Doi L, Cheyne H, Jepson R. Alcohol brief interventions in Scottish antenatal care: a qualitative study of midwives attitudes and practices. yes, it is very important that we generate the activity to get something for the work that were doing, but at the end of the day we are looking at patient centred care, so if its easier and the best outcome for mother and baby then thats what we have to do (Other role, Interview 1). A summary of potential barriers and enablers from which these themes emerged is presented in Supplementary File 1. These midwifery group practices cater for only a small proportion of vulnerable pregnant women and so many other women continue to have antenatal care that does not meet their needs. The consolidated framework for implementation research 2019 [Available from: https://cfirguide.org/. 2021;38(7):6438. Professional interpreters are available if you need help to communicate with staff. While midwifery group practice for vulnerable women is recommended based on evidence from small international studies, it is not known how widespread or effective the model is in Australia. 2023 BioMed Central Ltd unless otherwise stated. To identify these potential barriers and enablers, a context assessment was undertaken for a proposed midwifery group practice for vulnerable women at a single site tertiary maternity service in Queensland, Australia. BMC Pregnancy Childbirth. 2016;40:15361. "The benefits of this type of midwifery model lie in the continuity of care which enables the development of a relationship between a woman and her midwife throughout the pregnancy journey.. 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. (Midwife, Interview 6). 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. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Barriers and facilitators of accessing perinatal mental health services: the perspectives of women receiving continuity of care midwifery. Midwifery. Midwifery group practice (MGP) has consistently demonstrated optimal health and wellbeing outcomes for childbearing women and their babies. Implement Sci. 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. An interdisciplinary team that is already part of the organisational structure and engaged in planning the model is likely to be essential. The Family Birthing Centre (FBC) offers a safe and comfortable setting in which healthy expectant parents with uncomplicated pregnancies can give . 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. The perspectives of consumers, and staff who were less experienced and/or from culturally and socially diverse backgrounds were not given, nor was there discussion in the interviews about the impact of the proposed model on these women. 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%). Although, it was highlighted that any potential changes to how the team works with the midwifery group practice would need to be implemented carefully. 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]. 76024 Suite 1/118 Main Street Murwillumbah | 6672 1698. Peer checking was undertaken independently (by CK) through analysis of the de-identified research transcripts using Leximancer V4. CAS 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. PubMed Independent analysis and consistency of results further enhances the credibility and trustworthiness of the study, along with research reflexivity throughout the study. J Cross-Cult Psychol. Cookies policy. California Privacy Statement, Participants also suggested ways to address the womans disengagement through awareness and actions by the midwives: We have to be open and transparentso theres a consistent approach and that we can be strong and recognise it when it (disengagement) happens and maintain the relationship (Midwife, Interview 10). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Royal Brisbane and Womens Hospital. 2015;52(8):133242. If there were differences in manual and computer analysis results, the research team planned to reach a consensus on emerging themes through discussion. Gynecological care. 2009;4(1):50. 9:00am-6:00pm on Mondays, Wollongong Hospital Australias mothers and babies. The dataset supporting the conclusions of this article are available from the corresponding author on reasonable request. Relationships between women and carers that are grounded in an interdisciplinary continuity of care and carer model increases womens access to services and provide safe spaces for disclosure of sensitive information that guides high quality health care delivery [19]. 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. Kilgour C, Bogossian F, Callaway L, Gallois C. Experiences of women, hospital clinicians and general practitioners with gestational diabetes mellitus postnatal follow-up: A mixed methods approach. The integral way in which having a known midwife provides benefit and support for women was repeatedly discussed by participants. BMC Health Serv Res 22, 1265 (2022). Dixon L, Neely E, Eddy A, Raven B, Bartle C. Maternal socio-economic disadvantage in Aotearoa New Zealand and the impact on midwifery care. Midwifery group practices have been established for Torres Strait Islander women and women carrying Aboriginal and Torres Strait Islander babies in recognition of the importance of continuity of carers for this vulnerable group [27, 28]. Diabetes Res Clin Pract. Vulnerable women may also experience domestic and family violence isolation in addition to poor maternal health, further compromising the fetus and neonate [1]. Data saturation was achieved following 10 interviews however, the research team elected to continue data collection due to many stakeholders wishing to participate. This may be further exacerbated by the reading and preparation prior to interview done by some participants. Springer Nature. Midwifery care during labor and birth. We will book the interpreter for you. Association Between Self-reported Prenatal Cannabis Use and Maternal, Perinatal, and Neonatal Outcomes. An interdisciplinary group of stakeholders from a purposeful sample of 31 people participated in semi-structured interviews. 2012;28(2):16372. New Z Coll Midwives J. In the United Kingdom, smokers were significantly more likely to have a late booking appointment after 18 weeks gestation (Odds Ratio 1.6) [6]. We aimed to identify the potential barriers and enablers for implementing a midwifery group practice for vulnerable women. Potential enablers of implementation included perceptions that the model facilitates a relationship of trust with vulnerable women, that clinical benefit outweighs cost and universal stakeholder acceptance. Privacy The structural characteristics of the setting for this research were that it is a mature and large maternity service, with a range of existing and well-supported midwifery group practices already established. Conducting the context assessment instilled confidence in readiness of the maternity service to adopt the proposed change. Leximancer 4 generated themes from stakeholder interviews. Shellharbour Hospital Carpark: Access to car parking facilities via the Hospital entrance on Madigan Boulevarde. 2007;7:268. Midwifery. The MGP model of care provides continuity of maternity care by a known midwife throughout pregnancy, labour and birth, and the early weeks following the birth of your baby. Call our 24/7 hotline on (07) 3810 1242 or (07) 3810 1564 to speak with a midwife about your questions or concerns. Implementation of a standard outcome set in perinatal care: a qualitative analysis of barriers and facilitators from all stakeholder perspectives. 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. View on Google maps. Tweed Midwifery Group Practice provides assistance to new mums. 2:00pm-7:30pm on Wednesdays and Thursdays Midwifery Group Practice (MGP) continuity of care is where the woman and her family know the midwives who provide her care through pregnancy, labour, birth and at home after the baby is born. LC: Writing Original Draft, Supervision. 8:30am-12:00pm on Fridays. BMC Public Health. 2021;21(1):113. Demographic data were collected from all participants by a written survey at the interview to provide an overview of participants characteristics. Kilgour C, Bogossian FE, Callaway L, Gallois C. Postnatal gestational diabetes mellitus follow-up: Australian womens experiences. 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. Well mums & babies will be discharged home 4 to 6 hours after birth and followed up with a postnatal visit at home within 12 to 24 hours of birth. The Midwifery Group Practice (MGP) is a program run by Armadale Health Service (AHS) for women who prefer to be cared for by the same midwife throughout their pregnancy and postnatal period. All times AEST (GMT +10). Consolidated Framework for Implementation Research. However, if the need for medical consultation or . Participants were also advised their involvement was voluntary and that their responses could be withdrawn at any stage up to two-weeks post-interview. In this study we have identified, with an interdisciplinary stakeholder perspective, both the potential barriers and enablers that will need to be considered in the next phases of planning and implementing a midwifery group practice for vulnerable women. Our intent is to identify and share the results of the context assessment which can be applied to other maternity services across Australia and demonstrate implementation science methods as an appropriate approach. We aimed to identify the potential barriers and enablers for implementing a midwifery group practice for vulnerable women. Notes were also made by the interviewers. There was recognition that the proposed model of care is supported by research and a view that clinical benefits will outweigh costs, however supervision and support is required for midwives to manage and limit vicarious trauma. Furthermore, to ensure sustained success, implementation of a midwifery group practice for vulnerable women requires careful planning using the principles of implementation science [30]. Thirteen individual interviews and 7 group sessions were held over a months period in 2019 on-site at the facility. In Northern NSW, MGP models are available for healthy, well women at Tweed, Murwillumbah, Byron and Lismore Hospitals. 2014;14(1):170. Each researcher independently analysed the data, highlighted key terms and assigned their own codes. Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Sotiriadou P, Brouwers J, Le T-A. Implementation barriers and enablers of midwifery group practice for vulnerable women: a qualitative study in a tertiary urban Australian health service, https://doi.org/10.1186/s12913-022-08633-8, https://www.pretermalliance.com.au/Alliance-News/Latest-News/Midwifery-Continuity-of-Care, https://metronorth.health.qld.gov.au/rbwh/about-us, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, [email protected]. The second analysis was compared with themes from first round analysis thus establishing findings across three researchers using two methods, and substantiating trustworthiness in the study [44]. Discussion around the womans experience identified enablers for the proposed model. As the interviews were guided by the CFIR, questions were not pilot tested. Midwifery Group Practice. Discuss this option with your midwife at the first visit if you are interested. We wish to acknowledge Tristan Elder as his administrative assistance with this study was invaluable. Processes that demonstrate evidence of planning and reflecting across all CFIR domains, especially regarding linkages between different health professional disciplines and costs, are also important. the midwife would need to be capable of referring to those that can help (Midwife, Interview 16). Our MGP program offers you one midwife (who works in a team) who will care for you through your pregnancy, through your birth and at home for 2 weeks after your baby is born. We are proud of our long tradition of providing sensitive, thorough care for women. Participants were clear that midwives would lead continuity of care, while having expert health professionals involved to provide comprehensive care for the women. How should I prepare for going into labour? Cat. The two novice researchers, both dual registered nurses and midwives at senior and middle management levels were known to all participants. Active pursuit of the voices of consumers and staff from a representative range of backgrounds in planning new models of maternity care across Australia is recommended by the researchers. 2018;66:7987. 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. The State of Queensland (Queensland Health) 2023, www.goldcoast.health.qld.gov.au | | _v1_, Gold Coast Health is recognised for quality patient care, nursing and midwifery excellence and innovations in professional nursing and midwifery practice under the, Aboriginal & Torres Strait Islander service, Aboriginal and Torres Strait Islander Health, Services, Emergency Contacts and Resources, Lesson 1 - Using language strategies in everyday routines, Feeding babies for women isolated and quarantined, Partner with the National Centre for Neuroimmunology and Emerging Diseases. Not all stakeholders may be supportive and there may be less-visible aspects of the health service that may make sustained implementation of a midwifery group practice for vulnerable women difficult. You will give birth at the Gold Coast University Hospital in the Birth Centre or Birth Suite, and you will be supported to go home soon after birth. Following the interviews, participants were notified that their de-identified information would be considered in subsequent planning for a midwifery group practice for vulnerable women. 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. Theres also the opportunity to develop an interdisciplinary trust (Nurse, Interview 14). Implement Sci. The continuity of midwives would ensure the deep needs of each woman were met. It not only makes the patient feel safe and more comfortable with their surroundings, in my opinion, it makes the patient a bit more accountable and builds rapport with that clinician and women would be more engaged to come back (Other role, Interview 1). Click on the individual services for more information on our clinics and programs. Google Scholar. Waltz TJ, Powell BJ, Fernndez ME, Abadie B, Damschroder LJ. Article Feedback on study results at completion of the study was provided to participants who requested follow-up. 2018;298(3):487503. To access a hospital-based midwife, your GP will refer you, or you may check with your local hospital and self-refer. BMC Pregnancy Childbirth. 2018;18(1):431. Midwifery Group Practices (MGPs) provide care to pregnant women in a group of (4-6) midwives. Midwifery. Group interviews included between two and five members based on availability of attendees. If material is not included in the articles Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The Midwifery Group Practice (MGP) is a free service offered by Gold Coast Health and is located within the Birth Centre at the Gold Coast University Hospital. Corsi DJ, Walsh L, Weiss D, Hsu H, El-Chaar D, Hawken S, et al. Google Scholar. per night. Women Birth. Private practice and a collaborative arrangement. The difficulty in attracting midwives to the proposed model of care was an identified barrier to implementing a high standard of care: attracting the midwives that would have an interest in it, we almost need a mother-like figurewould have to be resilient and have had a few more life experiences (Medical Officer, Interview 13). Participant knowledge and awareness was assessed through the use of nine open-ended questions (Table1). 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. continuing to have the multi-disciplinary input and multi-disciplinary team meeting is going to be beneficial (Medical Officer, Interview 20). Copyright 2019NSW Health - Illawarra Shoalhaven Local Health District. The Tweed Hospital runs an extensive Rehabilitation Outpatient Service for a range of health issues including fracture clinic, gynaecological needs, paediatric services, and pre-surgery. If you cannot be seen by the MGP program, we have other pregnancy clinics that may suit you. 2012;22(4):41350. In Finland, women who smoked and consumed alcohol were significantly more likely to receive insufficient antenatal care defined as between zero and five visits (Odds Ratios 1.87 and 1.48 respectively) [7]. Womens views and experiences of having their mental health needs considered in the perinatal period. Castleberry A, Nolen, AJCiPT, Learning. Many participants expressed empathy for the likely patient cohort and placed the proposed model as a high priority for the health service. All data were de-identified in preparation for data analysis. Participants weighed the relative advantages of the proposed model of care over the existing care provided to vulnerable women and believed that the health benefits for the women and infants would outweigh the costs. While womens disengagement from the proposed model might be identified as a risk, in discussions around this barrier solutions were identified. Contact 0459078011 or visit website www.midwifelibby.com Nat Hills .Registered M idwife since 2008 and attending homebirths since 2011. Stakeholders had a positive attitude towards the intervention; they placed a high value on the proposed model of care. 2020;10(2):e033895. If we are unable to offer you a place at this time you will be notified by text message and your name placed on a waiting list. An additional strength was the alignment of the manual and computer-assisted thematic results. In this study, we have used the CFIR to identify potential barriers and enablers to implementing a midwifery group practice for vulnerable women, with both local and national relevance. Reflexivity and reduction of potential researcher bias was identified and considered throughout the interview and analysis processes [38]. Quality evidence drawn from Australian studies [10, 13] builds confidence amongst stakeholders, which is a strong enabler. An absence of continuity of care has been identified as a barrier to seeking help for mental illness [18, 23]. Walsh D, Spiby H, McCourt C, Grigg C, Coleby D, Bishop S, et al. volume22, Articlenumber:1265 (2022) Last modified 21/7/2021. Information received by email post-interview was collated for de-identification and included in the analysis. As part of this ethical review, we were required to provide brief background information on the proposed MGP model of care to participants. 2017;17(1):339. Need an Interpreter? (07) 5523 2888 6a Tweed Office Park, 24-28 Corporation Circuit, Tweed Heads South Get ready for the Murwillumbah Art Trail See Pages: 15, 26 Liftout Map: 24-25 IT'S ALWAYS BETTER TO TALK. Wollongong Hospital Carpark: Access to the North and South Carpark entrances via New Dapto Road or Dudley Street. Allen J, Gibbons K, Beckmann M, Tracy M, Stapleton H, Kildea S. Does model of maternity care make a difference to birth outcomes for young women? Correspondence to Support for the inclusion of an interdisciplinary team in the proposed model of care was identified as an enabler and was particularly supported by non-midwife participants: I would love it, because we felt [from observation of previous staffing arrangements] that when the midwives were staying in the role longer it felt very organised and that we knew the patients very well (Allied Health Practitioner, Interview 9). The authors declare no conflicts of interest are held in relation to this study. Canberra: AIHW; 2021. The overall sentiment across disciplines was that: Everyones ready for a change in the space and a growth in the space and how we can improve for the women and I think it would be highly supported, valued and everyone would be on board (Nurse/Midwife Leader, Interview 3). still having that multi-disciplinary approach is fantastic (Midwife, Interview 11). Dos Santos JF, de Melo Bastos Cavalcante C, Barbosa FT, Gita DLG, Duzzioni M, Tilelli CQ, et al. Our MGP program offers you one midwife (who works in a team) who will care for you through your pregnancy, through your birth and at home for 2 weeks after your baby is born. Midwifery Group Practice. * send the MGPform aboveto this address:[email protected]. Participants saw the proposed new model as an opportunity for midwives to gain new skills and expand their scope of practice which was identified as an enabler: There are a few midwives out there currently upskilling themselves and are really passionate and interested and already preparing for being part of the team (Nurse/Midwife Leader, Interview 3). Organising the data in this way also enabled understanding of factors that may lead to successful and sustained implementation of a MGP for vulnerable women internationally as the CFIR has become a universal implementation language. PER 101. When mapping the themes to the CFIR domains, the implications of local results to Australian maternity services became evident. Employment Type: Permanent Part Time / Full Time \nPosition Classification: Registered Midwife \nRemuneration: $33.13 - $46.52 per hour \nHours Per Week: up to 38 \nRequisition ID: REQ303794\n\n \nThe Tweed Midwifery Group Practice is seeking a Registered Midwife to coordinate and deliver high quality women and newborn-centred midwifery care in accordance with the Nursing and Midwifery Board . Midwifery. Gao Y, Gold L, Josif C, Bar-Zeev S, Steenkamp M, Barclay L, et al. All your prenatal appointments will be with your own midwife, where possible. Participants (n=9) in management / leadership roles were invited to respond to an additional question in relation to costs. 2018;65:815. These views become potential enablers when preparing detailed business cases that demonstrate strategic and strong stakeholder support as well as alignment with evidence and policy advocating woman-centred care. Midwifery Group Practice (MGP) care is offered to women with no to moderate complicating health factors, who wish to have a normal birth. 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. To do this, we conducted a qualitative context assessment using the Consolidated Framework for Implementation Research (CFIR) [31,32,33]. Planning an active labour & birth To do this, we conducted a qualitative context assessment using the Consolidated Framework for Implementation Research (CFIR) [31,32,33].The CFIR was chosen to guide the context assessment because the process required engagement with individuals and groups across multiple . Article Am J Perinatol. This is known as continuity of care. Beasley S, Ford N, Tracy SK, Welsh AW. An interdisciplinary team was therefore an important and well supported component of the model, and no barriers to including an inter-disciplinary team in the model were identified. Participants believed that the health benefits of the proposed model of care would outweigh the perception that a midwifery group practice for vulnerable women was a more expensive model of care. Holiday rental platforms like Stayz and Airbnb have come out swinging against a recommended 60-day cap on Byron holiday rentals - while council is thrilled. Midwifery Group Practice and Standard Hospital Care: A cost and resource study of women with complex pregnancy . Interviews were recorded with participant consent and transcribed verbatim by an administration support officer. THE new Tweed Midwifery Group Practice (TMGP) has welcomed the birth of its first baby. . 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.
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