Glossary

Aboriginal or Torres Strait Islander: A person of Aboriginal and/or Torres Strait Islander descent who identifies as an Aboriginal and/or Torres Strait Islander.

antenatal: The period covering conception up to the time of birth. Synonymous with prenatal.

antenatal care: An episode of care between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy. It does not include care where the sole purpose is to confirm the pregnancy. Also known as an antenatal visit.

birth centre: Is commonly known as an alternative setting to the conventional hospital setting for labour and birth. These can either be within a hospital or separate to the hospital i.e. ‘freestanding’. A common feature in a birth centre is a homely space, midwife-led care with a philosophy of normality and avoidance of interventions. Only a small number of maternity services around the country have a birth centre by this definition.

collaborative maternity carer(s): The health professional(s) who collaborate with the designated or lead maternity carer to provide care for women during the antenatal, intrapartum or postnatal stages of maternity care, based on the women's identified needs and individual circumstances. Collaborative carers have a planned role with each woman in the model of care, however may not provide direct clinical care to them.

combined care: A major model category within the MaCCS where antenatal care is provided by a private maternity service provider (doctor and/or midwife) in the community. Intrapartum and early postnatal care is provided in a public hospital, by hospital midwives and doctors. Postnatal care may continue in the home or community by hospital midwives. This model of care usually exists without an established shared care agreement. There is no agreed schedule of visits between the two different providers and the community-based private maternity carer does not provide any care in the hospital.

complex or high risk pregnancy: A target group within the MaCCS. This is selected if the model is provided in a public hospital by multidisciplinary specialists for complex maternal, medical and fetal conditions and limited obstetric conditions. It is not used for conditions that require obstetric input such as high body mass index (BMI), endocrine, or gestational diabetes.

continuity of carer: Continuity of carer means care is provided, or led, over the full length of a maternity period (the antenatal, intrapartum, or postnatal period) by the same named carer. Other caregivers may be involved in the provision of care, either as a backup to the named carer or to collaborate in the provision of care, however the named carer continues to coordinate and provide ongoing care throughout. The MaCCS looks at the extent of continuity of carer across the continuum of maternity care (the antenatal, intrapartum, and postnatal periods) within each model of care. There are 6 categories to describe the extent of continuity of carer within a model ranging from no continuity of carer across any stage of the maternity period to continuity of carer across the whole duration of maternity period—antenatal, intrapartum and postpartum.

designated maternity carer: The health professional who coordinates the care for a woman during the antenatal, intrapartum or postnatal stages of maternity care, based on the woman's identified needs and individual circumstances. May also be known as the maternity care co-ordinator, primary or lead carer or named carer within a model. In some cases, this may not be an individual but a multi-disciplinary team or shared care arrangement. The designated maternity carer may not always be the most senior clinician involved in the care of women in the model. Possible values for this data element include: specialist obstetrician—public; specialist obstetrician—private; general practitioner obstetrician; midwife—public; midwife—private; midwife—privately practising; general practitioner; maternal—fetal medicine subspecialist; aboriginal maternal infant care practitioner; nurse; shared care; multidisciplinary team; and other.

general practitioner obstetrician care: A major model category within the MaCCS in which antenatal care is provided by a GP obstetrician. Intrapartum care is provided in either a private or public hospital by the GP obstetrician in collaboration with the hospital midwives. Postnatal care is usually provided in the hospital by the GP obstetrician and hospital midwives.

group antenatal/postnatal sessions: Some models of care offer antenatal and/or postnatal care in groups sessions such as the centering pregnancy (R) model. Group sessions consist of two or more women and must include both education and clinical care in a group setting. This does not refer to ‘parenting’ classes or ‘antenatal education’ classes.

hospital (excluding birth centre): Is a setting for birth that describes areas used for birthing in a hospital (other than a birth centre). These areas may be known by a variety of names such as birth suite, delivery suite, labour ward, labour and delivery.

intrapartum: Is the period of time from the commencement of labour and including the birth.

major model category: This is the overarching descriptor of a maternity model of care based on its characteristics. It describes the intent of a model of care. Although there is variation between different models of care, each can be grouped into one of 11 broad categories based on their specific characteristics. These 11 categories are: combined care; general practitioner obstetrician care; midwifery group practice caseload care; private midwifery care; private obstetrician and privately practising midwife joint care; private obstetrician (specialist) care; public hospital high risk maternity care; public hospital maternity care; remote area maternity care; shared care; and team midwifery care. 

midwifery caseload: A type of maternity care where women have a primary midwife assigned to them throughout pregnancy, labour and birth and the postnatal period. Each midwife cares for an agreed number (caseload) of women per year. Caseload midwives usually work on a 24-hour on-call basis (this may be organised within a group) and may be employed on an annualised salary. This is also known as a midwifery continuity of carer model of care and may be a private or public arrangement. Midwifery caseload may be managed within a midwifery group practice model where a small number of midwives join together in a group with each midwife having their own caseload and providing backup for the other midwives in the group practice. A key aspect of caseload midwifery practice that differentiates it from team midwifery models is that women have a named midwife, caseload midwives have a self-managed workload that is outside of a traditional roster structure and provides a high level of continuity of carer across the continuum of maternity care.

midwifery group practice caseload care:  A major model category within the MaCCS in which antenatal, intrapartum and postnatal care is provided within a publicly funded caseload model by a known primary midwife with secondary backup 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 the hospital, community or home with intrapartum care in a hospital, birth centre or home. By definition this major model category provides continuity of carer for the whole of duration of the maternity period.

perinatal: Pertaining to, or occurring in, the period shortly before or after birth (usually up to 28 days after).

postnatal: Pertaining to the period immediately after the birth and lasts for 6 weeks. The terms postpartum and postnatal are often used interchangeably (including in this report) however explicitly, ‘postpartum’ refers to the woman and ‘postnatal’ refers to the baby.

postpartum: Pertaining to the period immediately after the birth and lasts for 6 weeks. Postpartum and postnatal are often used interchangeably (including in this report) however explicitly, postpartum’ refers to the woman and ‘postnatal’ refers to the baby.

private midwifery care: A major model category within the MaCCS in which antenatal, intrapartum and postnatal care is provided by a privately practicing 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. This is selected when the designated maternity carer is a privately practicing midwife, even if the care is provided from a private midwifery caseload group practice. It is not selected if the model of care is shared care between a private midwife and a hospital as part of a formal arrangement.

private obstetrician and privately practising midwife joint care: A major model category within the MaCCS in which 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 obstetrician in collaboration with hospital midwifery staff. Postnatal care is usually provided in the hospital and may continue in the home, hotel or hostel by the privately practicing midwife.

private obstetrician (specialist) care: A major model category within the MaCCS in which antenatal care is provided by a private specialist obstetrician. Intrapartum care is provided in either a private or public hospital by the private specialist obstetrician in collaboration with hospital midwives. Postnatal care is usually provided in the hospital by the private specialist obstetrician and hospital midwives and care by midwives may continue in the home, hotel or hostel.

public hospital high risk maternity care: A major model category within the MaCCS in which antenatal care is provided to women with medical high risk/complex pregnancies by public hospital maternity care providers (specialist obstetricians and/or maternal-fetal medicine subspecialists in collaboration with midwives). Intrapartum and postnatal care is provided by hospital doctors and midwives. Postnatal care may continue in the home or community by hospital midwives.

This category is not used for specialised obstetric-led clinics (models of care) such as those specifically for women with diabetes or with obstetric risk factors such as high BMI. Obstetric-led clinics or models requiring obstetric input but not multi-disciplinary medical specialised care are classified as public hospital maternity care.

public hospital maternity care:  A major model category within the MaCCS in which antenatal care is provided in hospital outpatient clinics (either onsite or outreach) by midwives and/or doctors and may include specific clinics, for example diabetes clinics, and Next birth after Caesarean (NBAC) clinics. Care could also be provided by a multidisciplinary team. Intrapartum and postnatal care is provided in the hospital by the midwives and in collaboration with doctors as required. Postnatal care may continue in the home or community by hospital midwives.

remote area maternity care: A major model category within the MaCCS in which 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 (often involving temporary relocation prior to labour) by hospital midwives and doctors.

routine relocation: This is where the intention of the model of care is that all women cared for in the model require relocation from their communities to another location prior to labour for intrapartum care and birth. Routine relocation often applies to models where women reside in a rural or remote community where there is no access to an appropriate birth facility and are routinely relocated to a larger town or city some weeks prior to birth. This is not used if the model only requires the transfer of some women with increased risk factors due to complexities of pregnancy.  

shared care: A major model category within the MaCCS in which antenatal care is provided by a community maternity service provider (doctor and/or midwife) in collaboration with a hospital medical and/or midwifery staff under an established agreement, and can occur both in the community and in hospital outpatient clinics. This would usually include an agreed schedule of antenatal care between the two providers. Intrapartum and early postnatal care usually takes place in the hospital, by hospital midwives and doctors, often in conjunction with the community doctor or midwife (particularly in rural settings).

target group: Some models of care are targeted at specific groups of women with similar characteristics. These may be based on geographical area, risk status, obstetric or medical condition or social/cultural characteristics. Having a target group does not necessarily mean the model is restricted to only those women (although the model is specifically targeted at them) and other women may also access the model of care. Some models are targeted at more than one group of women so multiple values for this data element may be selected. In the MaCCS the possible values for this data element include: Aboriginal or Torres Strait Islander identification; migrant or refugee; low risk or normal pregnancy; complex or high risk pregnancy; breech presentation of fetus; multi fetal pregnancy; next birth after caesarean section; planned homebirth; maternal diabetes and other endocrine disorders; maternal obesity or high body mass index; maternal drug or alcohol use; maternal age—young; maternal mental health condition; maternal remote area of residence; other specific cultural groups not already specified; other social groups not already specified; other vulnerable groups not already specified; other maternity target group.

team midwifery care: A major model category within the MaCCS in which 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 the hospital or birth centre. Postnatal care may continue in the home or community by the team midwives. By definition, no continuity of carer during any period exists within this category.