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• W4386444504 abstract "Continuity of midwifery care is imperative to holistic health and wellness outcomes for women, with long-term implications for community health (Renfrew et al., 2014; The First 2000 Days Framework, 2019). However, fear, created through risk-averse dialogues and the increasingly medicalised maternity care paradigm, has the potential to disempower midwifery autonomy if left unchecked (Catling et al., 2020; Jackson et al., 2020). Australian women experience restricted birth location choices, including limited access to publicly funded homebirth models (Coddington et al., 2023). However, women increasingly demand alternative evidence-based care options to avoid the fragmented maternity system. The Central Coast Local Health District (CCLHD) has experienced a significant increase in service demand over the last several years, requiring a review of service delivery and strategic planning. Reviews acknowledged a need for more choices for women in birth location, especially given the closure of Wyong Birthing Services due to Covid- 19. Privately Practising Midwives (PPM) offer the only current alternative to a hospitalised birth. However, the CCLHD has only four PPMs, significantly limiting access to the facilitation of a homebirth option for women. The CCLHD has a well-established midwifery group practice caseload model, providing continuity of midwifery care to women and families over the last 15 years. In wishing to honour the CCLHD's commitment to consumer engagement and satisfaction, a survey was attended, with a resounding request for homebirth by a significant proportion of women. In valuing the consumer's voice, the leadership team employed their united belief in holistic primary maternity care to advocate for women's choice and consumer demand. With this belief, the challenge of implementing a publicly funded homebirth model was undertaken. Transformational leadership continues to drive and empower the implementation of this critical practice change. Key stakeholders were invited to be involved throughout the consultation process, providing valuable input and reflections. Support has been sourced from other Local Health Districts throughout the implementation process, including developing clinical governance documents and mentoring midwives to offer labour, birth, and early postnatal care in the home. Midwives from the pre-existing caseload midwifery model are undertaking the developed accreditation process. They maintain active participation and focus on the opportunity and advocacy of providing homebirth to women and families. Education and training, including skills and drills in the home environment, have been powerful tools in reframing perspectives and facilitating midwifery engagement, demonstrating a clear commitment to the overall vision. Although still a work in progress, critical reflections acknowledge the great value midwives place in being a part of something powerful, inspiring, and uniquely based on the heart of midwifery philosophy. This collaborative engagement continues to fuel the determination of the leadership team, especially when challengers have posed obstacles to the proposed model. Additionally, renewed midwifery autonomy, collective voice, and re-ignited passions have improved midwifery retention rates in our caseload model, with recently piqued curiosity toward recruitment. Lastly, the joy and unique gift derived from standing together and advocating for the power and art of midwifery." @default.
• W4386444504 created "2023-09-06" @default.
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• W4386444504 date "2023-09-01" @default.
• W4386444504 modified "2023-09-27" @default.
• W4386444504 title "Transforming Dreams to Reality: Reflections on Navigating the Maternity System in attempting to Implement a Publicly Funded Homebirth Model" @default.
• W4386444504 doi "https://doi.org/10.1016/j.wombi.2023.07.014" @default.
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