Emma Quinn1, Jacqueline Noble, Holly Seale, Jeanette Elizabeth Ward. 1. NSW Public Health Officer Training Program, NSW Ministry of Health, Australia; School of Public Health and Community Medicine, University of New South Wales, Australia. Electronic address: equin@doh.health.nsw.gov.au.
Abstract
BACKGROUND: Since the National Maternity Services Review, non-medical models of care involving midwives as the primary care giver are gaining prominence in urban settings in Australia. However, there remains a paucity of evidence about which non-medical primary maternity care models are best suited for rural and remote communities. AIM: We investigated the perceptions, acceptability and barriers and enablers to the delivery of non-medical primary maternity care models in Far West NSW, as an example of remote Australia. METHODS: We purposively sampled and invited 24 clinicians and/or policy makers to an in-depth interview via the phone or face-to-face. Quantitative items were coded and analysed descriptively, whereas qualitative responses were analysed for thematic content via two independent authors. RESULTS: Of 16 eligible participants, 14 consented to participate and were very experienced practitioners from a range of roles and settings. There was strong agreement that evidence supporting non-medical models of care was relevant to the remote context in Far West NSW. Participants reported that pregnant women and health service partners would find midwifery-led care very acceptable and that team models would be the easiest to deliver in their setting. Reported barriers and enablers for the delivery of midwifery-led care conversely reflected each other and emphasised the need for retention of local maternity staff to provide continuity of care. CONCLUSIONS: Local health service partners are demonstrably ready for further local improvement in providing midwifery-led models of maternity care to women who live in very remote communities in NSW, Australia. Crown
BACKGROUND: Since the National Maternity Services Review, non-medical models of care involving midwives as the primary care giver are gaining prominence in urban settings in Australia. However, there remains a paucity of evidence about which non-medical primary maternity care models are best suited for rural and remote communities. AIM: We investigated the perceptions, acceptability and barriers and enablers to the delivery of non-medical primary maternity care models in Far West NSW, as an example of remote Australia. METHODS: We purposively sampled and invited 24 clinicians and/or policy makers to an in-depth interview via the phone or face-to-face. Quantitative items were coded and analysed descriptively, whereas qualitative responses were analysed for thematic content via two independent authors. RESULTS: Of 16 eligible participants, 14 consented to participate and were very experienced practitioners from a range of roles and settings. There was strong agreement that evidence supporting non-medical models of care was relevant to the remote context in Far West NSW. Participants reported that pregnant women and health service partners would find midwifery-led care very acceptable and that team models would be the easiest to deliver in their setting. Reported barriers and enablers for the delivery of midwifery-led care conversely reflected each other and emphasised the need for retention of local maternity staff to provide continuity of care. CONCLUSIONS: Local health service partners are demonstrably ready for further local improvement in providing midwifery-led models of maternity care to women who live in very remote communities in NSW, Australia. Crown