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Midwives’ views of changing to a Continuity of Midwifery Care (CMC) model in Scotland: a baseline survey

Martin, Colin; Hollins-Martin, Caroline J.; MacArthur, Juliet; Martin, Colin R.; McInnes, Rhona J.

Authors

Colin Martin

Caroline J. Hollins-Martin

Juliet MacArthur

Colin R. Martin

Rhona J. McInnes



Abstract

Background: There is good evidence that Continuity of Midwifery Care (CMC) is associated with improved clinical outcomes, greater maternal satisfaction, and improved work experiences for midwives. Changes made to the organisation require careful implementation, with on-going evaluation to monitor progress.

Aim: To develop a survey tool that incorporates several validated scales, which was used to collect baseline data prior to implementing a high-quality Continuity of Midwifery Care (CMC) model in Scotland.9 This tool gathered data about midwives’ personal and professional wellbeing prior to service reorganisation, with a longitudinal study intended to measure change in midwives’ reportage across time. This paper reports the baseline data-collection.

Methods: An on-line survey was shared with practising midwives (n=321) in Scotland via the NHS intranet, verbally, email, and paper. The survey elicited midwives views about Continuity of Midwifery Care (CMC); values and philosophies of care; attitudes towards their professional role; personal and professional demographics; quality of life and wellbeing. Psychometric attitudinal scales were scored and free text comments themed according to positive/negative opinions of the new Continuity of Midwifery Care (CMC) model to highlight key concerns to be addressed and identify change barriers or facilitators.

Findings: The majority of midwives indicated support for philosophies underpinning Continuity of Midwifery Care (CMC), which includes physiological birth and providing autonomous midwifery care. Participants also indicated positive attitudes towards their current role and organisation, with some worrying about how the organisation was going to implement the changes required. Worries included, receiving an overburdening workload, being deskilled in certain areas of midwifery practice, and lack of support were litigation to arise.

Conclusion: Midwives support the values and philosophies that underpin Continuity of Midwifery Care (CMC), yet worry about organisational change involved in evolving systems of care. Hence, management require to implement strategies to reduce fears. For example, delivering accurate and honest information, enabling midwives to plan, design and implement changes themselves, and providing emotional and material help.

Journal Article Type Article
Journal Women and birth
Print ISSN 1871-5192
Publisher Elsevier
Peer Reviewed Peer Reviewed
APA6 Citation Hollins-Martin, C. J., MacArthur, J., Martin, C. R., & McInnes, R. J. (in press). Midwives’ views of changing to a Continuity of Midwifery Care (CMC) model in Scotland: a baseline survey. Women and Birth, https://doi.org/10.1016/j.wombi.2019.08.005
DOI https://doi.org/10.1016/j.wombi.2019.08.005
Keywords Childbirth; Continuity of midwifery care; Midwife; Midwifery model; Organisational change; Survey
Publisher URL https://www.womenandbirth.org/article/S1871-5192(19)30375-0/fulltext
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