Sustainable midwifery : Supporting improved wellbeing and greater equity

NZIER report to New Zealand College of Midwives.

Caseload midwifery is community-based and at the front line of perinatal public health interventions and outcomes. NZIER was commissioned to investigate the contribution of midwifery to improving health outcomes.

Pay and conditions were not the main focus of the project, but this emerged as an underlying factor in the sustainability of improving perinatal health outcomes. The workforce faces challenges from increasing medical and social complexities, which are demanding more time per pregnancy than is allowed under section 88 of the New Zealand Public Health and Disability Act 2000.

Studies have shown that, for low-risk pregnancies, midwifery can reduce the risk of interventions such as caesarean section, contributing to better health outcomes and health system savings. Adequate training, resources and integration are critical in achieving those outcomes.

NZIER finds that improved well-being and equity for mothers and babies depends on addressing the 3Cs faced by community midwives - complexity, caseloads and conditions.