We consider the most appropriate way to consider basic maternity service provision is from the woman, up – rather than from the service, down. This leads to woman-centred care, which is theoretically a goal of maternity service provision.
Maternity care models that centre on the mother-baby dyad acknowledge the fundamental facts of modern maternity care, including:
• Birth is not an illness
• The midwife is the only primary carer who is equipped to attend women throughout their maternity care
• Each woman/baby requires a specific, time limited episode of care
• Mothers or babies who experience complications or illness require specific services that are appropriate for the condition
Current Australian maternity services are frequently unable to apply evidence based best practice options broadly, because funding for maternity care, whether in the public or private sector, dictates models that are service-centric and provider-centred rather than woman-centred.
We believe it is unhelpful to consider basic maternity service from a ‘rural and remote’ versus ‘urban’ framework. The woman (mother-baby dyad) is the unit, and basic maternity care needs for well women are the same regardless of location or other epidemiological factors.
We therefore recommend to the Review that all basic maternity service issues be applied to the woman, rather than to the service provider.
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