Australian Women and Families for Universal Access to Midwifery-Led Continuity of Care

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A message from Australian women and their families to the Australian Government, Department of Health and to the National Strategic Approach to Maternity Services (NSAMS) decision-makers: We want to have universal access to Quality, Midwifery-Led Continuity of Care/Carer nearby where we live.

The Australian government is redesigning the maternity healthcare system and they need your voice! If your voice is not included other more powerful groups with an interest in keeping things as they are, will cloud over consumer's choices. We know how passionate you are about your own and your families' health and wellbeing and we know how passionate you are about having the best care available to you during the perinatal period - pregnancy, childbirth and postnatally. That is why we are demanding that our government listen to consumers and hear them loud and clear - Australian women and their families, maternity healthcare consumers - are adamant about having access to the best possible care for them and their babies. We want to have the option to access Quality Midwifery-Led Continuity of Care nearby where we live. We know from the latest research that this model of care provides the best outcomes for mothers and babies (see links to research below). Less than 8% of women in Australia have access to this model. We are here to change this!

 

FAQs

- Who can sign this document?
Australian citizens who are consumers of maternity healthcare, their families and support networks. If you are signing this document as a support person, please mention this in your statement, e.g - I would like our family to have access to Midwifery Led Continuity of Care.

- What is a maternity healthcare consumer?
Any person who accesses any healthcare (midwifery services, a GP, an OB, a nurse, hospital, medical centre, birth centre, etc.) during the time they are pregnant, giving birth and postnatally. We believe that in the case of maternity healthcare, the immediate family, friends and support networks of the consumer are directly impacted by the access and services consumers receive. We therefor extend submissions to close family members and support members for the primary person seeking this care.

- Why is it important to have your say?
The Australian Government is currently holding a review of maternity services across Australia. International qualitative and quantitive research has repeatedly shown that quality Midwifery-Led Continuity of Care provides better outcomes for mothers and for their babies (see list of evidence below). In Australia, less than 8% of women have access to this model of care. ​

- What is Midwifery Led Continuity of Care & or Carer (MLCC)?                                                             The MLCC model includes: continuity of care; monitoring the physical, psychological, spiritual and social well-being of the woman and family throughout the childbearing cycle; providing the woman with individualised education, counselling and ANC; attendance during labour, birth and the immediate postpartum period by a known midwife; ongoing support during the postnatal period; minimising unnecessary technological interventions; and identifying, referring and coordinating care for women who require obstetric or other specialist attention.

 

Research, evidence and recommendations on MLCC models of care.

The Research bodies conducting the below reports are the most respected and recognised for quality the world over. The research was conducted with information from various countries around the world, including Australia and is definitive in its definitions of Midwifery-Led Care, the methods of research and the results of the research conducted. These bodies are ethical and unbiased.

>> Midwife-led continuity models of care compared with other models of care for women during pregnancy, birth and early parenting
Source: Cochrane
Authors: Sandall J, Soltani H, Gates S, Shennan A, Devane D
Published: 28 April 2016
Summery: The main benefits were that women who received midwife-led continuity of care were less likely to have an epidural. In addition, fewer women had episiotomies or instrumental births. Women’s chances of a spontaneous vaginal birth were also increased and there was no difference in the number of caesarean births. Women were less likely to experience preterm birth, and they were also at a lower risk of losing their babies. In addition, women were more likely to be cared for in labour by midwives they already knew. The review identified no adverse effects compared with other models.

>> WHO recommendation on midwife-led continuity of care during pregnancy
Source: WHO - the World Health Organisation
Published: 1 November 2016
Methods: The quality of the scientific evidence underpinning the recommendations was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) (5) and Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) (6) approaches, for quantitative and qualitative evidence, respectively. Up-to-date systematic reviews were used to prepare evidence profiles for priority questions.
Recommendation: Midwife-led continuity-of-care models, in which a known midwife or small group of known midwives supports a woman throughout the antenatal, intrapartum and postnatal continuum, are recommended for pregnant women in settings with well functioning midwifery programmes.

>> The Lancet Series on Midwifery
Source: The Lancet
Executive Summery: The essential needs of childbearing women in all countries, and of their babies and families, are the focus of this thought-provoking series of international studies on midwifery. Many of those needs are still not being met, decades after they have been recognized. New solutions are required. The Series provides a framework for quality maternal and newborn care (QMNC) that firmly places the needs of women and their newborn infants at its centre. It is based on a definition of midwifery that takes account of skills, attitudes and behaviours rather than specific professional roles. The findings of this Series support a shift from fragmented maternal and newborn care provision that is focussed on identification and treatment of pathology to a whole-system approach that provides skilled care for all.

2 of the Key Messages from the Lancet series (more in the linked review):

  1. These findings support a system-level shift, from maternal and newborn care focusedon identification and treatment of pathology, to a system of skilled care for all, with multidisciplinary teamwork and integration across hospital and community settings. Midwifery is pivotal to this approach.
  2. Midwifery is associated with more efficient use of resources and improved outcomes when provided by midwives who are educated, trained, licensed, and regulated, and midwives are only effective when integrated into the health system in the context of effective teamwork and referral mechanisms and sufficient resources.

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