Demographic data were collected from all participants by a written survey at the interview to provide an overview of participants characteristics. PubMed Central All interviews were conducted in-person except for two where phone interviews were used at the request of the participants. The Family Birthing Centre (FBC) offers a safe and comfortable setting in which healthy expectant parents with uncomplicated pregnancies can give . Midwifery and midwifery group practice is recommended for all vulnerable women [12, 14,15,16] because of improved health outcomes for both mothers and babies. Call today to arrange a time that suits you. BMC Health Services Research Modifications would need to be made to traditional midwifery group practice design due to perceived heavy demands from deep engagement with vulnerable women and the potential for vicarious trauma, burnout, and other emotional impacts for the midwives. Stakeholders had a positive attitude towards the intervention; they placed a high value on the proposed model of care. Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Australias mothers and babies. How can I get emotional support? A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Participants were also invited to provide further information via email at their convenience, but transcripts would not be returned to comments for comment or correction. However, participants were conscious of the burden of such a maternity care model on the workforce, both in terms of the emotional challenge due to the womens complex care requirements and managing the financial cost of the service which would require further evaluation. MGP midwives allocate new clients once a month. The midwife researchers reflected on and acknowledged both the potential bias of being midwives investigating a topic they may have a self-interest in, along with the benefits of improved engagement from participants as they were known colleagues. Midwifery Group Practice (MGP) is the common name given in Australia to an evidence based model of care in which women are allocated a primary midwife who provides their care throughout their pregnancy, labour, birth and postnatal period. Perceptions around cost that are both potential enablers and barriers to gaining support and successful implementation would need to be clarified as fact in a business case before the proposed model is implemented. 2018;298(3):487503. All data were de-identified in preparation for data analysis. The benefits of continuity of care and carer are well documented [10] and are likely to be seen in vulnerable women. 2021;38(7):6438. Whilst participants were sent relevant information containing brief background to the proposed study in advance of the interview, some attendees advised they wanted to come well prepared. Themes identified were the womans experience, midwifery workforce capabilities, identifying gold standard care, the interdisciplinary team and costs. Cost reduction appears to be achieved through reorganising the way care is delivered in the public hospital system with the introduction of Midwifery Group Practice or caseload care. About us Brisbane: Queensland Government; 2021 [Available from: https://metronorth.health.qld.gov.au/rbwh/about-us. Referrals to the service can be made through a general practitioner or by self-referring by calling the Tweed Hospital Women's Care Unit on (07) 5506 7490. Shellharbour Hospital Carpark: Access to car parking facilities via the Hospital entrance on Madigan Boulevarde. A qualitative context analysis using the Consolidated Framework for Implementation Research was conducted at a single-site tertiary health facility in Queensland, Australia. 2011;5(6):2801. Tarasoff LA, Milligan K, Le TL, Usher AM, Urbanoski K. Integrated treatment programs for pregnant and parenting women with problematic substance use: Service descriptions and client perceptions of care. 2018;10(6):807 15. However, concerns were expressed regarding when having a known midwife might be a disincentive for women to engage. Annals of Leisure Research. 2016;40:15361. THE new Tweed Midwifery Group Practice (TMGP) has welcomed the birth of its first baby. Dos Santos JF, de Melo Bastos Cavalcante C, Barbosa FT, Gita DLG, Duzzioni M, Tilelli CQ, et al. New Z Coll Midwives J. Birth. Arch Gynecol Obstet. Computer-assisted analysis was undertaken to mitigate the recognised and acknowledged potential inherent bias in qualitative analysis [41]. The two novice researchers, both dual registered nurses and midwives at senior and middle management levels were known to all participants. We are proud of our long tradition of providing sensitive, thorough care for women. 2012;28(6):e874-9. 2:00pm-7:30pm on Wednesdays and Thursdays 2012;52(6):57681. Last modified 21/7/2021. Overall, the most common terms were caseload midwifery (n = 63, 36%), midwifery-led continuity (n = 60, 34%), or team/midwifery group practice (n = 40, 23%). 2015;52(8):133242. Born on April 27, Emme Millard claimed the precious title of the first baby born with the assistance of the TMGP, which formed earlier this year. Two female researchers (PS and DR) conducted the interviews with PS facilitating all, and DR co-leading all but three sessions due to her clinical availability. Correspondence to Student placements situated within models of care which provide continuity of midwifery care should be proactively enabled by health services and universities . Peer checking was undertaken independently (by CK) through analysis of the de-identified research transcripts using Leximancer V4. Midwifery group practice (MGP) has consistently demonstrated optimal health and wellbeing outcomes for childbearing women and their babies. An additional strength was the alignment of the manual and computer-assisted thematic results. An absence of continuity of care has been identified as a barrier to seeking help for mental illness [18, 23]. Please contact us to discuss fees, Medicare rebates, the Pharmaceutical Benefits Scheme, etc Illawarra and Shoalhaven Local Health District, https://www.islhd.health.nsw.gov.au/services-clinics/welcome-division-maternity-and-womens-health/mgp, Welcome to the Division of Maternity and Women's Health, Click here for more information about theIllawarra Health Care Interpreter Service, Antenatal (Pregnancy) Care - Milton Ulladulla Hospital, Antenatal (Pregnancy) Care - Shoalhaven Hospital, Antenatal (Pregnancy) Clinic - Wollongong Hospital, Antenatal (Pregnancy) Shared Care with your GP, Childbirth & Early Parenting Education - groups and videos, Early Pregnancy Assessment Service (EPAS), Maternity Ward (C2 West) - Wollongong Hospital, Midwifery Group Practice (MGP) - Wollongong, Neonatal (Baby) Unit - Shoalhaven Hospital, Neonatal (Baby) Unit - Wollongong Hospital, Coronavirus (Covid-19) - Pregnancy and Breastfeeding, Diabetes in pregnancy- Gestational (GDM), Type 1 or Type 2, Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (HG), Resources and brochures - pregnancy, baby, other languages. Whilst some MGPs are already established there is no ability to be engaged concomitantly with the antenatal model of care available to vulnerable women [36]. Lancet. What will happen when I arrive at the hospital? The team of six midwives working with the professor of obstetrics, the consultant obstetrician and a physician cares for a caseload of 200 high-risk women a year. Implement Sci. While womens disengagement from the proposed model might be identified as a risk, in discussions around this barrier solutions were identified. Further, the interdisciplinary team engaged in this research was supportive of midwifery group practice. PubMed PER 101. Group interviews included between two and five members based on availability of attendees. Thematic analysis of qualitative research data: Is it as easy as it sounds? Wollongong Hospital Carpark: Access to the North and South Carpark entrances via New Dapto Road or Dudley Street. These are: intervention characteristics such as details of the new service being proposed; outer setting such as external influencing factors; inner setting such as unique aspects of the health service itself; characteristics of individuals who are involved in and/or exposed to the new service; and process such as ways of implementing and evaluating the new service [31]. A midwife or small team of midwives will provide your primary care with medical practitioner. The 1000-bed health service is located in an inner suburb of an Australian capital city, with a diverse population catchment including large numbers of disadvantaged groups. The belief amongst participants of strong, quality evidence in favour of the proposed model was identified as an enabler, and there were no barriers highlighted by participants in terms of available evidence. 2015;10(1):21. Midwifery Group Practice is a continuity of care model for pregnant women who provide individualised care through her antenatal (pregnancy), intra partum (labour and birth) and early postnatal journey. The theme Gold standard care mapped to five constructs indicates that either a perception, or knowledge of evidence supporting midwifery group practice for vulnerable women would be critical to its success. Clinics are available on specific weekdays and appointments can be negotiated for aconvenient time: Shellharbour Hospital A thorough consideration of potential experiences for the woman, the workforce and costs when preparing a business case, will be a determinant of model implementation success. Your prenatal appointments may be at the hospital, at a community health centre or in your home. Active labour, normal birth, breastfeeding and early discharge home from the Birthing Unit are important to us. A midwifery group practice for vulnerable women should be designed with flexibility in the case where a rapport is not being established between the care givers and the woman [46]. While this second barrier is contradictory to the initial workforce enabler identified in this theme, participants became solution focussed in the interviews, which is reflected in the theme reported below The interdisciplinary team. 2015;42(5):53344. * Your GP will refer you to the Antenatal (Pregnancy) Clinic, but please also fill out a form for the MGP team (Step 2 below). Nagle U, Farrelly MJM. The dataset supporting the conclusions of this article are available from the corresponding author on reasonable request. For the midwife dealing with only these women, it could over time be mentally challenging potentially exhausting and tiring (Midwife, Interview 6). Conducting the context assessment instilled confidence in readiness of the maternity service to adopt the proposed change. How should I prepare for going into labour? How health care setting affects prenatal providers risk reduction practices: a qualitative comparison of settings. Whilst Australian data on non-attendance at antenatal appointments is limited, international evidence suggests antenatal care is not well accessed by vulnerable women. J Subst Abuse Treat. Midwifery care focuses on womens individual needs or woman-centred care. Midwifery group practice is also safe in terms of maternal and neonatal outcomes, is associated with a reduction in maternal risk-taking behaviours, and is a less-costly model of maternity care [24,25,26]. This study aimed to examine the cost utility of a publicly funded Midwifery Group Practice (MGP) caseload model of care compared to other models of care and demonstrate the feasibility of conducting such an analysis to inform service decision-making. You may benefit from Midwifery Group Practice if this is your first baby, you would like a vaginal birth after having a previous caesarean section, want to birth at home, or do not have a lot of support at home or in the community. To promote rigor and dependability in the study findings, a second round of analysis was conducted [39,40,41]. Participant knowledge and awareness was assessed through the use of nine open-ended questions (Table1). Vulnerable women may also experience domestic and family violence isolation in addition to poor maternal health, further compromising the fetus and neonate [1]. The participants identified through purposeful sampling [37] were sent invitations including an information sheet providing a brief background to the study, via email, with open invitations also promoted at staff meetings. Sotiriadou P, Brouwers J, Le T-A. The cost of the proposed model had not been established but was imagined by participants to be higher than both the current model of care and comparative midwifery group practices. Key phrases and meaning from interview data were used to allocate themes to constructs. Thirteen individual interviews and 7 group sessions were held over a months period in 2019 on-site at the facility. Reid N, Gamble J, Creedy DK, Finlay-Jones A. Smith, P.A., Kilgour, C., Rice, D. et al. The identification of this enabler suggests that the initial enthusiasm for the intervention would sustain its implementation over time. Primarily this related to women with involvement of child protection services or times where personal factors impacted on building rapport and a therapeutic relationship was not established between the woman and the midwife. Consequently, there may have been fewer inner setting barriers to establishing the proposed model of care compared to Australian maternity services in which midwifery group practice is new or not yet established. This was particularly evident for participants who had undertaken reading prior to the interview with participants expressing: I have looked online to have a look at the research shows the best outcome for babies and mothers across the board in terms of continuity of care models (Other role, Interview 1).
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