First Nations mothers and babies thrive under new model of care

Baggarrook Clinical Midwife Specialist Storm Henry with patient Ash
3 November 2023 |

Continuity of midwife care, known as caseload midwifery, provides better perinatal health outcomes for women accessing maternity services.

In the caseload midwifery model, women are provided with a known midwife throughout their hospital care journey.

Between 2017 and 2020, three major maternity services in Melbourne, including the Women’s, introduced caseload midwifery specifically for Aboriginal and Torres Strait Islander mothers and for non-Indigenous women giving birth to an Aboriginal and Torres Strait Islander baby.

In this study, researchers from the Women’s explored the capacity of the three maternity services to implement, embed and sustain a culturally responsive caseload midwifery model for First Nations families.

The researchers sought First Nation women’s views and experiences, to understand the positive and negative aspects of the care they wanted and received.

Lead Researcher Professor Della Forster said 90 per cent of the 844 women offered the model accepted it. This represented a 21-fold increase in the number of First Nations women participating in caseload midwifery at the three sites during the study period.

“Women reported positive aspects of the culturally responsive caseload care as: knowing their midwife, feeling emotionally safe - supported, reassured and safe in the relationship, and feeling clinically safe,” Prof Forster said.

Aunty Gina Bundle, Program Coordinator of the Women’s Badjurr- Bulok Wilam centre and a member of the research team, said the voices of First Nations people must be placed at the centre of service design and delivery, rather than maternity services deciding how care will be provided for them.

“We are seeing clear evidence that our Baggarrook midwifery team, with assistance from our Aboriginal Hospital Liaison Officers, is ‘closing the gap’,” Aunty Gina said.

“The number of Aboriginal babies being admitted to our Neonatal Intensive Care Unit and Special Care Nursery is decreasing, as less Aboriginal babies are born prematurely and/or at low weight.”

Prof Forster said the expansion of this caseload model should be prioritised, with further research focused on understanding key features of sustaining the model and continuing to bridge the partnership between First Nations and mainstream health services.

This research was published in Women and Birth and eClinicalMedicine.