Delivering continuity of midwifery care to Queensland women

Section 2
Midwifery continuity models
—what do they look like
It is easy to tell if a service is offering continuity of
midwifery care. The litmus test is to ask the woman “who
is your midwife and what is her contact number” If
the woman is able to tell you, then the service is offering
continuity of care. In situations where the woman does
not know, or isn’t sure, the service obviously is not providing
continuity of care.
(consumer feedback)
This section provides an introduction to midwifery continuity models. The ways midwives
actually provide care, including on-call and off-call arrangements and day-to-day clinical
care, are outlined in Section 10 Midwifery practice in continuity models.
Definitions
The following definitions are intended to assist discussion with commonly understood
meanings. In practice, models may not fit precisely into a definition, but it is essential for
those establishing new models to focus on individual women’s experience of continuity and
their relationships with caregivers.
Caseload midwifery
In caseload midwifery each woman has a primary midwife providing the majority of her
pregnancy, birth and post birth care (Homer, Brodie & Leap 2008). This model is also
referred to as a “continuity of carer model” or “one to one” midwifery care.
Caseload midwives provide care to a number of women per year, organise their time flexibly
around their women’s care needs (Homer, et al. 2008) and don’t work rostered shifts.
Private practice midwives frequently provide care in a caseload model (see Section 13 for
further discussion about eligible midwives).
Case load
The actual number of women a caseload midwife is ‘carrying’ or providing care for
(i.e. her workload).
Midwifery Group Practice
A Midwifery Group Practice (MGP) is the organisational or management unit in which
caseload midwives usually work (Homer, et al. 2008). The purpose of the MGP is to support
the practice of the caseload midwives within it and to facilitate communication within the
MGP and with management.
Within Queensland Health most caseload midwives work in a Midwifery Group Practice.
There may be more than one MGP within a facility.
Maternity Care Co-ordinator
This person is nominated by the woman to coordinate her maternity care (National Health
and Medical Research Council 2010). This is usually a primary maternity care provider such
as a midwife or GP. In the private hospital sector this may also be the woman’s private
obstetrician.
In a Midwifery Group Practice the woman’s primary midwife would also be her maternity
care coordinator. An important part of the role is to coordinate the woman’s access to
services and care from other clinicians according to her needs.
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Delivering continuity of midwifery care to Queensland women