O9 - Keeping Rural Maternity Services a top priority: a case review of transitioning to a midwifery-led model of care

Abstract

Midwifery-led Continuity of Care (MCoC) models is the gold standard in maternity care. This presentation will outline how a regional district health service in NSW implemented its first MCoC model, ensuring a small rural maternity service did not close. Evaluation of the model proved it is safe, cost-effective and highly valued by women. Case review of a district health service co-design and implementation journey that achieved access to a MCoC model in a regional context. The small rural maternity service previously supported on average 40 women a year to birth under a GP led model. The service was proving unsustainable and at risk of closure. With executive support, a MCoC model was co-designed and implemented in partnership with community, midwifery and obstetric teams. Commencing in 2020, the model successfully commenced whilst enduring the impacts of simultaneously moving to a new hospital build and managing a pandemic response. The implementation of the MCoC model enabled access to care for all women, including those with risk during pregnancy by bringing specialist obstetric care to the local community. This is of particular importance in the region to ensure access to safe care for all women and their families close to home in rural and reginal settings. Compared with the previous service, women who received care from the MCoC model in 2021 had improved outcomes, including higher rate of spontaneous labour, more likely to have a normal birth, a reduced rate of caesarean section, required less medical pain relief and were more likely to breastfeed. Access to the MCoC increased the likelihood of women to access pregnancy care early and ongoing.