Michelle Newton1, Kate Dawson2, Della Forster3, Helen McLachlan2. 1. School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora 3086, Australia. Electronic address: michelle.newton@latrobe.edu.au. 2. School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora 3086, Australia. 3. Judith Lumley Centre, La Trobe University, Bundoora 3086, Australia; The Royal Women's Hospital, 20 Flemington Road, Parkville 3052, Australia.
Abstract
BACKGROUND: Midwife-led continuity of care has substantial benefits for women and infants and positive outcomes for midwives, yet access to these models remains limited. Caseload midwifery is associated with professional satisfaction and lower burnout, but also impacts on work-life boundaries. Few studies have explored caseload midwifery from the perspective of midwives working in caseload models compared to those in standard care models, understanding this is critical to sustainability and upscaling. AIM: To compare views of caseload midwifery - those working in caseload models and those in standard care models in hospitals with and without caseload. METHODS: A national cross-sectional survey of midwives working in Australian public hospitals providing birthing services. FINDINGS: Responses were received from 542/3850 (14%) midwives from 111 hospitals - 20% worked in caseload, 39% worked in hospitals with caseload but did not work in the model, and 41% worked in hospitals without caseload. Regardless of exposure, midwives expressed support for caseload models, and for increased access to all women regardless of risk. Fifty percent of midwives not working in caseload expressed willingness to work in the model in the future. Flexibility, autonomy and building relationships were positive influencing factors, with on-call work the most common reason midwives did not want to work in caseload. CONCLUSIONS: There was widespread support for and willingness to work in caseload. The findings suggest that the workforce could support increasing access to caseload models at existing and new caseload sites. Exposure to the model provides insight into understanding how the model works, which can positively or negatively influence midwives' views.
BACKGROUND: Midwife-led continuity of care has substantial benefits for women and infants and positive outcomes for midwives, yet access to these models remains limited. Caseload midwifery is associated with professional satisfaction and lower burnout, but also impacts on work-life boundaries. Few studies have explored caseload midwifery from the perspective of midwives working in caseload models compared to those in standard care models, understanding this is critical to sustainability and upscaling. AIM: To compare views of caseload midwifery - those working in caseload models and those in standard care models in hospitals with and without caseload. METHODS: A national cross-sectional survey of midwives working in Australian public hospitals providing birthing services. FINDINGS: Responses were received from 542/3850 (14%) midwives from 111 hospitals - 20% worked in caseload, 39% worked in hospitals with caseload but did not work in the model, and 41% worked in hospitals without caseload. Regardless of exposure, midwives expressed support for caseload models, and for increased access to all women regardless of risk. Fifty percent of midwives not working in caseload expressed willingness to work in the model in the future. Flexibility, autonomy and building relationships were positive influencing factors, with on-call work the most common reason midwives did not want to work in caseload. CONCLUSIONS: There was widespread support for and willingness to work in caseload. The findings suggest that the workforce could support increasing access to caseload models at existing and new caseload sites. Exposure to the model provides insight into understanding how the model works, which can positively or negatively influence midwives' views.