Simcock G, Kildea S, Kruske S, Laplante DP, Elgbeili G, King S. Disaster in pregnancy: midwifery continuity positively impacts infant neurodevelopment, QF2011 study. While midwifery group practice for vulnerable women is recommended based on evidence from small international studies, it is not known how widespread or effective the model is in Australia. Data were analysed using manual and then Leximancer computer assisted methods. The continuity of midwives would ensure the deep needs of each woman were met. A thesis submitted for the Degree of Doctor of . Midwifery Group Practice (MGP) (also known as caseload midwifery) describes a model where women receive midwifery care from the same midwife or small group of midwives throughout their pregnancy, birth and postnatal period. Active labour, normal birth, breastfeeding and early discharge home from the Birthing Unit are important to us. Feedback on study results at completion of the study was provided to participants who requested follow-up. We aimed to identify the potential barriers and enablers for implementing a midwifery group practice for vulnerable women. Modifications would need to be made to traditional midwifery group practice design due to perceived heavy demands from deep engagement with vulnerable women and the potential for vicarious trauma, burnout, and other emotional impacts for the midwives. Midwifery Group Practice (MGP) allows women and families having a baby to be cared for by a known midwife throughout their pregnancy, during labour and birth, and postnatally. Key words and phrases which were repeated amongst participants were tabulated. Implement Sci. Two female researchers (PS and DR) conducted the interviews with PS facilitating all, and DR co-leading all but three sessions due to her clinical availability. While womens disengagement from the proposed model might be identified as a risk, in discussions around this barrier solutions were identified. Smith, P.A., Kilgour, C., Rice, D. et al. The researchers conferred to agree on a joint understanding of the themes which emerged. Continuity of care by a primary midwife (caseload midwifery) increases womens satisfaction with antenatal, intrapartum and postpartum care: results from the COSMOS randomised controlled trial. Am J Perinatol. A midwifery group practice was perceived to meet the needs of vulnerable women because for example, some with abuse histories dont want to go over those histories over and over (Midwife, Interview 2). A retrospective cohort study. Of the 40 people invited to an interview, 31 consented to participate (77.5%) with no response received from 9 others. Caseload midwifery compared to standard or private obstetric - PubMed Participants were mostly clinicians with more than 10 years experience and so were likely able to make accurate assumptions around the number of workforce hours required to build rapport with women, discuss the care being delivered with the women and amongst colleagues, and deliver the volume of care required to optimise health outcomes. The cost of the proposed model had not been established but was imagined by participants to be higher than both the current model of care and comparative midwifery group practices. Implement Sci. Registered Midwife - Tweed Midwifery Group Practice Whilst participants were sent relevant information containing brief background to the proposed study in advance of the interview, some attendees advised they wanted to come well prepared. Allen J, Kildea S, Stapleton H. How optimal caseload midwifery can modify predictors for preterm birth in young women: Integrated findings from a mixed methods study. The CFIR outlines domains and constructs that are associated with effective implementation of new interventions. Most participants were female (87%) and between 41 and 50 years of age (35.5%). Implementation barriers and enablers of midwifery group practice for vulnerable women: a qualitative study in a tertiary urban Australian health service. Asking women about mental health and social adversity in pregnancy: results of an Australian population-based survey. Midwifery practice arrangements which sustain caseloading Lead Maternity Carer midwives in New Zealand. Bayrampour H, McNeil DA, Benzies K, Salmon C, Gelb K, Tough S. A qualitative inquiry on pregnant womens preferences for mental health screening. Cost reduction appears to be achieved through reorganising the way care is delivered in the public hospital system with the introduction of Midwifery Group Practice or caseload care. Midwifery and midwifery group practice is recommended for all vulnerable women [12, 14,15,16] because of improved health outcomes for both mothers and babies. All interviews were conducted in-person except for two where phone interviews were used at the request of the participants. Tweed Valley Weekly, May 25, 2017 - Issuu The service design would need to ensure that midwives can be changed across groups. Themes and sub-themes similar to those that emerged from manual analysis were around the womans experience, workforce, standards of care and opportunity. Canberra: AIHW; 2021. Our MGP program offers you one midwife (who works in a team) who will care for you through your pregnancy, through your birth and at home for 2 weeks after your baby is born. Quicklinks. Theres also the opportunity to develop an interdisciplinary trust (Nurse, Interview 14). Further, that demonstrated engagement in the context assessment by stakeholders was an indicator that individuals were at an advanced stage of change in relation to redesigning maternity care for vulnerable women. Benchmarking for Midwifery Group Practice - WCHA Two strategies for qualitative content analysis: An intramethod approach to triangulation. Although, it was highlighted that any potential changes to how the team works with the midwifery group practice would need to be implemented carefully. Background: Although there is high-level evidence supporting positive perinatal outcomes for midwifery group practice (MGP) care, not all women can access this model due to a failure to implement or sustain it. Opening Times: Monday to Friday 09:00 - 18:00 Share this page Twitter Facebook Contact NHS Borders Copyright 2019NSW Health - Illawarra Shoalhaven Local Health District. A midwife or small team of midwives will provide your primary care with medical practitioner. BMC Pregnancy Childbirth. DR: Investigation, Formal analysis, Writing Review and Editing. Midwifery care during labor and birth. A thorough consideration of potential experiences for the woman, the workforce and costs when preparing a business case, will be a determinant of model implementation success. Allen J, Gibbons K, Beckmann M, Tracy M, Stapleton H, Kildea S. Does model of maternity care make a difference to birth outcomes for young women? To identify these potential barriers and enablers, a context assessment was undertaken for a proposed midwifery group practice for vulnerable women at a single site tertiary maternity service in Queensland, Australia. Thematic analysis of qualitative research data: Is it as easy as it sounds? Armadale Health Service - Midwifery Group Practice Midwifery Group Practice. The Midwifery Group provides: Prenatal care. CAS 2023 BioMed Central Ltd unless otherwise stated. Potential barriers and enablers were identified from the interview data and grouped into themes: the womans experience, midwifery workforce, gold standard care, the interdisciplinary team, and costs. 2002;109(3):26573. To access a hospital-based midwife, your GP will refer you, or you may check with your local hospital and self-refer. A qualitative context analysis using the Consolidated Framework for Implementation Research was conducted at a single-site tertiary health facility in Queensland, Australia. Women Birth. Participants had concerns around costs which may be reflected by decision-makers when examining the rigor in which a business case has been prepared. To do this, we conducted a qualitative context assessment using the Consolidated Framework for Implementation Research (CFIR) [31,32,33].The CFIR was chosen to guide the context assessment because the process required engagement with individuals and groups across multiple . Birth Centre: Midwifery-led care for low- to medium-risk women who want minimal intervention with their labour and birth. Correspondence to Collaboration in maternity care is achievable and practical. 2017;17(1):339. There is strong international evidence that these womens pregnancies are more likely to result in placental abruption, preterm birth, neonates that are small for gestational age, and neonatal admission to an intensive care unit [3, 4]. Planning an active labour & birth In Northern NSW, MGP models are available for healthy, well women at Tweed, Murwillumbah, Byron and Lismore Hospitals. Midwifery Group Practice (MGP) | Illawarra Shoalhaven Local Health 1). It is also unknown how accepted midwifery group practice is amongst key stakeholders in Australia. Midwife, Registered Nurse, Medical Officer and more on Indeed.com Midwifery Group Practice $75,200 Jobs in New South Wales (with Salaries) 2022 | Indeed.com Australia 2016;41:308. Participants were clear that midwives would lead continuity of care, while having expert health professionals involved to provide comprehensive care for the women. 2021;38(7):6438. There are criteria around this involving your general health, obstetric history and your current address. Following the interviews, participants were notified that their de-identified information would be considered in subsequent planning for a midwifery group practice for vulnerable women. Call our 24/7 hotline on (07) 3810 1242 or (07) 3810 1564 to speak with a midwife about your questions or concerns. 9:00am-6:00pm on Mondays, Wollongong Hospital 2023-03-17 09:56:17. For most women your group of midwives will be able to provide the majority of your care. THE new Tweed Midwifery Group Practice (TMGP) has welcomed the birth of its first baby. Discussion around the womans experience identified enablers for the proposed model. The theme Gold standard care mapped to five constructs indicates that either a perception, or knowledge of evidence supporting midwifery group practice for vulnerable women would be critical to its success. Participants saw the proposed new model as an opportunity for midwives to gain new skills and expand their scope of practice which was identified as an enabler: There are a few midwives out there currently upskilling themselves and are really passionate and interested and already preparing for being part of the team (Nurse/Midwife Leader, Interview 3). "It's what midwifery is all about": Western Australian midwives Twenty individual or small group interviews were conducted. Whilst Australian data on non-attendance at antenatal appointments is limited, international evidence suggests antenatal care is not well accessed by vulnerable women. 2012;22(4):41350. Midwifery Group Practice is a continuity of care model for pregnant women who provide individualised care through her antenatal (pregnancy), intra partum (labour and birth) and early postnatal journey. The aim of Midwifery Group Practice (MGP) is to provide you with a known midwife for your birth and postnatal care at home. A summary of potential barriers and enablers from which these themes emerged is presented in Supplementary File 1. Tweed Midwives Group Practice celebrate their first baby We therefore aimed to identify the barriers and enablers that might impact the implementation of a midwifery group practice for vulnerable women. Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, Matthieu MM, et al. Continuity of midwifery care (Midwifery Group Practice)your care is provided by a midwife during your pregnancy, when have your baby and for up to 6 weeks after the baby is born. About us Brisbane: Queensland Government; 2021 [Available from: https://metronorth.health.qld.gov.au/rbwh/about-us. Gregory I, Kinge S. Maternity focus: caring for vulnerable pregnant women. Midwifery. There are 8000 staff on campus encompassing a multitude of complex health services [34] This study setting was selected as midwifery managers sought to improve accessibility of care delivered to vulnerable women, acutely aware of a high failure-to-attend rate where more than 25% (n=205) of vulnerable women do not attend their scheduled antenatal care compared to 8% in the general population each year (unpublished health service data available on request). Ongoing postnatal care is then personalised to you and the needs of your baby, and consists of regular home visits in the first few weeks after the birth of your baby. Patients and visitors Our services The Tweed Practice The Tweed Practice Details and latest news from The Tweed Practice can be found on the Hay Lodge Health Centre website. Sotiriadou P, Brouwers J, Le T-A. The participants identified through purposeful sampling [37] were sent invitations including an information sheet providing a brief background to the study, via email, with open invitations also promoted at staff meetings. NZCOM J. CFIR Research Team. Leximancer is a well-known text mining software used to identify concepts grounded in the study data [39] and has been used in Australian maternity settings [42, 43]. Australian maternity services can use our results to compare how the perceptions of local stakeholders might be similar or different to the results presented in this paper. This may be further exacerbated by the reading and preparation prior to interview done by some participants. Women using the Midwifery Group Practice (MGP) model of care will have a known midwife who works with one or more backup midwives to provide care from early in pregnancy, throughout labour and birth, and for up to six weeks after birth. An interdisciplinary team that is already part of the organisational structure and engaged in planning the model is likely to be essential. Leximancer 4 generated themes from stakeholder interviews. per night. Participants believed that the health benefits of the proposed model of care would outweigh the perception that a midwifery group practice for vulnerable women was a more expensive model of care. Outpatient Clinics | Northern NSW Local Health District The integral way in which having a known midwife provides benefit and support for women was repeatedly discussed by participants. Midwifery Group Practice (MGP): Midwifery-led care for low- to medium-risk women from a designated . A major workforce barrier to implementation success was how midwifery group practice would place high psychological demand on the midwives leading to burnout or vicarious trauma: very complex women with personality disorders and high psychological needs and that could be quite demanding of one midwife as the primary caregiver (Nurse/Midwife Leader, Interview 3). The diversity and large relative number of stakeholders involved in the study also ensured the qualitative data were reflective of a comprehensive sample from which data saturation was readily achieved. Management and sustainability of midwifery group practice - PubMed Midwifery. Notes were also made by the interviewers. Participants suggested that to overcome this barrier, caseloads should be reduced, and midwives should be well supervised and mentored as described also by others [46], especially when caring for vulnerable women [47]. 2018;298(3):487503. Tracy SK, Hartz DL, Tracy MB, Allen J, Forti A, Hall B, et al. Overall, the most common terms were caseload midwifery (n = 63, 36%), midwifery-led continuity (n = 60, 34%), or team/midwifery group practice (n = 40, 23%). If there were differences in manual and computer analysis results, the research team planned to reach a consensus on emerging themes through discussion. Midwifery Group Practices (MGPs) provide care to pregnant women in a group of (4-6) midwives. Nagle U, Farrelly MJM. Active labour, normal birth, breastfeeding and early discharge home from the Birthing Unit are important to us. Peer checking was undertaken independently (by CK) through analysis of the de-identified research transcripts using Leximancer V4. Doi L, Cheyne H, Jepson R. Alcohol brief interventions in Scottish antenatal care: a qualitative study of midwives attitudes and practices. These committees also determined that informed consent was not required to be obtained from participants, and only a participant information sheet was provided. Midwifery Group Practice | Northern NSW Local Health District Arch Gynecol Obstet. Clinics are available on specific weekdays and appointments can be negotiated for aconvenient time: Shellharbour Hospital Furthermore, to ensure sustained success, implementation of a midwifery group practice for vulnerable women requires careful planning using the principles of implementation science [30]. Canberra: Australian Government; 2021. It was another blockbuster weekend in the NRRRL, with a physical grand final rematch and one of the comebacks of the season so far among the highlights. Yelland J, Brown SJJB. Please contact us to discuss fees, Medicare rebates, the Pharmaceutical Benefits Scheme, etc Illawarra and Shoalhaven Local Health District, https://www.islhd.health.nsw.gov.au/services-clinics/welcome-division-maternity-and-womens-health/mgp, Welcome to the Division of Maternity and Women's Health, Click here for more information about theIllawarra Health Care Interpreter Service, Antenatal (Pregnancy) Care - Milton Ulladulla Hospital, Antenatal (Pregnancy) Care - Shoalhaven Hospital, Antenatal (Pregnancy) Clinic - Wollongong Hospital, Antenatal (Pregnancy) Shared Care with your GP, Childbirth & Early Parenting Education - groups and videos, Early Pregnancy Assessment Service (EPAS), Maternity Ward (C2 West) - Wollongong Hospital, Midwifery Group Practice (MGP) - Wollongong, Neonatal (Baby) Unit - Shoalhaven Hospital, Neonatal (Baby) Unit - Wollongong Hospital, Coronavirus (Covid-19) - Pregnancy and Breastfeeding, Diabetes in pregnancy- Gestational (GDM), Type 1 or Type 2, Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (HG), Resources and brochures - pregnancy, baby, other languages. Implementation barriers and enablers of midwifery group practice for vulnerable women: a qualitative study in a tertiary urban Australian health service, https://doi.org/10.1186/s12913-022-08633-8, https://www.pretermalliance.com.au/Alliance-News/Latest-News/Midwifery-Continuity-of-Care, https://metronorth.health.qld.gov.au/rbwh/about-us, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmchealthservicesresearch@biomedcentral.com. An alternative to this is Midwifery Group Practice (MGP), also called continuity of midwifery or caseload midwifery which has been implemented globally and largely focusses on low-risk pregnancies [10, 13].
