Midwifery Continutity of Care
The Australian College of Midwives believes that it is the right of every pregnant woman to have access to continuity of care by a known midwife for her pregnancy, labour and early postnatal period. Midwives are the most appropriate primary care providers for healthy mothers and newborn babies and are able to refer to specialist medical care if the need arises (Hicks, Spurgeon & Barwell, 2003). Midwives must work within the competency standards enforced by The ANMC Australian Nursing & Midwifery Council (2006) in order to obtain and practice as a registered midwife in Australia. Competency 4 states Midwives should “promote safe and effective practice” (ANMC, 2006), this is achievable by providing Midwifery continuity of care to women and
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1999). Continuity of care is an effective primary health strategy enabling women to participate in decision making about their health and their health care. Mothers felt that they had significantly more choice over location of birth, type of maternity care, delivery and pain relief; they were also more satisfied with information provided about details of care, preparation for labour and pregnancy testing (Carolan & Hodnett, 2007). Midwives are qualified to work in continuity of care models in a variety of settings, including public and private hospitals, community services, rural and remote health care and private practice. Australia is one of the few developed countries where access to a known midwife for the childbirth continuum remains uncommon with fewer than 5% of women having the choice of care by a known midwife throughout their maternity episode (ACM).
Continuity of midwifery care has been shown to reduce interventions in labour, particularly augmentation of labour, analgesia use and electronic fetal monitoring (Homer et al. 2001). A small Canadian trial in 200 women demonstrated a significant reduction in caesarean section rate and an Australian trial reported a trend towards a reduced elective caesarean section rate in high risk women (Homer et al. 2001). Page et al. (1999) noted a significant reduction in epidural analgesia, lower rates of episiotomies and perineal lacerations and