Private midwifery practices will boost the workforce and provide better care

A new study by Charles Darwin University’s (CDU) Molly Wardaguga Research Centre has shown that Australian private midwifery programs have achieved better outcomes for women and their babies compared to the Australian national average. 

Through private midwifery programs, women are allocated a primary midwife who is on call from the initial booking through to six weeks post-partum.

This continuity of care model has proved to be beneficial with women who attended a private midwifery program having less birth complications such as fewer labour inductions, caesarean sections, episiotomies, and more spontaneous vaginal births. 

Multidisciplinary care was evident with discussion, consultation, or referral to other specialists occurring for 58.5 per cent of women at booking and 68.9 per cent at birth. 

CDU’s Molly Wardaguga Research Centre Data and Integrity lead Associate Professor Yu Gao said there are many options for maternity care in Australia. 

“The many options include private midwifery services, though few women can afford this service,” Associate Professor Gao said.

“Until now there has been limited evidence of the outcomes of women receiving private midwifery care in Australia.”

To be better informed, researchers analysed data of more than 2700 women across nine years who received care from My Midwives, the largest provider of private maternity care in Australia.

CDU’s Molly Wardaguga Research Centre Research and Innovation lead Professor Sue Kildea said results showed the positive impacts of the program. 

“The data indicates that the My Midwives program has reduced complications for women compared to the national average. It also indicated that 12.4 per cent of women birthed at home and 14.5 per cent at a birth centre,” Professor Kildea said.

“It also showed positive impacts for collaborating public hospitals who require less intrapartum midwifery staff and receive a net benefit between $1,643 per birth in Queensland to $808 in the Australian Capital Territory, even when bed fees were waived.”

Professor Kildea said these results provide reassurance for women but more importantly, suggest barriers to access need to be removed.

“Only 2.1 percent of women in Australia are accessing private midwifery care,” Professor Kildea said. 

“Waiving bed fees and private adjustment fees for hospitals for women who do not have private health insurance, should be actioned without delay.”

Managing Director of My Midwives Karen Hollindale also stressed the urgency of the recommendations generated by the research. 

“It is clear that full implementation of the Medicare for Midwives review recommendations should be immediate. The positive impact this model has shown not only clinical outcomes but also on financial sustainability demonstrates a more environmentally sustainable approach to healthcare delivery," Ms Hollindale said. 

"Continued removal of barriers for midwives to achieve endorsement would aid the scale up of similar models and provide opportunity to improve reach into our rural and remote areas.”

There is a shortage of midwives right across Australia at the moment, including in remote and very remote areas, the evidence shows rolling out private midwifery programs is a positive financial solution to build this workforce and provide care that is much needed across the country.

The study Clinical outcomes and financial estimates for women attending the largest private midwifery service in Australia compared to national data: a retrospective cohort appeared in Women and Birth Journal.