O74 - Support for midwives to practice with professional autonomy within their full scope of practice: Evidence from a scoping review

Abstract

Midwives in Australia are educated and professionally accountable to practice in partnership with childbearing women and their families, yet most do not practice to their scope. There is an urgent need to review models of maternity care in Australia to facilitate growth in midwifery continuity of carer, relationship building, and partnership to optimise perinatal health and wellbeing, and to reduce midwifery burnout. This systematic scoping review of the literature maps the role and scope of contemporary midwifery practice in Australia to identify key issues that impact upon midwives practising to their full scope of practice. A scoping review guided by Arksey and O’Malley’s five-stage methodological framework, together with a ‘best fit’ framework synthesis using the Nursing and Midwifery Board of Australia’s Midwifery Standards for Practice. Following initial screening, 517 publications were retrieved, and with full text review evidence from 96 papers was included in this review. Key themes that emerged from the review included the central tenet of Partnership with women, facilitated by the Professional roles of the midwife, and mediated by Contextual influences . Tensions were identified between the midwifery scope of practice associated with optimal outcomes for women and babies supported by current evidence and the actual role and scope of most midwives employed in models of care in the current Australian public healthcare system. There is a mismatch between the operational parameters for midwifery practice in Australia and the evidence-based models of continuity of midwifery carer that are associated with optimal outcomes for childbearing women and babies and the midwives themselves. There is an urgent need to review the representation of the midwifery profession at leadership, executive and policy levels to support the role of the midwife to practice with professional autonomy within their full scope of practice.