Delivering continuity of midwifery care to Queensland women

• clearly outline what constitutes emergency situations.
• clearly outline other circumstances in which you want immediate contact to be initiated
• consider use of a pager for emergency situations only so that your mobile can be turned
off for periods of time
• develop a triage system for non-urgent off-call contact with your partner midwife/s
• limit phone time to five minutes when out of hours.
Group antenatal or postnatal care
Group antenatal care is generally provided from a community-based centre. Midwives may
have any or all of their clients attend these sessions so they are able to meet their partner
midwives’ clients. Sessions generally occur once a week. This method of provision of care is
best suited to the middle to late weeks of pregnancy where visits are frequent and women
have formed a relationship with their care provider. It is also possible for midwives to
provide this type of care postnatally, after the initial postnatal period when feeding is being
established.
In Queensland various services offer this type of pregnancy care. Logan Hospital group
practice uses this model with young mothers.
The following list identifies some of the essential elements of group antenatal care (Homer,
et al. 2008; Rising, Powell Kennedy & Klima 2004):
• health care and pregnancy assessment is provided in the group space
• women are involved in self-care activities such as opportunity for massage
• the group is not “conducted” by an expert, rather facilitated
• the group is not rigid, but is relatively stable
• the leadership is also relatively stable.
Whilst there is a plan for the sessions, the discussion is triggered by scenarios or returning
group members (Homer, et al. 2008).
The benefit of this model is that it maximises effective use of education time as the midwife
provides educational sessions once, rather than spending time discussing the same
elements with each woman individually. The other significant benefit in using a group model
for antenatal care is the relationships that are built within the group. This relationship also
tends to decrease reliance on health practitioners (Homer, et al. 2008).
Diarising the next 6—12 months
Midwives providing continuity of care will benefit greatly from planning their caseload work
around six months in advance. When allocating women to midwives, accepting a woman on
to your caseload, or discussing with a woman whether you are available to provide their care,
there are a number of considerations:
• indicate any periods where you will be away and/or require a complete day or subsequent
days off
• consider professional development leave of partners
• blocking off leave in advance is extremely important
• consider the mix of primiparous and multiparous women each month
• be aware that after a particularly busy period, where there have been unexpected
elements, it is important to take additional down time. Management support for this
element is critical.
The most important element of having a mix of personal and professional time is to create
trusting relationships between the women for whom you are the primary midwife and
the midwives providing you with back up. The ability to hand over care of a woman with
confidence in your backup midwife is the indication of success.
Leave within the MGP needs to be considered in relation to the whole group. Unexpected
leave does provide periods of increased load and therefore increased stress. Having a
manager or clinical midwife able to fill periods of unexpected leave may assist with this.
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Delivering continuity of midwifery care to Queensland women