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Midwifery practice arrangements which sustain caseloading Lead Maternity Carer midwives in New Zealand

Abstract:

Background: The New Zealand Lead Maternity Carer (LMC) midwifery model has benefits for women and babies and is a satisfying way to work for midwives. Due to the need to be on-call for long periods of time, there have been questions raised about the sustainability of the model for midwives and the potential for burnout. Objective: This qualitative descriptive study explored what sustains on-call, caseloading Lead Maternity Carer (LMC) midwives in New Zealand. Methods: Eleven midwives with 12 to 20 years in practice were interviewed and thematic analysis used to identify themes which sustained these LMC midwives in practice. Findings: Overall, the study found that it was the joy of midwifery practice, managing the unpredictability of being on-call, having clear boundaries, having good relationships with colleagues, having supportive families and friends, and workable practice arrangements which sustain them in practice. This paper presents the findings from the theme: workable practice arrangements. The midwives interviewed explained that having regular time off, a manageable caseload size, working together as a practice, the financial arrangements, and the sharing of arrangements with women created a sustainable way to practice. Conclusion: This paper has identified aspects of sustainable practice which are congruent with the international research but also very specific to the New Zealand model of midwifery.

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Caseloading, midwives, practice arrangements, sustainability