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Partnership and reciprocity with women sustain Lead Maternity Carer midwives in practice

Abstract:

New Zealand has a unique maternity service model, whereby women at low risk of complications receive their maternity care from a community based Lead Maternity Carer (LMC) who is usually a midwife, but could be a general practitioner or an obstetrician. Over 80% of women in New Zealand choose to have a midwife as their LMC (Grigg & Tracy, 2013; Guilliland & Pairman, 2010). LMC midwives practise under contract to the Ministry of Health, taking a caseload and providing continuity of care (which requires being on call) for the women booked with them. This qualitative descriptive research set out to understand what sustains on call case- loading LMC midwives who have practised as LMCs for at least eight years. Eleven midwives with 8 to 20 years in practise were recruited and interviewed. Thematic and content analysis was carried out on the data. This article presents an overview of the findings from this study and extracts of selected data. Themes emerged from the findings which described how midwives were sustained in on call, caseloading practice. Themes identified include: the joy of midwifery practice; working in partnership; supportive family relationships; supportive midwifery relationships; generosity of spirit; like-minded midwifery partners, practice arrangements; managing the unpredictability of being on-call; realising one is not indispensable; learning to say “no”; negotiating and keeping boundaries; and passing on the passion for midwifery. This paper is the first in a series. It explores the themes of partnership, and how working in partnership sustains the joy of practice and provides context to the study. Future papers from the study will report on other themes from the study. The significance of this research is that it informs present and future maternity service provision and education.

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Caseloading, midwives, partnership, reciprocity, sustainability