A Model of Midwifery Care as an Integral Component of a Multidisciplnary Primary Health Care Service

This research describes the model of midwifery care embedded in Newtown Union Health Service (NUHS). This model of care is different from the way most midwifery services in New Zealand are organised. The main New Zealand midwifery services are provided by self-employed midwives and hospital midwives. NUHS was set up to provide accessible health services to a low income population. Pivotal to the service is the employment of a multidisciplinary team which aims to meet most of the health needs of its registered population. As the NUHS midwifery service was set within the larger organisation the case study research method was chosen as it is a method which stresses the importance of understanding the context of a case. It permits the use of several sets of data to capture the complexity of a case. Data collection included interviews with five midwives and seven multidisciplinary team members including managers working at NUHS. An unsuccessful attempt was made to gain access to and interview pregnant women who had used this service. Other data came from several documents about the Newtown community and the service. Data analysis revealed that the NUHS model of midwifery care was made up of five interrelated and interacting components: the community, NUHS, the midwives as integral to the multidisciplinary team, the midwives and the women in the care of the midwives. A discussion of the model includes what was extrapolated as three distinctive features of the model: their philosophy, the union influence and the midwives in the multi disciplinary team. The NUHS model of midwifery care is then related to other national and international models where its distinctiveness is supported.