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.
Keywords
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Article info
Publication history
Published online: July 08, 2020
Accepted:
June 22,
2020
Received in revised form:
June 17,
2020
Received:
May 19,
2020
Identification
Copyright
© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
