The true value of midwives

Having a baby is a life changing event in a woman’s life. A supportive midwife can make all the difference, guiding a woman through the ups and downs of pregnancy, birth and the early parenting period. 

Although we know midwives play an important role, how can we measure this unique relationship?

Current research relies on clinical outcomes like maternal and perinatal mortality rates to show the effectiveness of midwife-led care. Now, researchers from the University of Technology Sydney (UTS) and the University of Dundee, Scotland, are digging deeper to evaluate the emotional side of the experience. 

“The slightly softer outcomes regarding how women feel, how they react, and the relational quality are not measured at the moment, at least not very well,” said Dr Andrew Symon from the University of Dundee.  

“There are all sorts of issues out there that we know are important but which are not routinely measured.” 

Dr Symon is collaborating with Dr Allison Cummins from UTS’s Faculty of Health, to develop a new framework to measure the impact of midwife-led models of care. The researchers hope to build a stronger evidence based tool-kit to improve the interactions pregnant women have with midwives and caregivers.

As part of the Key Technology Partnership (KTP) Visiting Fellow Program, Dr Symon travelled to Australia to collaborate face-to-face. Here, the researchers will use the Quality Maternal and Newborn Care (QMNC) model to collect data from on-site evaluations in Western Sydney’s Westmead Hospital and the regional Broken Hill Hospital.

“We’re looking into two very different settings, at quite a big hospital and a much more remote place, to see whether the theory of the research works well in different settings,” said Dr Symon.

“It replicates a little bit of what we did in Scotland a year ago with different models of care.”

The QMNC model is an evidence-based framework that places the needs of women and their newborn infants at its centre. Previously, the framework has been used for theoretical research, so bringing it into the community is an important step towards more tangible outcomes. 

“It’s just been great fun to come out and work with the framework that we are using, expanding the work and making it more widely known. This has been the first time it has been used as a data collection tool. So we are the first, as far as I know, to do that, which is quite exciting,” said Dr Symon.  

While visiting the hospitals, the researchers were able to make other initial observations such as the importance of accessibility. Diverse groups with differing needs, for example Indigenous Australians and non-English speaking women, can face exclusions largely due to accessibility.  

The collaboration has also provided the opportunity for comparison between the healthcare systems of Scotland and Australia. Whilst there are slight variations between the two countries, women share similar needs and desires regardless of the country where they are giving birth. 

 “I think we can safely say that the results show that the relational quality between a pregnant woman and the midwife is really important. This is something which is very difficult to measure, because you don't think of measuring it in quantitative terms, but the trust within that relationship, which goes two ways, is really important,” said Dr Symon.

Under the KTP arrangement, academics from UTS and its partner universities have the opportunity to deepen their research ties through academic exchange, co-publication and the joint supervision of PhD candidates. During his visit to Australia, Dr Symon was able to meet with post-graduate and research students to share his expertise, as well as build valuable contacts leading to a resource rich environment. 

Following the KTP fellowship visit, Dr Symon and Dr Cummins are excited about the opportunity to continue working together and expand their research to cover low-income settings in other countries abroad. 

“The more places we have, the more comparisons we can make and the stronger the evidence base gets,” said Dr Symon.