A shift to a midwifery group practice model in regional Victoria will provide continuity of care and help deliver a better birthing experience for local families, according to Castlemaine health.
After an extensive review of operations, planning, ongoing consultation with key stakeholders and consumer groups, a midwifery-led model was developed encompassing a remote, on-call group practice of four midwives to the existing hospital midwifery team.
A clinical governance model between the Bendigo and Castlemaine campuses underpins these processes, allowing an ongoing exchange of information and resources between the two hospitals.
Midwives from Castlemaine’s group practice meet fortnightly with Bendigo Health to assign a risk rating of clients, ensuring that GP’s, obstetricians, midwives and other health staff remain aware of each consumer’s requirements.
Low-risk clients will generally be birthed at Castlemaine, while “amber”, or medium risk clients will be shared between the two health campuses. “Red”, or high-risk clients, will be referred onwards to Bendigo for the duration of their pregnancy, though may return to Castlemaine for post-natal care.
After an extensive period of consultation and review the clinic re-opened in March. Di Senior, Castlemaine Health’s Executive Director, Clinical and Community, said the resulting program was worth the wait.
“All the evidence and literature shows that [midwifery-led care] provides very good continuity of care for women who book here,” Ms Senior said.
“I think we’ve opened up now with a very good model for the women of Castlemaine.”
Ms Senior said that the aforementioned consultation with the ANMF was a key part of developing the new program, which helped to revise and shift some long-standing practices at the hospital.
Midwives, specialised in group practice care, were employed to help deliver the ‘continuity of care’ model, often working remotely and on-call, with a buddy system used should there be clashes in scheduling for the respective group practice midwives.
The hospital’s existing midwifery team work as the ‘second midwife’ to assist with births at the hospital, providing key natal support, and allowing the group practice midwives to also focus on antenatal and postnatal care.
Ms Senior said while some staff were adapting to the new processes, the hospital was otherwise adjusting to the new model, with several births delivered already.
“We’re starting to find our feet… It’s a very good model for our community, and the women, I think, love it.”
Castlemaine Hospital’s Midwifery Coordinator, and Midwifery Group Practice Midwife, Claire Ross, echoes this sentiment, describing the process of setting up the program as both “really exciting” and “overwhelming”.
“The midwifery staff were really on board with this big change that was occurring,” Ms Ross said.
“But of course, there has been some shifting of roles and responsibilities, which can always be a bit tricky… we’ve had regular meetings and talks.”
Despite the challenges of administrating and embedding a new model, Ms Ross was clear about the rewards that the group practice structure offers.
“You get to know them [birthing women] really well, you know what their plan is and their preferences for their birthing experience and their post-natal care so when you get called in at 3am it is actually worth it because you know that woman and you know that family… it’s quite lovely,” Ms Ross said.
“I get a lot out of having that relationship built with my client.”
More information about the Midwifery Group Practice model can be found at the Castlemaine Health website.