Operationalising caseload midwifery in the Australian public maternity system : Findings from a national cross-sectional survey of maternity managers

Journal article


Dawson, Kate, Forster, Della A., McLachlan, Helen L. and Newton, Michelle S.. (2018). Operationalising caseload midwifery in the Australian public maternity system : Findings from a national cross-sectional survey of maternity managers. Australian Midwifery. 31(3), pp. 194-201. https://doi.org/10.1016/j.wombi.2017.08.132
AuthorsDawson, Kate, Forster, Della A., McLachlan, Helen L. and Newton, Michelle S.
Abstract

Background
Despite high-level evidence of the benefits of caseload midwifery for women and babies, little is known about specific practice arrangements, organisational barriers and facilitators, nor about workforce requirements of caseload. This paper explores how caseload models across Australia operate.

Methods
A national cross-sectional, online survey of maternity managers in public maternity hospitals with birthing services was undertaken. Only services with a caseload model are included in the analysis.

Findings
Of 253 eligible hospitals, 149 (63%) responded, of whom 44 (31%) had a caseload model. Operationalisation of caseload varied across the country. Most commonly, caseload midwives were required to work more than 0.5 EFT, have more than one year of experience and have the skills across the whole scope of practice. On average, midwives took a caseload of 35–40 women when full time, with reduced caseloads if caring for women at higher risk. Leave coverage was complex and often ad-hoc. Duration of home-based postnatal care varied and most commonly provided to six weeks. Women’s access to caseload care was impacted by many factors with geographical location and obstetric risk being most common.

Conclusion
Introducing, managing and operationalising caseload midwifery care is complex. Factors which may affect the expansion and availability of the model are multi-faceted and include staffing and model inclusion guidelines. Coverage of leave is a factor which appears particularly challenging and needs more focus.

Keywordscaseload midwifery; maternity care; continuity of care; midwife led care; primary midwife care
Year2018
JournalAustralian Midwifery
Journal citation31 (3), pp. 194-201
PublisherElsevier BV
ISSN1871-5192
Digital Object Identifier (DOI)https://doi.org/10.1016/j.wombi.2017.08.132
Scopus EID2-s2.0-85030166958
Research or scholarlyResearch
Page range194-201
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online28 Sep 2017
Publication process dates
Accepted28 Aug 2017
Deposited15 Jul 2021
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