Midwifery-led Continuity of Care (MCoC) models is the gold standard in maternity care.
This presentation will outline how a regional district health service in NSW implemented
its first MCoC model, ensuring a small rural maternity service did not close. Evaluation
of the model proved it is safe, cost-effective and highly valued by women.
Case review of a district health service co-design and implementation journey that
achieved access to a MCoC model in a regional context. The small rural maternity service
previously supported on average 40 women a year to birth under a GP led model. The
service was proving unsustainable and at risk of closure. With executive support,
a MCoC model was co-designed and implemented in partnership with community, midwifery
and obstetric teams. Commencing in 2020, the model successfully commenced whilst enduring
the impacts of simultaneously moving to a new hospital build and managing a pandemic
The implementation of the MCoC model enabled access to care for all women, including
those with risk during pregnancy by bringing specialist obstetric care to the local
community. This is of particular importance in the region to ensure access to safe
care for all women and their families close to home in rural and reginal settings.
Compared with the previous service, women who received care from the MCoC model in
2021 had improved outcomes, including higher rate of spontaneous labour, more likely
to have a normal birth, a reduced rate of caesarean section, required less medical
pain relief and were more likely to breastfeed. Access to the MCoC increased the likelihood
of women to access pregnancy care early and ongoing.