A small Central Victorian hospital, which has adopted a midwifery continuity of carer model, has been labelled as “gold standard” by La Trobe University experts.
Mothers have described the continuity of carer model – otherwise known as Midwifery Group Practice (MGP) – at Dhelkaya Health (previously Castlemaine Health) as “empowering” and “respectful”.
Maternity Unit Manager, April Jardine, says the holistic and revolutionised midwifery service puts mothers first.
“[For] the birth of my first child … the care was very impersonal. At Castlemaine, it was the opposite; I felt as though my midwife took the time to get to know me and my family, took the time to discuss any concerns and respected my decisions and preferences”
– study participant
Amid a decline of more than 200 birthing suites across rural and remote locations over the past two decades, April says that specialist services in regional areas are vital for locals and surrounding residents.
“Empowering experience because of my freedom to make decisions that were based on clear and unbiased information from midwives”
– study participant
In May 2020, Dhelkaya Health suspended its maternity service following an extensive review and concerns midwives were not utilising their full scope of practice under the hospital’s GP obstetric-led model at the time.
April says that the one-year closure had an immense impact on the small community.
A review recommended that the ward reopen its doors to deliver and development the MGP model of midwifery care. In early June 2021, the first baby was born in the ward.
The MGP model provides personalised support and enables a woman to be cared for by the same (or a backup) midwife throughout their entire pregnancy, labour and birth, and postnatal journey.
Researchers from La Trobe’s Judith Lumley Centre evaluated the first 12 months of the MGP operation at Dhelkaya Health.
They discovered that women particularly valued the continuity of care by a known midwife, the tailored care to their individual needs and circumstances, and the ability to access the service locally. They reported low levels of anxiety during labour and birth and felt that they coped physically and emotionally better than they anticipated.
The evaluation shared the experiences of 44 women, including 22 women who birthed at Dhelkaya Health, 18 women who were transferred to birth at Bendigo Health and two women who birthed before arrival, from its reopening until May 2022.
April says the feedback from the evaluation speaks on the success of the model.
The importance of continuity of carer was also highlighted by mothers who felt their experience was negatively affected when continuity was lost during transfer to another service.
“All the midwives and doctors were so supportive and positive and made me feel completely free to be vocal and move how I needed to. At no point did I feel judged or rushed”
– study participant
April works with a committed team of MGP midwives, core midwives and nurses from their Maternity Unit in Castlemaine. She says the service continues focus on what’s most important to women and families as they look to the future.
“Every staff member that I crossed paths with during my pregnancy was absolutely fantastic. My wishes were always respected, and they made me feel heard and supported”
– study participant
Jardine says she hopes the success of the model at Dhelkaya Health can stand as a blueprint for other health services.
The overall success of the MGP model at Dhelkaya Health has informed other rural maternity services across Victoria to introduce similar models, including Maryborough and Cohuna, which developed a model based on Castlemaine.
“I feel deeply, deeply honoured to have had the experience I had. I would give so much for every woman to have the sort of care and experience I had. I am beyond grateful Castlemaine opened up again”
– study participant
