Midwifery Group Practice
Sometimes known as 'Caseload Midwifery', MGP enables women to be cared for by the same midwife (primary midwife) supported by a small group of midwives throughout their pregnancy, during childbirth and in the early weeks at home with a new baby.
Midwifery Group Practice (MGP) acknowledges that the land where we provide our service is the traditional land of the Kaurna people and we respect their spiritual relationship with their country. We also acknowledge the Kaurna people as the custodians of the greater Adelaide region and that their cultural heritage beliefs are as important to the living Kaurna people today.
Also known as 'Caseload Midwifery', MGP enables women to be cared for by the same midwife (primary midwife) supported by a small group of midwives throughout their pregnancy, during childbirth and in the early weeks at home with a new baby. Midwifery care focuses on women's individual needs, or 'woman-centred care'. MGP care has shown to be safe with women experiencing less intervention in their pregnancy and high satisfaction.
Midwives provide care for normal pregnancy and consult/refer with doctors as needed when needed working collaboratively to coordinate the best care for mother and baby. The Primary Midwife will continue to provide care to you in which ever setting is required and whatever medical involvement is needed. This may occur at home, Birthing Centre, Delivery Suite or operating theatre depending.
MGP midwives provide access and care to planned homebirth and adheres to the SA Health Planned Birth at Home Clinical Directive. Discuss this option with your midwife at the first visit if you are interested.
MGP supports midwifery students from Flinders University and the University of SA.
Midwives in Australia are currently regulated by statutory Nurses Boards in all states and territories
How to access this service
Please request MGP at your first visit in Women’s Outpatients. You will be referred and informed if successful in gaining a position, as access is limited.
3rd Floor – Queen Victoria Building
The World Health Organisation defines a midwife in this way:
"She must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum periods, to conduct deliveries on their own responsibility and to care for the newborn infant. This care includes preventative measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counselling and education, not only for the women, but also within the family and community. The work should involve antenatal education and preparation for parenthood, and extends to certain areas of gynaecology, family planning and child care. She may practice in hospitals, clinics, health units, domiciliary conditions, or in any other service."
MGP midwives are all registered/licensed with the Nurses Board of SA and bring many years experience caring for mothers and babies in different settings. MGP midwives share a respect for childbearing women, their families and communities.
Women having a baby are the most important teachers for both experienced and student midwives and play an important role in midwifery education.
Midwifery Group Practice supports midwifery students from Flinders University and the University of SA. Student midwives accompany MGP midwives and, with the permission of service users, may provide care appropriate to their level of education.
MGP midwives are committed to ensuring that that quality of care provided is enhanced by the presence of student midwives. Women using the service are encouraged to discuss the presence of students and especially to raise any concerns, as midwifery education is an important part of MGP.
Midwives in Australia are currently regulated by statutory Nurses Boards in all states and territories. They must be registered as a Midwife to practise midwifery and are bound by the Competency Standards, Professional Code of Practice, and Code of Ethics of their national professional bodies, the Australian College of Midwives (ACM) and the Australian Nurses and Midwives Council.
In Midwifery Group Practice, 'Woman-Centred Care':
- Focuses on the woman's individual unique needs, expectations and aspirations rather than the needs of the institutions or professions involved.
- Recognises women's rights to self determination in terms of choice, control and continuity of care from a known caregiver or caregivers.
- Encompasses the needs of the foetus/baby, the woman's family, her significant others and community as identified and negotiated by the woman herself.
- Follows the woman across the interface between institutions and the community, through all phases of pregnancy, birth and after the birth of her baby. It therefore involves collaboration with other health professionals when necessary.
- is 'holistic' in terms of addressing the woman's social, emotional, physical, psychological, spiritual and cultural needs and expectations.
Antenatal care (care during your pregnancy) is important for a healthy pregnancy and as preparation for the the birth of your child.
If you take part in the WCH Midwifery Group Practice Program we will ask for copies of any antenatal records for your current pregnancy and relevant records from any previous pregnancies.
At your regular antenatal visits your midwife will monitor your blood pressure, your baby's growth, heart rate, position, and check on the general health of both you and your baby. Midwives will discuss available screening tests (blood tests and ultrasounds) with you during your pregnancy, arranging these as required.
During your pregnancy, MGP is able to provide up to 10 scheduled antenatal visits, including one home visit. These visits take place approximately monthly until 36 weeks and then more frequently until you give birth. This antenatal schedule is flexible and may be adjusted according to your needs. Occasionally the time of your appointment may need to be changed because your midwife is assisting with the birth of another baby. You are welcome to bring other people to your appointment.
Your midwife will provide lots of information about labour, childbirth and looking after your newborn baby. You may also wish to attend other antenatal classes at the WCH.
Midwives are on-call and available 24 hours a day by pager, once you have informed a midwife that you think your labour has started. During early labour you can be in touch with a midwife by phone, as you feel the need. Once active labour is established, you will be cared for by your primary midwife (or an associate from her MGP group if she is unavailable). A second midwife may be called when labour is advanced, depending upon your wishes and needs, and the birth context / place.
Midwives provide skilled clinical, physical an emotional support during labour and birth. During your labour and birth your midwife will be monitoring labour progress, checking your vital signs (blood pressure, pulse and temperature), checking yoiur baby's position, assessing your baby's heart rate, assisting with the birth of your baby and placenta, conducting a physical assessment of the newborn, and assessing your condition during and after the birth. Your midwife will support you to work with / manager your labour pain by suggesting position changes and other measures (eg: birthing ball, hot packs, shower, bath, birthing bar and pharmacological pain relief, if requested) to assist you. Your midwife will also provide your with feedback relevant to your labour. Your midwife will encourage an active labour and birth, where possible and appropriate.
The most important emotional support is likely to be provided by your partner, family and/or close friends and we encourage you to have at least one person who can support you during your labour and the birth of your baby. If possible it is helpful if your midwife meets your support person/people at one of your antenatal visits.
If there are no complications you may decide to go home a few hours after your baby is born.
Your Midwifery Group Practice Midwife will remain with you until they are certain that all is well for you and your baby. During this time your midwife will help you breastfeed your baby.
After you have had your baby at the WCH and all is well with you and your baby, you can go home three to four hours after your baby is born. MGP will then follow you up at home checking on you and your baby. Going home as soon as you can has many advantages including less risk of a hospital acquired infection and more rest. Please discuss this with your MGP midwife. Alternatively, if you experience complications and/or feel a stay in the Post-Natal Ward is required, this will be arranged (usually 1 day).
Normally your midwife will visit you after your baby is born:
- on the first, third and fifth day
- between the seventh and tenth day
- between the 10th and 14th day
- three weeks
- four weeks.
Depending on where you live, some of these visits will be in your home. Other visits will be in the Midwifery Clinic with your Primary Midwife or her practice associates. If you have urgent questions or concerns that cannot wait for a scheduled visit, you may page your midwife.
The Child and Family Health Service (CaFHS) will provide a Universal Home Visit with your consent at around two to three weeks in your home.
The 6 week visit may be arranged with your known GP where you have discussed and negotiated this, in advance, with your MGP Midwife.
We are required to keep the original copies of your midwifery record on file, however we respect your right to complete confidentiality and will not share information from your records with anyone outside our practice without your permission. You may access your records at any time. At your final visit you will be given copies of your midwifery record to keep or give to your GP, if requested.
Midwifery care is based on promoting good health and taking preventative steps to avoid or minimise problems. Women choosing Midwifery Group Practice are active participants in their own health care and must take responsibility for their health and that of their baby. If you are required to have a medical/obstetric consultation for a complication or a planned procedure, please reinforce that your primary care provider is Midwifery Group Practice.
Midwives provide support in helping you address known risk factors such as obesity, smoking and alcohol use. During pregnancy, we encourage you to eat a balanced diet, become informed, participate actively in your antenatal care and get plenty of sleep and exercise.
In order to take care of you, we need you to take the lead in keeping us informed of any problems, concerns or situations which may affect your health or that of your baby.
It is essential for the midwives to have access and contact, either by mobile or land line, with women accepted into Midwifery Group Practice.
We encourage breastfeeding, however we respect your choice to bottle feed. We encourage you to breastfeed as soon as possible after your baby is born - this provides valuable colostrum for your baby and helps minimise blood loss for you.
By becoming informed about issues, you will be able to make better decisions about your choices.