Initiating and Managing Change in the Delivery of Midwifery Care

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AuthorNatalie Zammit
Abstract Expectant mothers are becoming more aware of the type of quality of care they need and expect during pregnancy, delivery and in the puerperium. Clients need and expect a better type of service than the fragmented type of care they have been offered so far. Their need is for a system that would provide them with a continuity of care and carer providers. This continuity of care can be provided in several ways. Team Midwifery is one such system, whereby a small team of midwives provide all the care needed by mothers throughout pregnancy, delivery and the puerperium. The purpose of this study was to evaluate the effectiveness or otherwise of a "Team Midwifery System of Care". In the United Kingdom this type of system has proved very successful and the levels of maternal and midwives' satisfaction were reported to have greatly increased. The aims of the study were to provide a higher level of maternal satisfaction during the three phases of childbirth with possibly a resulting increase in job satisfaction for the midwives. These two aims should have resulted in the provision of a more efficient and dynamic system of care. The study was conducted at Karen Grech Hospital between July 1994 and March 1995. Forty mothers were booked under the Team Midwifery System of Care and their care was provided by a team of six midwives. The team of midwives followed the mothers throughout pregnancy, delivery and in the puerperium. All the mothers and midwives participating in the study were asked to answer a standard set of questions. From the results obtained it was evident that the aims of the study had been met. All forty mothers (100%) said that they were satisfied with the service they were provided with under-this system of care. They themselves suggested that this system should be extended and made known to all women. The team midwives were very enthusiastic about this concept of care and all agreed that every midwife should permanently belong to a team. All the mothers and midwives agreed that a trusting relationship was enhanced between them and therefore satisfaction by both parties had been achieved.

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Key wordsThesis, Health Services Management, Change, Delivery of Midwifery Care

Compiled by: Dr. I. Stabile    Dr. J. Pace