Evaluation of a regional midwifery caseload model of care integrated across five birthing sites in South Australia: Women's experiences and birth outcomes

Introduction: The ongoing closure of regional maternity services in Australia has significant consequences for women and communities. In South Australia, a regional midwifery model of care servicing five birthing sites was piloted with the aim of bringing sustainable birthing services to the area. An independent evaluation was un-dertaken. This paper reports on women's experiences and birth outcomes.Aim: To evaluate the effectiveness, acceptability, continuity of care and birth outcomes of women utilising the new midwifery model of care. Method: An anonymous questionnaire incorporating validated surveys and key questions from the Quality Maternal and Newborn Care (QMNC) Framework was used to assess care across the antenatal, intrapartum and postnatal period. Selected key labour and birth outcome indicators as reported by the sites to government perinatal data collections were included.Findings: The response rate was 52.6% (205/390). Women were overwhelmingly positive about the care they received during pregnancy, birth and the postnatal period. About half of women had caseload midwives as their main antenatal care provider; the other half experienced shared care with local general practitioners and caseload midwives. Most women (81.4%) had a known midwife at their birth. Women averaged 4 post-natal home visits with their midwife and 77.5% were breastfeeding at 6-8 weeks. Ninety-five percent of women would seek this model again and recommend it to a friend. Maternity indicators demonstrated a lower induction rate compared to state averages, a high primiparous normal birth rate (73.8%) and good clinical outcomes.Conclusion: This innovative model of care was embraced by women in regional SA and labour and birth outcomes were good as compared with state-wide indicators.

Automated summary

The closure of regional maternity services in Australia has serious consequences. A regional midwifery model of care was piloted in South Australia to provide sustainable birthing services. The evaluation showed positive experiences and good birth outcomes among women utilizing this new model of care.