Coming of age: Taking a leap of faith and embarking on private midwifery practice with visiting rights

Abstract

Background: The 2009 maternity service reforms and subsequent legislative changes, provided unprecedented opportunity for midwives in Australia to offer continuity of care as a privately practicing practitioner with visiting access to a public maternity facility. Reform has been slow, however, with very few midwives working this way. Aim: To explore the experiences of midwives who transitioned into private practice and attained visiting access to a public hospital. Method: Using a qualitative descriptive approach six midwives with visiting access participated in a digitally recorded in-depth interview. Thematic analysis was used to analyse the data set. Ethical approval was obtained. Findings: The midwives in this study strongly identified with their role as lead care providers to childbearing women working across their full scope of practice and providing continuity of midwifery care. They were committed to ensuring access to primary focused care that was evidenced based and woman-centred. Their desire to practice their ‘core midwifery values’ underpinned and drove their journey into private practice. This was described through four main themes; ‘searching for a practice context that fits’, ‘taking a leap of faith’, ‘finding our way on the other side – trials and tribulation of private practice’ and ‘we CAN do this’. Conclusion: Private practice with visiting access provided midwives with a service model that aligned their core midwifery values with their clinical practice. The model facilitated their ability to work as lead care professionals, provide evidenced based woman-centred and be supported by a collaborative network of health care professions. However, despite the increased opportunities afforded by the legislative changes, the midwives continued to face system based constraints that limited women's access and threatened the sustainability of the model. Further reform is required to ensure equitable access and sustainability of the model.