Embracing the continuity of care experience: A new Australian graduate entry master of midwifery course with a student caseload of 15 women per year

Published:November 28, 2022DOI:



      Women receiving continuity of midwifery care have increased satisfaction and improved outcomes. Preparation of midwifery students to work in continuity models from the point of graduation may provide an ongoing midwifery workforce that meets rising demand from women for access to such care.

      Aim of the paper

      The aim of this paper is to describe an innovative midwifery course based on a continuity model, where students acquire more than 50 % of clinical hours through continuity of care experiences. Additional educational strategies incorporated in the course to enhance the CCE experience within the philosophy of midwifery care, include a virtual maternity centre, case-based learning and the Resources Activities Support Evaluation (RASE) pedagogical model of learning.


      Australian accredited midwifery courses vary in structure, format and philosophy; this new course provides students with an alternative option of study for those who have a particular interest in continuity of midwifery care.


      A midwifery course which provides the majority of clinical hours through continuity of care may prepare graduates for employment within midwifery group practice models by demonstrating the benefits of relationship building, improved outcomes and the reality of an on-call lifestyle.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. K. Hames, National Maternity Services Plan. In: Health Do, editor. Canberra: The Australian Health Ministers' Conference, 2010,

        • Sandall J.
        • Soltani H.
        • Gates S.
        • Shennan A.
        • Devane D.
        Midwife‐led continuity models versus other models of care for childbearing women.
        Cochrane Database Syst. Rev. 2016;
        • McLachlan H.
        • Forster D.
        • Davey M.
        • et al.
        Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial.
        BJOG: Int. J. Obstet. Gynaecol. 2012; 119: 1483-1492
        • Kildea S.
        • Gao Y.
        • Hickey S.
        • et al.
        Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia.
        EClinicalMedicine. 2019; 12: 43-51
        • Dencker A.
        • Smith V.
        • McCann C.
        • Begley C.
        Midwife-led maternity care in Ireland - a retrospective cohort study.
        BMC Pregnancy Childbirth. 2017; 17: 101
        • Turienzo C.F.
        • Sandall J.
        • Peacock J.L.
        Models of antenatal care to reduce and prevent preterm birth: a systematic review and meta-analysis..
        BMJ Open. 2016; 6 (e009044-e009044)
        • Bradfield Z.
        • Hauck Y.
        • Kelly M.
        • Duggan R.
        "It's what midwifery is all about": Western Australian midwives' experiences of being "with woman' during labour and birth in the known midwife model.
        BMC Preg. Childbirth. 2019; 19
        • Fenwick J.
        • Sidebotham M.
        • Gamble J.
        • Creedy D.K.
        The emotional and professional wellbeing of Australian midwives: a comparison between those providing continuity of midwifery care and those not providing continuity.
        Women Birth. 2018; 31: 38-43
      2. ANMAC. Midwife Accreditation Standards 2014. Canberra: Australian Nursing and Midwifery Council, 2014.

        • Edmondson M.C.
        • Walker S.B.
        Working in caseload midwifery care: The experience of midwives working in a birth centre in North Queensland.
        Women Birth. 2014; 27: 31-36
        • Larsson B.
        • Rubertsson C.
        • Hildingsson I.
        A modified caseload midwifery model for women with fear of birth, women’s and midwives’ experiences: a qualitative study..
        Sex. Reprod. Health. 2020; 24100504
        • Jepsen I.
        • Juul S.
        • Foureur M.
        • Sørensen E.E.
        • Nøhr E.A.
        Is caseload midwifery a healthy work-form? – a survey of burnout among midwives in Denmark.
        Sex. Reprod. Health. 2016; 11: 102-106
        • Newton M.S.
        • McLachlan H.L.
        • Willis K.F.
        • Forster D.A.
        Comparing satisfaction and burnout between caseload and standard care midwives: findings from two cross-sectional surveys conducted in Victoria, Australia.
        BMC Pregnancy Childbirth. 2014; 14 (426-16 pages)
        • Henderson C.W.
        Investigators at royal women’s hospital discuss findings in midwifery ( Comparing satisfaction and burnout between caseload and standard care midwives: findings from two cross- sectional surveys conducted in Victoria, Australia).
        Women'S. Health Wkly. 2015; : a64
        • Rawnson S.
        A qualitative study exploring midwifery students' experiences of carrying a caseload as part of their midwifery education in England.
        Midwifery. 2011; 27: 786-792
        • Browne J.
        • Haora P.
        • Taylor J.
        • Davis D.
        "Continuity of care" experiences in midwifery education: Perspectives from diverse stakeholders.
        Nurse Educ. Pract. 2014; 14: 573-578
        • Sweet L.P.
        An exploration of the midwifery continuity of care program at one Australian University as a symbiotic clinical education model.
        Nurse Educ. Today. 2011; 333: 262-267
        • Kuliukas L.
        • Bradfield Z.
        • Costins P.
        • et al.
        Midwifery students’: Developing an understanding of being ‘with woman’––a qualitative study..
        Midwifery. 2020; : 84
        • Kuliukas L.
        • Bayes S.
        • Geraghty S.
        • Bradfield Z.
        • Davison C.
        Graduating midwifery students’ preferred model of practice and first job decisions: a qualitative study.
        Women birth: J. Aust. Coll. Midwives. 2021; 34: 61-68
      3. C. Reidsema, L. Kavanagh, R. Hadgraft, N. Smith, The flipped classroom: practice and practices in higher education / Carl Reidsema, Lydia Kavanagh, Roger Hadgraft, Neville Smith, editors: Singapore: Springer Nature, 2017.

        • Abeysekera L.
        • Dawson P.
        Motivation and cognitive load in the flipped classroom: definition, rationale and a call for research.
        High. Educ. Res. Dev. 2014; 34: 1-14
        • Churchill D.
        • King M.
        • Fox B.
        Learning design for science education in the 21st century.
        Zb. Inst. za Pedagoš. istraživanja. 2013; 45 (404-21)
        • McLean S.F.
        Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature.
        J. Med. Educ. Curric. Dev. 2016; 3: S20377
        • Thistlethwaite J.E.
        • Davies D.
        • Ekeocha S.
        • et al.
        The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23.
        Med. Teach. 2012; 34: e421-e444
        • Kuliukas L.
        • Hauck Y.
        • Sweet L.
        • et al.
        A cross sectional study of midwifery students’ experiences of COVID-19: Uncertainty and expendability.
        Nurse Educ. Pract. 2021; 51102988
      4. International CoM. ICM Global Standards for Midwifery Education (Revised 2021). International ICM, 2021.

      5. International CoM. ICM Professional Framework for Midwifery 2021, 2022.

      6. COAG Health Council. Woman-Centred Care. Strategic Directions for Australian Maternity Services. In: Health Do, editor. Canberra: Creative Common Licence, 2019.