Abstract
Background
There is good evidence that Continuity of Midwifery Care (CMC) is associated with
improved clinical outcomes, greater maternal satisfaction, and improved work experiences
for midwives. Changes made to the organisation require careful implementation, with
on-going evaluation to monitor progress.
Aim
To develop a survey tool that incorporates several validated scales, which was used
to collect baseline data prior to implementing a high-quality Continuity of Midwifery
Care (CMC) model in Scotland (Hewitt et al., 2019). This tool gathered data about
midwives’ personal and professional wellbeing prior to service reorganisation, with
a longitudinal study intended to measure change in midwives’ reportage across time.
This paper reports the baseline data-collection.
Methods
An on-line survey was shared with practising midwives (n = 321) in Scotland via the NHS intranet, verbally, email, and paper. The survey elicited
midwives views about Continuity of Midwifery Care (CMC); values and philosophies of
care; attitudes towards their professional role; personal and professional demographics;
quality of life and wellbeing. Psychometric attitudinal scales were scored and free
text comments themed according to positive/negative opinions of the new Continuity
of Midwifery Care (CMC) model to highlight key concerns to be addressed and identify
change barriers or facilitators.
Findings
The majority of midwives indicated support for philosophies underpinning Continuity
of Midwifery Care (CMC), which includes physiological birth and providing autonomous
midwifery care. Participants also indicated positive attitudes towards their current
role and organisation, with some worrying about how the organisation was going to
implement the changes required. Worries included, receiving an overburdening workload,
being deskilled in certain areas of midwifery practice, and lack of support were litigation
to arise.
Conclusion
Midwives support the values and philosophies that underpin Continuity of Midwifery
Care (CMC), yet worry about organisational change involved in evolving systems of
care. Hence, management require to implement strategies to reduce fears. For example,
delivering accurate and honest information, enabling midwives to plan, design and
implement changes themselves, and providing emotional and material help.
Keywords
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Article info
Publication history
Published online: November 25, 2019
Accepted:
August 12,
2019
Received in revised form:
August 12,
2019
Received:
June 6,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of Australian College of Midwives. All rights reserved.
