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Table 2 The major Model Categories from the Maternity Care Classification System [1]. Source: University of New South Wales and Australian Institute of Health and Welfare

From: A review of the impact of financing mechanisms on maternal health care in Australia

Model of care

Characteristics

 Private obstetrician (specialist) care

Antenatal care provided by a private specialist obstetrician. Intrapartum care is provided in either a private or public hospital by the private specialist obstetrician and hospital midwives in collaboration. Postnatal care is usually provided in the hospital by the private specialist obstetrician and hospital midwives and may continue in the home, hotel or hostel.

 Private midwifery care

Antenatal, intrapartum and postnatal care is provided by a private midwife or group of midwives in collaboration with doctors in the event of identified risk factors. Antenatal, intrapartum and postnatal care could be provided in a range of locations including the home.

 General Practitioner obstetrician care

Antenatal care provided by a GP obstetrician. Intrapartum care is provided in either a private or public hospital by the GP obstetrician and hospital midwives in collaboration. Postnatal care is usually provided in the hospital by the GP obstetrician and hospital midwives and may continue in the home or community.

 Public hospital maternity care

Antenatal care is provided in hospital outpatient clinics (either onsite or outreach) by midwives and/or doctors. Care could also be provided by a multidisciplinary team. Intrapartum and postnatal care is provided in the hospital by midwives and doctors in collaboration. Postnatal care may continue in the home or community by hospital midwives.

 Public hospital high-risk maternity

Antenatal care is provided to women with medical high risk/complex pregnancies by maternity care providers (specialist obstetricians and/or maternal-fetal medicine subspecialists in collaboration with midwives) with an interest in high-risk maternity care in a public hospital. Intrapartum and postnatal care is provided by hospital doctors and midwives. Postnatal care may continue in the home or community by hospital midwives.

 Shared care

Antenatal care is provided by a community maternity service provider (doctor and/or midwife) in collaboration with public hospital doctors and midwives under an established agreement and can occur both in the community and in hospital outpatient clinics. Intrapartum and early postnatal care usually takes place in a public hospital by hospital midwives and doctors often in conjunction with the community doctor or midwife (particularly in rural settings).

 Combined care

Antenatal care is provided by a community maternity service provider (doctor and/or midwife) in the community. Intrapartum and early postnatal care is provided in the public hospital by hospital midwives and doctors.

 Team midwifery care

Antenatal, intrapartum and postnatal care is provided by a small team of rostered midwives (no more than eight) in collaboration with doctors in the event of identified risk factors. Intrapartum care is usually provided

in a public hospital or birth centre. Postnatal care may continue in the home or community by the team midwives.

 Midwifery Group Practice caseload care

Antenatal, intrapartum and postnatal care is provided within a publicly-funded caseload model by a known primary midwife with secondary backup midwife/midwives providing cover and assistance with collaboration with doctors in the event of identified risk factors. Antenatal care and postnatal care is usually provided in a public hospital, community or home with intrapartum care in a hospital, birth centre or home.

 Remote area maternity care

Antenatal and postnatal care is provided in remote communities by a remote area midwife (or a remote area nurse) or group of midwives sometimes in collaboration with a remote area nurse and/or doctor. Antenatal care may also be provided via telehealth or fly-in-fly-out clinicians in an outreach setting. Intrapartum and early postnatal care is provided in a regional or metropolitan hospital (involving temporary relocation prior to labour) by hospital midwives and doctors.

 Private obstetrician and privately practising midwife joint care

Antenatal, intrapartum and postnatal care is provided by a privately practising obstetrician and midwife from the same collaborative private practice. Intrapartum care is usually provided in either a private or public

hospital by the privately practising midwife and/or private specialist obstetrician in collaboration with hospital midwifery staff. Postnatal care is usually provided in the hospital and may continue on in the home,

hotel or hostel by the privately practising midwife.

  1. ‘Doctors’ include specialist obstetricians, GP obstetricians and obstetricians in training