Delivering continuity of midwifery care to Queensland women

A mechanism to inform and engage the community is to develop an ‘options’ booklet
outlining the model of midwifery continuity of care. However this must not be used to
persuade a pre-determined direction of a service but a tool to ensure open and honest
communication. Another is invitation to information sessions within the community.
A further mechanism is for models to support consumer organisations in holding film nights
or other social functions highlighting midwifery care.
A well organised, supportive consumer organisation will be an asset in any cultural change
process. If you appoint consumer representatives to steering committees, or if they are
involved in clinical networks and other communication processes, they can help collaboration
between caregivers and provide a better understanding of consumer perspectives.
Culture of collaboration
Traditionally the role of the midwife has been to provide care under the direction of a
doctor. The midwife would seek advice and ultimately the responsibility for care would rest
with the doctor.
The move to midwifery continuity of care means that the midwife provides the care seeking
clarification, advice or information to support her own decision making. The midwife may
also get clarification, advice or information about the decisions made by the doctor in the
woman’s care. Under this primary health model, the midwife is responsible for the primary
care of the woman until care is transferred to a doctor.
Views and beliefs within the maternity unit
It is important to workshop or meet to discuss and outline the views and beliefs within your
maternity unit. This provides an opportunity to transparently outline various stakeholder
perspectives. It is important to develop a shared unit philosophy on continuity of midwifery
care. Continued engagement to build and maintain collegiality, unity and ownership of the
model is important.
Ensuring medical engagement and/or co-operation
Medical engagement and cooperation is often noted as a barrier for development of
Midwifery Group Practice.
Successful implementation of Midwifery Group Practice is only possible with collaboration
in maternity care across the whole team. Collaborative maternity care has been the focus of
federal maternity reforms and within this framework collaboration has increased importance
in health care.
Care is best provided by qualified health professionals who work collaboratively within a
high quality, tiered health service, to ensure that women receive appropriate and timely
care (Australian Health Ministers’ Advisory Council (AHMAC) 2008).
Collaboration in maternity care requires defined roles and responsibilities. The National
Health and Medical Research Council (2010) found that:
Collaboration aims to maximise a woman’s continuity of carer by providing a clear
description of roles and responsibilities to support the person who a woman nominates to
coordinate her care (her ‘maternity care coordinator’).
Staff engagement
Some staff may not be knowledgeable of midwifery models and what these models mean for
midwives and women. Some staff may view or treat MGP midwives differently to other staff
or MGP staff may view themselves differently. Midwifery continuity of care models are a gold
standard where they work with other models, not alone.
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Delivering continuity of midwifery care to Queensland women