A Successful Midwifery Model for a High Deprivation Community in New Zealand: A Mixed Methods Study

Abstract

In August 2011, the Ministry of Health (MOH) commissioned a report to provide information, evidence, and analysis regarding an integrated lead maternity care model for a midwifery practice situated in Counties Manukau, New Zealand, a high deprivation area. The final report was entitled “A Successful Lead Maternity Care Midwifery Practice in Counties Manukau” (Priday & McAra-Couper, 2011). The project was both qualitative (qualitative descriptive) and quantitative (descriptive statistics) in its review and audit of the Midwifery Practice. The midwives from this practice have been providing continuity of midwifery care for 17 years, and the MOH was interested in how this group of midwives (“the Midwifery Practice”) was working and the implications of this style of practice. The report demonstrated that the Midwifery Practice provides continuity of care for predominantly Pacific and Maori (indigenous) women and young women, including adolescents. The socioeconomic indicators of these women place them in the high deprivation index group. Given these three factors—ethnicity, age, and deprivation decile—high perinatal mortality and other adverse outcomes could be expected. However, statistics demonstrate low perinatal mortality and morbidity, with most women booking for care before 20 weeks’ gestation and recording optimal birth outcomes. The Midwifery Practice is integrated into the community facilitating a connected and accessible service for women and families. These findings are significant in light of the repeated call from the Perinatal and Maternal Mortality Review Committee (PMMRC, 2013), urging stakeholders who provide health and social services to identify the reasons why women are failing to engage with care and to identify interventions to address barriers. This article summarizes the findings from the report.