholders and understanding from their perspective the priorities, opportunities, and challenges so I can understand how I can then inform policy around maternity care more broadly.
Which stakeholders will you be dealing with?
It’s quite broad from the Commonwealth’s perspective, but the stakeholders could be anywhere from education providers, our tertiary institutions who support people to enter into the workforce in midwifery, our jurisdictions.
Most public maternity services are operationalised by the states and territories, so working with the states and territories is a key stakeholder in terms of maternity services.
But also, women and consumers are just absolutely at the forefront of those stakeholders to understand their experiences and their perspectives. So I’m engaging with various consumer groups as well to try and get that current understanding from their experiences.
Then we have different professional peak bodies as well, which are critical stakeholders – the College of Midwives in Australia, the Australian New Zealand College of Obstetricians and Gynaecologists for our medical workforce, and Aboriginal and Torres Strait Islander peak bodies such as CATSINaM [the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives].
There are so many different stakeholders that we engage with to understand all perspectives that influence the policy decisions that support maternity services.
What any your goals over the next year or so?
One goal is to establish meaningful relationships with our stakeholders to understand everybody’s priorities and where the opportunities might be to support our stakeholders in the work that they do, or to collaborate with them to inform policy. That is the number one priority for myself.
Other priorities are around supporting the government-funded Birthing on Country models that we have across Australia, and working with other areas within not only the department but in the sectors to support the growth and enhancement of those Birthing on Country models.
That’s something I hold close to my heart, as well as rural, regional and remote areas and how we ensure continuation of services in those areas: how we can support the workforce and the communities to be able to access the care that they hope for.
Having that lived experience ensures that the rural and remote priorities are front-of-mind for me because they can be quite complex in nature compared to a metropolitan area.
There’s a lot of opportunity, and for this to be the first time that the role has been implemented, I do feel honour but also respect for the role and what can be achieved.
Priorities in the maternity sector are quite complex and diverse, and there’s a lot we can achieve.
Being a midwife must be an incredible job
It’s hard to find the words sometimes to describe the experience that you have, and then you’re paid to do it too, right? It does blow you away.
Midwifery itself is such a relationship-based profession. The relationship with the woman and their family, or people they have with them during that experience, is very much based on that relationship and the trust in you and your role as a midwife, to advocate and support that woman with their choices.