Evaluation of a regional midwifery caseload model of care integrated across five birthing sites in South Australia: Women’s experiences and birth outcomes

Adelson, Pamela; Fleet, Julie-Anne; McKellar, Lois

Abstract

Introduction
The ongoing closure of regional maternity services in Australia has significant consequences for women and communities. In South Australia, a regional midwifery model of care servicing five birthing sites was piloted with the aim of bringing sustainable birthing services to the area. An independent evaluation was undertaken. This paper reports on women’s experiences and birth outcomes.

Aim
To evaluate the effectiveness, acceptability, continuity of care and birth outcomes of women utilising the new midwifery model of care.

Method
An anonymous questionnaire incorporating validated surveys and key questions from the Quality Maternal and Newborn Care (QMNC) Framework was used to assess care across the antenatal, intrapartum and postnatal period. Selected key labour and birth outcome indicators as reported by the sites to government perinatal data collections were included.

Findings
The response rate was 52.6% (205/390). Women were overwhelmingly positive about the care they received during pregnancy, birth and the postnatal period. About half of women had caseload midwives as their main antenatal care provider; the other half experienced shared care with local general practitioners and caseload midwives. Most women (81.4%) had a known midwife at their birth. Women averaged 4 post-natal home visits with their midwife and 77.5% were breastfeeding at 6–8 weeks. Ninety-five percent of women would seek this model again and recommend it to a friend. Maternity indicators demonstrated a lower induction rate compared to state averages, a high primiparous normal birth rate (73.8%) and good clinical outcomes.

Conclusion
This innovative model of care was embraced by women in regional SA and labour and birth outcomes were good as compared with state-wide indicators.

Citation

Adelson, P., Fleet, J., & McKellar, L. (2023). Evaluation of a regional midwifery caseload model of care integrated across five birthing sites in South Australia: Women’s experiences and birth outcomes. Women and Birth, 36(1), 80-88. https://doi.org/10.1016/j.wombi.2022.03.004

• Journal Article Type: Article
• Acceptance Date: Mar 10, 2022
• Online Publication Date: Mar 23, 2022
• Publication Date: 2023-02
• Deposit Date: Sep 14, 2022
• Publicly Available Date: Feb 17, 2023
• Journal: Women and Birth
• Print ISSN: 1871-5192
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 36
• Issue: 1
• Pages: 80-88
• DOI: https://doi.org/10.1016/j.wombi.2022.03.004
• Keywords: Midwifery, Models of midwifery care, Maternal Newborn Quality Care Framework
• Public URL: http://researchrepository.napier.ac.uk/Output/2898203