Delivering continuity of midwifery care to Queensland women

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• Midwifery Practice Review (MPR), organised by the ACM, is a formal, transparent, nationally consistent peer review mechanism that supports midwives to regularly reflect on their portfolio, their own midwifery practice and future professional development plans or identified needs. MPR is a recommended quality control tool. • Evaluation of each midwife’s outcomes should occur at 12 month intervals and be used to inform their ongoing professional development plan. Clinician networking Midwives transitioning to MGP models can benefit greatly from becoming professionally engaged with colleagues working in similar models across Queensland and Australia. This brings the opportunity to informally and formally reflect and compare models and practice. Social networks and electronic communication make it possible for midwives located significant distances apart to remain professionally engaged. The Australian College of Midwives, universities and other organisations have a variety of forums to enable midwives to engage with each other. Midwives Australia has developed a website forum to enable midwives working in continuity to speak to each other over the internet www.midwivesaustralia.com.au References Australian Nursing and Midwifery Council. (ANMC). (2006). National Competency Standards for the Midwife. Accessed March 27, 2011. www.nursingmidwiferyboard.gov.au/ Registration-Standards.aspx Blyth, J. (2005). Birthwork–a compassionate guide to being with birth. Gympie: Queensland Complete Printing Services. Leap, N. & Pairman, S. (2010). Working in partnership. In S. Pairman, C. Tracy, C. Thorogood & J. Pincombe. (Eds). Midwifery preparation for practice 2nd edition. Sydney: Elsevier. Pairman, S. (1998). The midwifery partnership: an exploration of the midwife/woman relationship. Unpublished masters thesis, Victoria University of Wellington, Wellington. Pairman, S. & McAra-Couper, J. (2010). Theoretical frameworks for midwifery practice. In S. Pairman, S. Tracy, C. Thorogood & J. Pincombe. (Eds). Midwifery preparation for practice 2nd edition. Sydney: Elsevier. Pelvin, B. (2010). Life skills for midwifery practice. In S. Pairman, S. Tracy, C. Thorogood & J. Pincombe.(Eds.). Midwifery preparation for practice 2nd edition. Sydney: Elsevier. Stewart, S. (2009). A Handbook to e-mentoring. Aged Care Organisation Queensland. http://ia600707.us.archive.org/31/items/HandbookForEmentoring/ HandbookForEmentoring.pdf Vernon, D. (2007). With Women. Midwives Experiences: from shift work to continuity of care. Canberra: Australian College of Midwives. 62 Delivering continuity of midwifery care to Queensland women
Section 10 Midwifery practice in continuity models Introduction Understanding midwifery practice in continuity models is essential to all Queensland Health maternity services. This section gives an overview and examples of midwives’ practice in continuity models. We strongly recommend staff developing or working in midwifery continuity models read “Midwifery Continuity of Care, A Practical Guide” by Homer, Brodie and Leap (2008) for more comprehensive information. Philosophy Working in midwifery continuity of care practice may require a change in the way midwives think, speak and provide care. The partnership between the woman and the midwife is likely to be different from any other clinical roles the midwife has experienced. Women are considered the expert in themselves and hold the ultimate power in decisions about their birth and their care. Midwives in continuity of care models will be working in a different context and therefore need support and guidance to make this transition. The key principles in providing continuity of care have been identified by Sandall (1997) and presented in Homer, Brodie and Leap (2008): • an ability to develop meaningful relationships with women, meaning that midwives offer continuity of carer, rather than being on-call for women they do not know • occupational autonomy and flexibility so that midwives are in control of, organise and prioritise their own work • support at home and at work including midwives meeting frequently to discuss practice issues, reflect on their work, share information and to ensure that they know when individual midwives may need more support due to home issues. Responsibility and autonomy Midwives who provide continuity of care take a leading or coordinating role for individual women’s maternity care. Compared to standard care, this gives the midwife greatly increased responsibility for their practice and for the woman and her baby’s outcomes within the usual scope of practice of the midwife. Autonomy means self-determination, the ability to be self-governing. The concept of autonomy in midwifery is used to provide understanding that midwifery is distinct from nursing and medicine in that it has its own distinct body of knowledge. The midwife also has her own individual knowledge making it possible to make decisions and determine actions within the midwifery context ‘in her own right’ without reference to others (Pelvin 2010). Evidence-based practice Understanding and being able to apply evidence to decision making is critical. Units making the transition to providing continuity of midwifery care may face opposition. Therefore it is essential the midwives must be able to back up their decisions with evidence: • Professional engagement is essential to remaining up to date with evidence and research in maternity care. • Skills in sourcing and analysing information about maternity care are an advantage, but may well be the role of a few individuals within the group. • Midwives’ attendance at professional midwifery seminars, workshops and conferences will assist in seeking information to support their practice. • Engaging with consumer organisations is another mechanism to source and reflect on evidence. A guide to implementation 63
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These reforms can be seen as part o
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Delivering continuity of midwifery care to Queensland women

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