School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora 3086, Australia.
School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora 3086, Australia.
Women Birth. 2021 Feb;34(1):e47-e56. doi: 10.1016/j.wombi.2020.06.006. Epub 2020 Jul 9.
Midwife-led continuity of care has substantial benefits for women and infants and positive outcomes for midwives, yet access to these models remains limited. Caseload midwifery is associated with professional satisfaction and lower burnout, but also impacts on work-life boundaries. Few studies have explored caseload midwifery from the perspective of midwives working in caseload models compared to those in standard care models, understanding this is critical to sustainability and upscaling.
To compare views of caseload midwifery - those working in caseload models and those in standard care models in hospitals with and without caseload.
A national cross-sectional survey of midwives working in Australian public hospitals providing birthing services.
Responses were received from 542/3850 (14%) midwives from 111 hospitals - 20% worked in caseload, 39% worked in hospitals with caseload but did not work in the model, and 41% worked in hospitals without caseload. Regardless of exposure, midwives expressed support for caseload models, and for increased access to all women regardless of risk. Fifty percent of midwives not working in caseload expressed willingness to work in the model in the future. Flexibility, autonomy and building relationships were positive influencing factors, with on-call work the most common reason midwives did not want to work in caseload.
There was widespread support for and willingness to work in caseload. The findings suggest that the workforce could support increasing access to caseload models at existing and new caseload sites. Exposure to the model provides insight into understanding how the model works, which can positively or negatively influence midwives' views.
助产士主导的连续性护理对妇女和婴儿有实质性的好处，对助产士也有积极的结果，但获得这些模式的机会仍然有限。产妇人数限定的助产模式与专业满意度和较低的倦怠感相关，但也会影响工作与生活的界限。很少有研究从在产妇人数限定的模式中工作的助产士的角度来探讨产妇人数限定的助产模式，了解这一点对于可持续性和扩大规模至关重要。
比较在有和没有产妇人数限定的医院中，在产妇人数限定模式和标准护理模式下工作的助产士对产妇人数限定助产模式的看法。
对在澳大利亚公立医院提供分娩服务的助产士进行了一项全国性的横断面调查。
从 111 家医院的 3850 名助产士中收到了 542 名（14%）的回复-20%的人在产妇人数限定模式下工作，39%的人在有产妇人数限定的医院工作，但不在该模式下工作，41%的人在没有产妇人数限定的医院工作。无论是否接触过该模式，助产士都表示支持产妇人数限定模式，并支持增加所有妇女的获得机会，无论风险如何。50%的不在产妇人数限定模式下工作的助产士表示愿意在未来从事该模式的工作。灵活性、自主性和建立关系是积极的影响因素，而随叫随到的工作是助产士不想从事产妇人数限定模式的最常见原因。
普遍支持并愿意在产妇人数限定模式下工作。调查结果表明，劳动力可以支持在现有和新的产妇人数限定地点增加获得产妇人数限定模式的机会。接触该模式可以深入了解该模式的运作方式，这可以对助产士的观点产生积极或消极的影响。
