Table 5 Factors differentiating midwifery and obstetric care in each model
Midwifery group practice (MGP) caseload care | Standard or routine hospital practice | Private obstetric care in the public hospital | |
|---|---|---|---|
Antenatal Care | Women receive care with MGP midwives in the hospital/at home or in the community | Women receive care from the hospital antenatal clinic midwives or in combination with a GP and the hospital clinic midwives. | Women pay a fee and receive care from a private obstetrician in the obstetrician's rooms. |
When risks are identified during pregnancy | Women continue to receive caseload midwifery care with the MGP midwife in consultation with a specialist clinic or with the obstetrician assigned to work with the Midwifery Group Practice. | Women are recommended to attend the doctor's clinic or a specialised clinic. | Women continue care with the private obstetrician or may be referred to a specialised clinic. |
When labour begins | Women contact their MGP midwife and decide with their midwife when to go to the labour ward or birth centre. | Women contact labour ward and are advised via telephone whether to come in to the labour ward. | Women contact labour ward and are advised via telephone to come in. Labour ward staff alert the private obstetrician to the admission. |
Labour care | Women are cared for by their known MGP midwife or her back-up partner. Problems are attended to by the registrar or consultant on call for birthing services. | Women are cared for by the rostered labour ward midwives. Problems are attended to by the registrar or consultant on call for birthing services. | Women are cared for by the rostered labour ward midwives in consultation with the private obstetrician. Urgent problems are attended to by the registrar on call until the private obstetrician arrives. |
Postnatal | Women are discharged at 4 hours postnatal or after a short stay in the postnatal ward and visited by the MGP midwives. | Women are discharged to the home visiting service after a short ward stay. | Women stay in the postnatal ward until the private obstetrician discharges them home. |
Conditions of employment | MGP midwives are employed on an annual salary which allows continuity of care for a caseload of women. They work in cycles of 152 hours over four (4) weeks; and do not work in excess of twelve (12) consecutive hours in any twenty four (24) hour period. | Midwives are rostered on wards or clinics and paid according to the award and whether they are full time (38 hours per week) or part time. They are employed to provide a rostered service. | Women booked under a private obstetrician receive the same public hospital midwifery care as those receiving Standard Care. |