That is not quite true Lisa, they never get labour ward staff, unless
they transfer to HDU where the midwife would still be actively involved
in the womans care. if the midwives are off or busy they get the backup
midwife they should have met or someone else from the group or when
extraordinarily busy someone from the other groups. Over 75 % of women
birth with their primary midwife but the Northern does better with a 95%
rate of primary carer at the birth.
The hours are extremely flexible, the reason mostly for the 12 hour in
hospital will be due to the complicated women they now get as it is an
all risk model normal laboring women are seen at home or keep in contact
with her midwife until they are established and come into hospital then,
so 12 hours later if they are still going and all is well (or not) t he
midwife may well stay on (I recently did 15hours) it depends on how she
is feeling what is happening what her day has been like etc.
While the groups work differently i think you have the wrong idea, it is
aimed at continuity of care.
The complexity is in being an all risk model. It is not perfect but keep
in mind the literature does show that it is continuity of care rather
that carer that results in increased satisfaction etcetera. It is also a
model that is working through many teething problems, staff turnovers,
personality, experience and practice differences (the groups don't
choose who they work or partner with, which has been shown to be a key
factor in successful group practice models) and I am not saying that is
specifically a problem here but does add to the complexity of working in
this type of service.
There is still a lot of work to be done in getting the support and
collaborative working relationships, respect etc across the board that
would increase the effectiveness and decrease fragmentation and make the
workload more manageable for the midwives...
Belinda
Lisa Barrett wrote:
The case load at the women's and children's hosp in Adelaide may only
have one midwife and a backup, however if either or both are a day off
or on holiday you just get the labour ward staff. Also they are
limited to working 12 hours at a time so you could still get change
over of staff etc etc. This is not continuity of care this is more a
sort of team approach. Obviously better than fragmented care but
hardly perfect.
Lisa
----- Original Message -----
*From:* suzi and brett <mailto:[EMAIL PROTECTED]>
*To:* [email protected]
<mailto:[email protected]>
*Sent:* Thursday, June 01, 2006 8:49 AM
*Subject:* Re: [ozmidwifery] Midwifery Strengths
You could look at the case load practice at Women's and Children's
hosp in Adelaide , where a primary midwife is allocated and a
small group of backup midwives. Also Northern Womens Community Mid
Program in Elizabeth Adelaide where a primary and a back up
midwife is allocated to each woman. They have their primary or
secod midwife for about 95% of births (although the organisation
is not hsp based, most of the women birth at Lyell McEwin Hsp
where the midwives have practising rights). There are the
community midwives in Perth, and the Mid programs in Belmont &
Ryde & St George Hsp NSW.
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