Benchmarking for Midwifery Group Practice

Midwifery Group Practice (MGP) is the common name given in Australia to an evidence based model of care in which women are allocated a primary midwife who provides their care throughout their pregnancy, labour, birth and postnatal period.  Most Midwifery Group Practices will include around 4 midwives, each with a caseload of women to whom they provide continuity of care for their maternity episode.  The midwives in the Group provide back up to one another as needed, to maximise the likelihood that women know the midwife who provides care to them.  

Many WHA member hospitals have invested in this model of care in response to significant unmet demand from women and in light of the published evidence that this model is safe for women and babies with typically less need for obstetric interventions during the labour and birth.   

A variety of models of MGP have emerged across Australia.  Some MGPs provide care only to women identified as being at low risk of developing obstetric complications.  Some ‘low risk’ MGPs transfer responsibility for care to standard care services if complexities arise during the pregnancy, others continue to provide care in partnership with medical teams.  Some MGPs book women regardless of their obstetric or medical risk factors.  Some MGPs specifically target women more likely to have obstetric risk factors or complex needs, such as women accessing a Maternal Fetal Medicine unit or women with drug or alcohol dependency.   

There is ongoing interest in assessing the care and outcomes for women accessing Midwifery Group Practice services.  WHA provides a benchmarking service that enables MGP midwives as well as maternity service leaders to evaluate the performance of their MGP service(s).  The reports include all of the same indicators used in WHA’s Benchmarking Maternity Care reports, but tailors the indicators to show the comparative care and outcomes both between MGP services and standard care, as well as between different models of MGPs.   

The data confirm the safety and effectiveness of MGP services compared with standard care in which women receive care from rostered midwives and doctors whom they do not know. Interestingly, ‘all risk’ MGPs appear to achieve the strongest outcomes compared with low risk models.