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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


Pamela Adelson

Julie-Anne Fleet


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.

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

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.

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.

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.

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
Keywords Midwifery, Models of midwifery care, Maternal Newborn Quality Care Framework
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