Impact of working in continuity of care models on Australian midwives: A scoping review

Problem

Global and national strategy directives identify continuity of midwifery carer (CoMC) models as important priorities for workforce development. There are concerns about the impacts of working in CoMC on the midwifery workforce in Australia.

Background

CoMC models enable care across the childbearing continuum from a single midwife or small group of midwives known to the pregnant woman, improving perinatal outcomes. Potential impacts on midwives working in these models include work-life balance, retention, professional progression, professional satisfaction, burnout and attrition.

Aim

To review and synthesise research reporting the impact of working in CoMC models on midwives in Australia, and identify knowledge gaps to guide future research.

Methods

This review adopted the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR check list. A search strategy was developed using keywords relating to the midwifery profession, location (Australia) and CoMC models. Four databases were searched, relevant papers were identified, data extracted and synthesised.

Findings

Thirty-two papers met the inclusion criteria for this review. Impacts were identified under the following themes: positive partnerships with women, improved professional satisfaction, work-life balance, impact on professional relationships and positive psychological health and wellbeing.

Discussion

These impacts are mostly positive, with evidence of lower levels of intention to leave the workforce and reduced levels of burnout, compared to those working in shift-based models.

Conclusion

The effect of variations in on-call arrangements were identified as an aspect of work-life balance for future research. Findings are relevant for health service design reform and strategic national workforce planning.