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Sample Paper on Continuity of Care Model in Midwifery

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Sample Paper on Continuity of Care Model in Midwifery

Introduction

Midwifery continuity of care refers to healthcare services provided to women and children to achieve and improve maternal care. Expectant women require thorough health care services ensuring the children and mothers are safe from diseases and healthcare threats. The midwifery continuity of care therefore provides medical services to ensure maternal care is enhanced. This reduces mortality rates as the trained midwives ensure expectant mothers deliver healthy children safely without risking their lives (CQC, 2011). The midwives also acknowledge new mothers require consulting with a healthcare provider. The provider should continuously check on both the mother and child regularly to ensure new healthcare issues are resolved immediately (Saultz, & Albedaiwi, 2004). The process of providing continuity of care through the midwifery continuity of care can involve individual midwives or a small group of midwives (Turnbull et al, 2009). However, they should have an extensive experience in delivery of continuity of care (Bentler, Morgan, Virnig & Wolinksy, 2014).

The continuity of care provided by midwives is therefore a cornerstone of patient-centered medical services to achieve high quality healthcare. Defining and quantifying continuity of care however can be challenging as traditional and modern measures capture patient experiences diversely. Nevertheless, this has not hindered midwives and the maternal care sector to report high rates of satisfaction with the midwifery continuity of care models. This research will therefore discuss how the midwifery continuity of care and the continuity of care have positively impacted the healthcare sector (Fereday, Collins, Turnbull, Pincombe & Oster, 2009).

 

 

Importance of Midwifery Continuity of Care Models

First, midwifery continuity of care models is fundamental to high quality healthcare. They ensure clinical services are safe, cost-effective, personalized, efficient, and safeguarding to patients. For example, they safeguard patients from healthcare risks likely to harm the mother and new born hence, reducing mortality rates. They also safeguard the patients from cause duplication and avoidable costs on social and healthcare matters ensuring the expectant or new mothers as well as the baby are protected and healthy (Carruthers & Ormondroyd, 2009). Patients’ experiences reviewing the effectiveness of midwifery continuity of care models indicate that the healthcare services are properly coordinated. As a result, they exemplify the impact of healthcare services as the process of planning, communicating, and coordinating how patients access them is effective and efficient. Consequently, patients develop a high level of trust with the caregivers. This is because midwives are also keen in ensuring human kindness, dignity, respect, and consideration is provided on a personal level (Sally, et al 2013).

Various interventions allied to midwifery continuity of care models are also available ensuring healthcare services improve on frontline and senior levels of seeking medical care. This further ensures every individual seeks and receives consistent, high quality, reliable, and trustworthy patient-centered healthcare. More so, patients and midwives or healthcare givers valuing continuity of care minimize unnecessary and unplanned transitions ensuring patients’ experiences are pleasant. Midwives enable women to develop a close and intimate relationship as care providers seeking to improve qualities of healthcare. However, it is crucial to ensure a woman maintains the same midwife before child labor, during, and after childbirth. This enables the patient and care provider increase confidence within their relationship (Sandall, Soltani, Gates, Shennan, & Devane, 2013).

Review of Midwifery Continuity of Care Models among Women

Several trials have been conducted among women across the world to review midwifery continuity of care models. This research will therefore review experiences among twenty women who have accessed and received midwifery continuity of care models. The women affirmed midwives are less likely to rely on drugs or epidurals to relieve pain. Midwives rely on natural methods safeguarding the mothers’ and babies’ health conditions (Tracy & Homer, 2010). As a result, women in midwifery care groups are more likely to have normal births as the midwives are always in control during labor and childbirth. As a result, midwives neither advocate nor support caesarean section during childbirth (Schroeder, et al 2010).

Midwifery continuity of care models differ from standard care due to emphasis on natural health care services. They advocate and strive to ensure women experience childbirth through natural methods. The methods applied therefore rely on minimal medical interventions while monitoring physical, spiritual, and psychological well being of the patients. Standard care provides expectant women with counseling in order to ensure they are ready to experience the new life of caring for a new and extremely fragile human being (Hatem, Sandall, Devane, Soltani & Gates, 2009). This is in attempts to confirm that all human beings across age groups and genders should be respected, loved, cared for, and the human dignity maintained. As a result, a continuous care model was developed by midwives in order to provide women and the newborn babies with dignified healthcare services. The midwives ensured they are equally respected and trusted as standard care healthcare providers. However, they also ensure they develop an intimate relationship with the patient in order for the continuous care model to be effective and efficient (CQC, 2011).

 

Midwifery Experiences among Women in Melbourne

 A group of six women from Melbourne was requested to provide an extensive description of their experience concerning midwifery continuity of care models. The group consisted of healthy and low risk women with and without experience in midwifery continuity of care models. Four of them confirmed they had sought and received midwifery services during pregnancy, labor and after childbirth. The rest affirmed they had neither attempted nor willing to seek midwifery continuity of care models. The four who had accessed and received midwifery continuity of care models confirmed had all experienced normal childbirth. None of them had experienced health scares or faced risks putting the mother or the child on danger (Sally et al, 2013). More so, they confirmed they none had undergone caesarean section. However, the rest confirmed experiencing health risks and scares putting the child and the mother at risk. One of them also confirmed giving birth through caesarean section as she faced the risk of losing the unborn child through a miscarriage (Turnbull, et al 2009).

Evaluation of Midwifery Continuity of Care Models among Melbourne Women

First, it was evident the four women who sought midwifery continuity of care models experienced the following symptoms. They reported coping extremely well during the pregnancy. This was because the midwives provided them safe and healthy medical services through the close and intimate relationship maintained between the patient and the caregiver (Sandall, Soltani, Gates, Shennan & Devane, 2013). For example, the midwives were always willing and ready to check up on the well being of the mother and unborn child. As a result, the expectant mothers received foot and whole body massages on a daily basis. This prevented and protected them from body swellings and soreness conditions that are described as extremely uncomfortable and sometimes painful. Ultimately, they confirmed women seeking midwifery continuity of care models are physically and emotionally stable as the experience of motherhood is generally positive (Ryan, Revill, Devane & Normand, 2013). More so, they are not likely to be admitted to neonatal intensive care units and other special healthcare facilities tasked in dealing with medical issues affecting women during pregnancy periods. As a result, they affirmed midwifery continuity of care models reduce the number of babies that are stillborn or reported as part of the high child mortality rates (Leap, Sandall, Buckland & Huber 2010).

Midwifery Experiences among Women in Western Australia

A group of fourteen women from Western Australia also provided reports explaining their personal experiences concerning midwifery continuity of care models. Sixty two percent of the women affirmed that midwifery continuity of care models is effective, efficient, and affordable. This is because they were able to save money through use of midwifery continuity of care models rather than seeking the same services from healthcare facilities. Several of them also affirmed that, friends and colleagues from Sidney believe midwifery continuity of care models is cost effective. Thus, they attempted to explain to the thirty-eight percent of women from group without experience concerning midwifery continuity of care models that the services are equally high quality, safe, and affordable (McLachlan, Forster, Davey, Farrell, Gold & Biro, 2013).

In order to emphasize midwifery continuity of care models is equally effective and efficient, a questionnaire was passed within the sixty two percent of women in the group. It sought to retrieve answers to the following questions.

  1. How many babies have you delivered through midwifery continuity of care models?
  2. Did you ever experience health care risks during pregnancy?
  3. How was the childbirth?

(Complicated, easy, normal, painful)

  1. Did the midwife rely on any form of medication or pharmacological analgesia during childbirth and labor?
  2. Do you have friends who have experienced midwifery continuity of care models?
  3. How long are the midwives willing to provide the continuous care after childbirth?

(One month, six months, one year, until the mother and child no longer desire the services of a midwife)

  1. Can you recommend midwifery continuity of care models to other women?
  2. Do you think midwifery continuity of care models is associated with caesarean section?
  3. Does midwifery continuity of care models limit the number of children a woman desires?
  4. Do you believe global policies should be implemented in order to recognize the efforts of midwives in delivery of continuity of care model?
Discussion

Based on the answers collected, the following can be confirmed about midwifery continuity of care models. Foremost, a mother can deliver an unlimited number of babies through the use of services provided by a midwife. This is because midwifery continuity of care models do not advocate for cesarean section. As a result, the midwife ensures the expectant woman experiences an unassisted vaginal delivery and labor (McLachlan, Forster, Davey, Farrell, Gold & Biro, 2010). More so, the midwife does not use pharmacological analgesia. This ensures the woman delivers a healthy baby safely without putting her health at the risk of failing to carry another pregnancy to fulltime and deliver a strong, vigorous, and fit child (Homer, Brodie & Leap, 2008). 

Several studies especially in Australia also indicate that midwives in delivery of continuity of care models are beneficial. For example, the practice of midwifery in Adelaide through a group of midwives providing the healthcare services confirmed the following. Women seeking the midwifery continuity of care models are often from low, middle and high-income groups. This is because the providers of midwifery care are neither discriminative nor advocating for prejudice in delivery of high quality healthcare services (Abraham, 2011). More so, they strive to ensure every woman from any community, religion, race, culture, and other factors defining diversity in the country are catered for effectively and efficiently (O’Donnell, Higgins, Chauhan, Mullen, 2008). As a result, women who have experienced the positive effects of relying on midwifery continuity of care models encourage their friends to pursue a similar experience (Parker, Corden & Heaton, 2010).

More so, expectant women are often afraid of experiencing excessive hemorrhage during childbirth. Midwifery continuity of care models affirms the hemorrhage rates are fewer. More so, the midwife is available to continue providing the newborn child and the mother with quality health care services at all times. They do not provide the patients with a time limit. Instead, they advice the patients to seek their services any time as they are dedicated healthcare providers seeking to ensure expectant mothers are receive quality healthcare at all times (Coleman, Parry, Chalmers, Chugh & Mahoney, 2007).

Code of Ethics

The Australian Nursing and Midwifery Council (ANMC) is a statutory body established to regulate the activities undertaken by midwives in delivery of quality maternity care. It regulates midwifery professionalism in order to protect the well being of women in the public domain seeking nursing services from midwives. The following regulations therefore guide delivery of midwifery continuity of care models (NZCM, 2002). Foremost, midwives should provide members of the public with high quality healthcare in order to safeguard and enhance the well-being. As a result, they should be keen in setting standards of providing nursing services. This is especially in delivery of maternal care to expectant and new mothers caring for fragile human beings (ANMC, 2006).

The regulatory body also affirms midwives should undergo training, conduct evaluation, and performance review. This is in attempts to ensure they deliver high quality health care to patients in a respectable, timely, and efficient manner throughout the career period. They should also undergo regular professional reviews to ensure their skills and knowledge in delivery of maternal care is up to date (McLachlan et al, 2008). Thus, the ANMC competency standards for midwives are code of professional conduct for midwives regulating the International Confederation of Midwives (ICM). Thus, the Australian ICM code of ethics relies on referral guidelines from ANMC to ensure delivery of midwifery continuity of care models involves clear and transparent processes (NMC, 2010). Thus, the midwives are investigated on regular bodies to ensure their standards of practicing midwifery continuity of care models are effective and efficient (ACM, 2006).

Recommendations

Based on the discussion and answers received from the twenty women involved in reviewing midwifery continuity of care models, it is evident midwives are vital resources within the healthcare sector. They ensure women receive high quality healthcare services through respectable, timely, effective, and efficient methods of delivering healthcare to people who actually need it at cost-affordable basis (Leap, Sandall, Buckland & Huber, 2010).

Jane Sandall provided a report explaining what high quality maternity care is all about. Foremost, she explained that dimensions of care quality should be defined as follows. They should be safe, efficient, patient- centered, and effective in ensuring the patients’ needs and wants are addressed. Thus, midwifery continuity of care models can be defined as high quality health care services providing maternity care. This is because they strive to ensure the patients are not harmed (Jane, 2013). More so, the care providers, either a midwife or a group of midwives, are tasked with ensuring the patients respond positively to the healthcare practices and services. For example, the care providers are often organized to ensure their services reach women unable to access and afford them. This achieves equitable cost effectively through a high quality maternity care system dedicated in providing optimal care to women and children (Bradley, Bowden, Furnival & Walton, 2011)

The midwives also ensure they develop a close relationship with the patients in order to achieve the following services. Post-natal care is crucial as it guarantees the mother and child are safe. As a result, the midwives strive and ensure the expectant mothers are also referred to named healthcare professionals in case of experiencing health care risks. This affirms the midwife is keen in ensuring her patients are healthy and safe. As a result, women develop a higher level of trust in midwives during child labor and birth. It boosts the patients’ confidence levels, as the continuous supports women receive are effective and efficient throughput the pregnancy period as well as after childbirth (Brocklehurst, Hardy, Hollowell, Linsell, Macfarlane, McCourt, 2010).

Conclusion

It is evident midwifery continuity of care models are effective and efficient in ensuring women and babies receive high quality health care. They also ensure every woman receives the best possible healthcare services they are entitled to during pregnancy and childbirth. As a result, midwifery continuity of care models are becoming part of the global efforts in ensuring women access and receive high quality health care services at affordable costs effectively and efficiently (Schroeder et al, 2010). National and international policies advocating for midwifery continuity of care models should therefore be embraced and implemented rather than ignored (WHO, 2006). This is because they centrally in efforts to contribute high quality and safe health care to women across the globe. More so, midwifery continuity of care models is effective, timely, equitable, efficient, and patient-centered (Rona, 2010). Women and families are therefore able to feel safe, dignified, respected, and supported as they undergo the experience of pregnancy and childbirth.


References

Abraham, A. (2011). Care and Compassion? Report of the Health Service Ombudsman on Ten Investigations into NHS Care of Older People [online]. Fourth Report of the Health Service Commissioner for England; session 2010–2011. HC 778. London, The Stationery Office.

Australian College of Midwives (ACM). (2006). Standards for the Accreditation of Bachelor of Midwifery Education Programs Leading to the Initial Registration as a Midwife in Australia. Australian College of Midwives Report.

Australian Nursing and Midwifery Council (ANMC). (2006). National Competency Standards for the Midwife, 1st edition. ANMC, Canberra, Australian Nursing and Midwifery Council Report.

Bentler, S. E., Morgan, R. O., Virnig, B. A., & Wolinksy, F. D. (2014). Do Claims-Based Continuity of Care Measures Reflect the Patient Perspective? Medical Care Review, 71(2), 153-73.

Bradley, B., Bowden, M., Furnival, J., & Walton, C. (2011). Service Redesign. A Change is in the Air. Health Service Journal, 121(6278), 29–31.

Brocklehurst, P., Hardy, P., Hollowell, J., Linsell, L., Macfarlane, A., McCourt, C. (2010). Prenatal and Maternal Outcomes by Planned Place of Birth for Healthy Women with Low Risk Pregnancies. The Birthplace in England National Prospective Cohort Study.

Care Quality Commission (CQC). (2011). Dignity and Nutrition Inspection Program: National Overview. Newcastle upon Tyne Care Quality Commission.

Carruthers, I., & Ormondroyd, J. (2009). Achieving Age Equality in Health and Social Care: A Report to the Secretary of State for Health. London, Department of Health.

Coleman, E. A., Parry, C., Chalmers, S. A., Chugh, A., & Mahoney, E. (2007). The Central Role of Performance Measurement in Improving the Quality of Transitional Care. Home Health Care Services Quarterly, 26(4), 93–104.

Fereday, J., Collins, C., Turnbull, D., Pincombe, J., & Oster, C. (2009). An Evaluation of Midwifery Group Practice. Part II: Women’s Satisfaction. Women & Birth. Journal of the Australian College of Midwives, 22(1), 11-6.

Hatem, M., Sandall, J., Devane, D., Soltani, H., & Gates, S. (2009). Midwife-Led Versus other Models of Care for Childbearing Women Review. Cochrane Library Issue.

Homer, C., Brodie, P., & Leap, N. (2008). Midwifery Continuity of Care: A Practical Guide. Elsevier.

Jane, S. (2013). The Contribution of Continuity of Midwifery Care to High Quality Maternity Care. The Royal College of Midwives.

Leap, N., Sandall, J., Buckland, S., & Huber, U. (2010). Journey to Confidence: Women’s Experiences of Pain in Labour and Relational Continuity. Journal of Midwifery & Women’s Health, 55(3), 234-42.

McLachlan, H. L., et al. (2008). Study Protocol, COSMOS: Comparing Standard Maternity Care with One-to-One Midwifery Support: A Randomized Controlled Trial. BMC Pregnancy and Childbirth, 8(35).

McLachlan, H., Forster, D., Davey, M., Farrell, T., Gold, L., & Biro, M. (2010). Effects of Continuity of Care by a Primary Midwife (Caseload Midwifery) on Caesarean Section Rates in Women of Low Obstetric Risk. The COSMOS Randomized Controlled Trial.

 McLachlan, H., Forster, D., Davey, M., Farrell, T., Gold, L., & Biro, M. (2013). The Effect of Caseload Midwifery on Women’s Experience of Labour and Birth: Results from the COSMOS Randomised Controlled Trial. Australian College of Midwives 18th Biennial Conference. Australian College of Midwives.

New Zealand College of Midwives (NZCM.) (2002). Code of Ethics. NZCM, Christchurch, New Zealand College of Midwives Report.

Nursing and Midwifery Council (NMC). (2010). Supervision, Support and Safety: Analysis of the 2008-2009 Local Supervising Authorities. London, Annual Reports to the Nursing and Midwifery Council.

O’Donnell, C. A., Higgins, M., Chauhan, R., Mullen, K. (2008). Asylum Seekers’ Expectations of and Trust in General Practice. A Qualitative Study, 58(557), e1–e11

Parker, G., Corden, A., & Heaton, J. (2010). Synthesis and Conceptual Analysis of the SDO Programme’s Research on Continuity of Care. London, National Institute for Health Research.

Rona, M. (2010). Midwifery 2020: Delivering Expectations. Department of Health, Social Services and Public Safety.

Ryan, P., Revill, P., Devane, D., & Normand, C. (2013). An Assessment of the Cost-Effectiveness of Midwife-Led Care in the United Kingdom. Midwifery Review, 29(4), 368-76.

Sally, K. T., et al. (2013). Caseload Midwifery Care versus Standard Maternity Care for Women of any Risk. A Randomised Controlled Trial: The Lancet.

Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2013). Midwife-Led Continuity Models versus other Models of Care for Childbearing Women. Cochrane Database of Systematic Reviews 2013.

Saultz, J. W., & Albedaiwi, W. (2004). Interpersonal Continuity of Care and Patient Satisfaction: A Critical Review. Annals of Family Medicine, 2(5).

Schroeder, E., et al. (2010). Cost Effectiveness of Alternative Planned Places of Birth in Woman at Low Risk of Complications: Evidence from the Birthplace. England, National Prospective Cohort Study.

Tracy, S. & Homer, C. (2010). A Randomized Controlled Trial of Caseload Midwifery Care. NHMRC.

Turnbull, D., Baghurst, P., Collins, C., Cornwell, C., Nixon, A. et al. (2009). An Evaluation of Midwifery Group Practice. Part I: Clinical Effectiveness. Women & Birth. Journal of the Australian College of Midwives, 22(1), 3-9.

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