A local midwifery care option for woman
Lesley Kuliukas, Course Coordinator BSc Midwifery, School of Nursing Midwifery and Paramedicine, Curtain University.
Perth Maternity was born in 2016; the brainchild of two midwives and a GP obstetrician who were able to see that there was a need for women to be able to access antenatal care locally, in their nearby Family Care, GP Practice or Medical Centre. They realised that women wanted to spend their time with the midwife rather than travelling to hospital appointments and waiting for hours in antenatal clinic waiting rooms. Similarly, the midwives wanted to be able to provide care from the very beginning of pregnancy, to be able to give women vital advice about diet, medications, general health care and the implications of underlying medical conditions. It was felt that providing early pregnancy care from a midwife would help women plan the whole childbirth journey from an optimal starting point.
The two Midwife Directors of Perth Maternity are experienced midwives who have been providing maternity care in a variety of settings worldwide for a combined 50 years of experience, and have an interest in providing local woman-centred, bulk-billed care which is convenient and comprehensive. The collaborating GP Obstetrician practices in a local second level maternity unit as well as Medical/GP Practice/Family Centres providing care over the continuum.
Over the last three years Perth Maternity has grown and now seven Endorsed Midwives provide care for women from 18 clinics over the Perth metropolitan area. Two of the midwives are also nurse practitioners and so are able to provide pre-conception care and family support including vaccinations up to four years of age. All midwives are self- employed working as contractors to the service.
During the initial visit women are counselled about all choices available to them, including the Perth Community Midwifery Home Birth Program and Next Birth After Caesarean (NBAC) service, two Birth Centres (one north and one south) and information about shared care with their local maternity hospital. Shared care with private obstetricians is also available when requested. The Perth Maternity midwives provide an all-risk model and take an early history and initial screening so that early referrals to the tertiary referral centres can occur appropriately. As all midwives are endorsed, the women are able to access screening and diagnostic forms and appropriate medications without requiring a double appointment with a GP. The GPs within each of the medical centres providing this care have embraced the service, seeing the advantage it gives women, particularly as more time is given to education and information.
Referrals are sent to the appropriate hospital after all of the initial screening is complete at around 14 weeks, and the women then usually attend a booking-in appointment at the hospital. Shared care between the hospital and the Perth Maternity Midwife continues thereafter. Relationship building is an important component of the Perth Maternity service with each midwife providing care for the same women over the whole pregnancy, with the exception of annual leave, when the midwives cover each other. All intrapartum care takes place with midwives in the referral hospital. Following the birth and after being discharged from the hospital visiting midwifery service, women return for postnatal care for up to seven weeks, either in the medical centre or at home. Women can also call upon the services of a Perth Maternity lactation consultant if required.
Feedback from the women speaks for itself with the following, a small example of, feedback on the Perth Maternity Facebook page:
"The service offered by Perth Maternity is great as this reduces the hassle of going to the hospital often"
"Really appreciate the awesome work you all are doing"
"Big Thank You from bottom of my heart; Just having had my 3rd baby, I had a different model of care for each, Private OB, GPO and finally midwifery led. I can honestly say that the care I received from Mel through Perth Maternity was my most preferred. The appointments were always very friendly and professional... I would definitely attend Perth Maternity again"
"What a brilliant service for expecting mothers; Karen was beyond incredibly amazing. Couldn’t speak more highly of the professionalism and love that this organization gives. 10/10"
"They are absolutely wonderful, I saw Dr Soma and Karen throughout and it was an amazing experience"
"This was my first and I feel the whole experience with Perth Maternity has made it such pleasant journey"